CARDIOMETABOLIC CHRONICLE: To what extent are lifestyle factors, like physical activity and nutrition, addressed during a routine visit?
DR. CARBONE: Frequently, clinical providers, including primary care physicians, cardiologists, endocrinologists, physician assistants, nurse practitioners and pharmacists tend to dedicate very little time to addressing lifestyle factors. But with a myriad of issues to think about, including optimizing medications, addressing patient compliance, potential recent admissions, and more, clinicians are extremely busy and simply do not have time. It is for this reason that the 2019 ACC/ AHA guidelines for primary CVD prevention16 encourage referrals of patients to clinicians and professionals that specialize in lifestyle medicine and can adequately address nutrition and physical activity, such as dietitians, whose role to improve cardiovascular health is too often underestimated. I still think, however, that in absence of a nutrition expert, providers can do a better job in doing a brief lifestyle assessment, for instance, asking some crucial questions about daily physical activity or diet, which could make a difference in our patients’ health. Definitely, increasing the number of hours dedicated to nutrition during medical school would help achieving such goal.