February is Heart Month! Although there has been significant efforts to educate the U.S public on the causes of heart disease, 1 in 4 deaths each year is due to heart disease. However, heart disease can be prevented with healthy behaviors and diet.
Knowing the risks for developing heart disease:
• There are several risk factors responsible for the high rates of heart disease in the United states. Some can be controlled, and some are simply genetic
• According to the CDC, about half of all Americans have at least one of the following 3 key controllable risk factors: high blood pressure, high cholesterol, and smoking
• High blood pressure: called the “silent killer” due to the fact that patients usually do not experience symptoms. Most patients are generally unaware of their blood pressure until they go to see a medical professional and have it checked. High blood pressure occurs when the force of blood pushing against the walls of the arteries is higher than normal. When left untreated, this can then lead to atherosclerosis (hardening of the arteries) and cause damage to the major organs.
• High cholesterol: happens when we intake more cholesterol through our diet than the body can use and it starts to build up in the walls of our arteries. This then causes narrowing of the arteries and restricts the blood flow to the heart and other major organs. Again, it is usually asymptomatic and only detected through a lipid profile blood test.
• Smoking: causes irreparable damage to the heart and blood vessels, which can then lead to atherosclerosis and heart attacks. Nicotine also leads to elevated blood pressure, and carbon monoxide from the cigarette smoke reduces the amount of oxygen your blood is able to carry.
• These are 3 key risk factors associated with heart disease. It is important to keep in mind that these factors can be symptoms of many other underlying chronic diseases. And the treatment may require an interdisciplinary approach in order to treat our patients with best practice and maintain our scope of practice.
• NCHS data brief on Prevalence of Uncontrolled Risk Factors for Cardiovascular Disease: United States, 1999–2010 https://www.cdc.gov/nchs/data/databriefs/db103.pdf
• Heart disease risk calculator: https://ccccalculator.ccctracker.com
• CDC article on high blood pressure and cholesterol rates in the US https://www.cdc.gov/vitalsigns/cardiovasculardisease/index.html
• Study on the nutritional recommendations for cardiovascular disease prevention https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3798927/
• Working with a dietitian or nutrition expert to establish how many calories an individual needs per day is the first step to preventing excess calorie consumption
• The next is to help an individual identify foods that can offer optimal nutrients to control weight, blood pressure and cholesterol levels
• It may be beneficial to start by identifying foods with optimal nutrients, and helping patients to discover new ways to incorporate nutrient dense foods into their diet rather than making a list of foods for patients to avoid or cut out.
• A diet rich in fruits & vegetables, whole grains, low fat dairy, skinless poultry and fish, nuts & legumes, and non-tropical vegetable oils is ideal to offer optimal health benefits
• Both the DASH diet (dietary approaches to stop hypertension) and the Mediterranean diet are two dietary patterns that are easily adaptable to different calorie needs and cultural preferences while offering cardiovascular benefits
• Help patients make healthy swaps for the things they are currently eating: help them to ease into eating more vegetables by finding low calorie/low fat sauces to add, switch from 2% or whole milk to 1% or skim, swap out one red meat item for a fish item per week. It may also help to swap out some processed items for a simple homemade recipe to increase the health benefits
• Be aware of sodium: The American Heart Association recommends 1500mg per day, while the average American consumes 3400mg in a day. Research has shown that sodium is linked to increased risk of heart failure, stroke, kidney disease, and high blood pressure.
- Help patients to understand food labels to assist with limiting sodium intake. Encourage them to compare labels and find the option with the lowest amount. As a general rule, 5% DV of sodium or less is considered low, and 20% or more is considered high.
CVD Prevention Strategies:
- Regular Health Screenings: It is important to regularly visit a physician in order to monitor blood pressure and cholesterol levels. Getting regular physicals can help to catch early signs of high blood pressure or cholesterol, and then start the appropriate strategies to control these lifestyle risk factors. If caught early enough, these risk factors may be controlled through diet and exercise without any pharmacological intervention.
- Exercise: Set a goal for 30-60 minutes of activity per day. Exercise is a good way to control your weight and prevent risk factors such as high blood pressure and high cholesterol. Aerobic or “cardio” exercise is especially beneficial as it elevates your heart rate, and when practiced overtime improves your circulation and cardiac output (how well your heart pumps).
- Maintain a healthy weight: Working with a dietitian to develop a dietary plan and an exercise regimen are two major steps to work towards reaching and maintaining a healthy weight. Excess body fat, especially around the abdomen increases the risk for heart disease. Reaching a healthy weight is also ideal for lowering blood pressure and cholesterol levels. Eating a healthy diet and incorporating strength training are the key to reducing body fat and building lean muscle.
- Eat a heart healthy diet: Work with your doctor or dietitian to find out what dietary approach works best for you. A dietitian can work with you to adapt any dietary pattern and help to make it more heart healthy. Ask your dietitian about the DASH diet or the mediterranean diet, as they have both been thoroughly researched and shown to offer a multitude of heart benefits.
- Stress management: People can deal with stress in many different ways. Overeating, smoking, and drinking are all coping techniques with harmful health effects. In addition to coping mechanisms, high levels of the stress hormone, cortisol, can lead to high blood pressure, high cholesterol and the buildup of plaque in the arteries. It is beneficial for cardiac health to find alternative coping mechanisms. Using exercise, meditation, or channeling the energy into a new hobby such as cooking are all better ways to deal with stress and they also offer cardiac benefits.