Cardiometabolic Chronicle

Nutrition for Cardiometabolic Health: Cutting Through the Noise

Despite a wide variety of dietary options available, a prolonged controversy still exists about optimal nutritional plans for cardiometabolic patients, which contributes to the challenges faced by clinicians while caring for these patients. A poor diet is a major contributor in exacerbating the impacts of the cardiometabolic disease; as well as a leading contributor to morbidity and mortality worldwide.1,2 Thus, proper nutrition for cardiometabolic health is paramount, a view emphasized in several clinical practice guidelines.3-5 However, defining proper nutrition for cardiometabolic disease is challenging and can be very controversial. Clinicians may not be aware of appropriate healthy eating patterns or the evidence for different dietary approaches on cardiometabolic health outcomes; this is more apparent by the fact that many clinicians do not receive adequate training on nutrition and are less likely to address nutrition as a topic during a clinical visit. To gain more insight in this area, we had an opportunity to talk with Stephen Devries, MD, FACC, a preventive cardiologist, and Executive Director of the Gaples Institute for Integrative Cardiology, a nonprofit dedicated to advancing the role of nutrition and lifestyle in medicine.

Because of all the diet and nutrition advice available, most people are puzzled with the concept of “the ideal diet.” Recently, the EAT-Lancet commission report, a largescale nutrition initiative by The Lancet, emphasized the consumption of plant-based diets over meat-based diets6, an approach that also is supported in the diabetes, hypertension, cholesterol, and primary cardiovascular disease (CVD) prevention guidelines.4,5,7,8 Dr. Devries echoed this approach: “the diet that would be most helpful for the vast majority of people would be one that is predominantly plant-sourced, a diet rich in vegetables, fruit, beans, whole grains. Although frequently overlooked, it’s best that these items be consumed in as close to their original state as possible–not ground into flour or extracted into juice.” – he told Cardiometabolic Chronicle.

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REFERENCES:

References:

  1. Devries, Stephen, et al. “A deficiency of nutrition education and practice in cardiology.” The American Journal of Medicine 130.11 (2017): 1298- 1305.
  2. Forouhi, Nita G., et al. “Dietary and nutritional approaches for prevention and management of type 2 diabetes.” BMJ 361 (2018): k2234.
  3. American Diabetes Association. “5. Lifestyle Management: Standards of Medical Care in Diabetes— 2019.” Diabetes Care 42.Supplement 1 (2019): S46-S60.
  4. Flack, John M., David Calhoun, and Ernesto L. Schiffrin. “The New ACC/AHA Hypertension Guidelines for the prevention, detection, evaluation, and management of high blood pressure in adults.” American Journal of Hypertension 31.2 (2018): 133-135.
  5. Grundy, Scott M., et al. “2018 AHA/ACC/AACVPR/ AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/ PCNA guideline on the management of blood cholesterol: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines.” Journal of the American College of Cardiology (2018): 25709.
  6. Willett, Walter, et al. “Food in the Anthropocene: the EAT–Lancet Commission on healthy diets from sustainable food systems.” The Lancet 393.10170 (2019): 447-492.
  7. Arnett, Donna K., et al. “2019 ACC/AHA guideline on the primary prevention of cardiovascular disease.” Journal of the American College of Cardiology (2019): 26029.
  8. Evert, Alison B., et al. “Nutrition therapy for adults with diabetes or prediabetes: a consensus report.” Diabetes Care 42.5 (2019): 731-754.
  9. American Cancer Society. “World Health Organization says processed meat causes cancer.” Available at https://www.cancer.org/ latest-news/world-health-organization-says-processed- meat-causes-cancer.html, accessed July 30, 2019.
  10. Mozaffarian, Dariush. “Dietary and policy priorities for cardiovascular disease, diabetes, and obesity: a comprehensive review.” Circulation 133.2 (2016): 187-225.
  11. Kahan, Scott, and JoAnn E. Manson. “Nutrition counseling in clinical practice: how clinicians can do better.” JAMA 318.12 (2017): 1101-1102.
  12. Adams, Kelly M., Martin Kohlmeier, and Steven H. Zeisel. “Nutrition education in US medical schools: latest update of a national survey.” Journal of the Association of American Medical Colleges 85.9 (2010): 1537 - 1542.
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