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A Clinician's Guide to Healthy Eating for Cardiovascular Disease Prevention.

Abstract

Despite continued advances in health care, the cardiovascular disease (CVD) mortality rate has plateaued in recent years and appears to be trending upward. Poor diet is a leading cause of obesity and type 2 diabetes mellitus, which are leading contributors to CVD morbidity and mortality. Although dietary modification is a cornerstone of CVD prevention, implementation in clinical practice is limited by inadequate formal training in nutrition science. In this report, we review the individual components of a heart-healthy diet, evidence-based dietary recommendations, and the impact of diet on CVD risk factor prevention and management. Furthermore, we examine the unique difficulties of dietary counseling in low-socioeconomic-status environments and provide an evidence-based approach to better serve these populations. We utilized PubMed searches in adults with no date restriction with the following search terms: "carbohydrate," "fat," protein," "DASH," "Mediterranean," "plant-based," "vegetarian," "cardiovascular disease," "obesity," "weight loss," "diabetes," "socioeconomic status," and "race." In this review, we demonstrate that patients should focus on implementing a general diet plan that is high in fruits, whole grains, legumes, and nonstarchy vegetables while low in trans-fats, saturated fats, sodium, red meat, refined carbohydrates, and sugar-sweetened beverages. The Dietary Approaches to Stop Hypertension, Mediterranean, and vegetarian diets have the most evidence for CVD prevention. Clinicians should understand the barriers that patients may face in terms of access to healthy dietary choices. Further research is needed to determine the dietary changes that are most economically, socioculturally, and logistically feasible to reduce these barriers. Improvement in diet is a public health priority that can lead to a significant population-level reduction in CVD morbidity and mortality. It is imperative that clinicians understand current dietary practice guidelines and implement evidence-based dietary counseling in those at high risk for CVD.

Authors+Show Affiliations

Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD.Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD.Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD.Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD.Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD.Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD.Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD. Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD.Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD.Department of Epidemiology, School of Public Health, University of Alabama at Birmingham.Cardiology Division, Feinberg School of Medicine, Northwestern University, Chicago, IL.Cardiology Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

31485563

Citation

Pallazola, Vincent A., et al. "A Clinician's Guide to Healthy Eating for Cardiovascular Disease Prevention." Mayo Clinic Proceedings. Innovations, Quality & Outcomes, vol. 3, no. 3, 2019, pp. 251-267.
Pallazola VA, Davis DM, Whelton SP, et al. A Clinician's Guide to Healthy Eating for Cardiovascular Disease Prevention. Mayo Clin Proc Innov Qual Outcomes. 2019;3(3):251-267.
Pallazola, V. A., Davis, D. M., Whelton, S. P., Cardoso, R., Latina, J. M., Michos, E. D., ... Welty, F. K. (2019). A Clinician's Guide to Healthy Eating for Cardiovascular Disease Prevention. Mayo Clinic Proceedings. Innovations, Quality & Outcomes, 3(3), pp. 251-267. doi:10.1016/j.mayocpiqo.2019.05.001.
Pallazola VA, et al. A Clinician's Guide to Healthy Eating for Cardiovascular Disease Prevention. Mayo Clin Proc Innov Qual Outcomes. 2019;3(3):251-267. PubMed PMID: 31485563.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Clinician's Guide to Healthy Eating for Cardiovascular Disease Prevention. AU - Pallazola,Vincent A, AU - Davis,Dorothy M, AU - Whelton,Seamus P, AU - Cardoso,Rhanderson, AU - Latina,Jacqueline M, AU - Michos,Erin D, AU - Sarkar,Sudipa, AU - Blumenthal,Roger S, AU - Arnett,Donna K, AU - Stone,Neil J, AU - Welty,Francine K, Y1 - 2019/08/01/ PY - 2019/04/26/received PY - 2019/05/14/revised PY - 2019/05/17/accepted PY - 2019/9/6/entrez PY - 2019/9/6/pubmed PY - 2019/9/6/medline KW - ACC, American College of Cardiology KW - AHA, American Heart Association KW - CHD, coronary heart disease KW - CVD, cardiovascular disease KW - DASH, Dietary Approaches to Stop Hypertension KW - HDL-C, high-density lipoprotein cholesterol KW - LCHF, low-carbohydrate high-protein/fat KW - LDL-C, low-density lipoprotein cholesterol KW - MI, myocardial infarction KW - PURE, Prospective Urban Rural Epidemiology KW - RCT, randomized control trial KW - SBP, systolic blood pressure KW - SES, socioeconomic status KW - SSB, sugar-sweetened beverage KW - USDA, US Department of Agriculture SP - 251 EP - 267 JF - Mayo Clinic proceedings. Innovations, quality & outcomes JO - Mayo Clin Proc Innov Qual Outcomes VL - 3 IS - 3 N2 - Despite continued advances in health care, the cardiovascular disease (CVD) mortality rate has plateaued in recent years and appears to be trending upward. Poor diet is a leading cause of obesity and type 2 diabetes mellitus, which are leading contributors to CVD morbidity and mortality. Although dietary modification is a cornerstone of CVD prevention, implementation in clinical practice is limited by inadequate formal training in nutrition science. In this report, we review the individual components of a heart-healthy diet, evidence-based dietary recommendations, and the impact of diet on CVD risk factor prevention and management. Furthermore, we examine the unique difficulties of dietary counseling in low-socioeconomic-status environments and provide an evidence-based approach to better serve these populations. We utilized PubMed searches in adults with no date restriction with the following search terms: "carbohydrate," "fat," protein," "DASH," "Mediterranean," "plant-based," "vegetarian," "cardiovascular disease," "obesity," "weight loss," "diabetes," "socioeconomic status," and "race." In this review, we demonstrate that patients should focus on implementing a general diet plan that is high in fruits, whole grains, legumes, and nonstarchy vegetables while low in trans-fats, saturated fats, sodium, red meat, refined carbohydrates, and sugar-sweetened beverages. The Dietary Approaches to Stop Hypertension, Mediterranean, and vegetarian diets have the most evidence for CVD prevention. Clinicians should understand the barriers that patients may face in terms of access to healthy dietary choices. Further research is needed to determine the dietary changes that are most economically, socioculturally, and logistically feasible to reduce these barriers. Improvement in diet is a public health priority that can lead to a significant population-level reduction in CVD morbidity and mortality. It is imperative that clinicians understand current dietary practice guidelines and implement evidence-based dietary counseling in those at high risk for CVD. SN - 2542-4548 UR - https://www.unboundmedicine.com/medline/citation/31485563/A_Clinician's_Guide_to_Healthy_Eating_for_Cardiovascular_Disease_Prevention L2 - https://linkinghub.elsevier.com/retrieve/pii/S2542-4548(19)30072-4 DB - PRIME DP - Unbound Medicine ER -