In many countries, mortality due to atherosclerosis has been decreasing over the decades.1 Yet atherosclerosis still correlates with very high health risks, including ischemic stroke, and modifiable lifestyle factors play a huge role.2-3 In the video below, Elizabeth Boham, MD, MS, RD, IFMCP, describes her first steps in working with patients to decrease their cardiometabolic health risks when atherosclerosis is present.
When a patient comes to see me with atherosclerosis, I always focus on those personalized lifestyle factors first and foremost. They form the foundation of the matrix, and they form the foundation of your health. We know so much about how those personalized lifestyle factors can really stabilize plaque and decrease inflammation in the body, and that’s so important for prevention of a heart attack.
So the first thing I focus on is the diet.
Always focus on the diet first.
And I often recommend the cardiometabolic diet. The cardiometabolic diet is a really low glycemic impact diet. It’s low glycemic load, so it’s not going to spike blood sugar or insulin after a meal. It’s really high in phytonutrients—all of your fruits and vegetables and color to help with lowering inflammation as well and high in omega–3 fats.
The second thing we focus on is exercise. Movement and exercise are critical for improving insulin sensitivity, decreasing metabolic syndrome, decreasing inflammation in the body, and improvement of heart health.
And the third thing we always focus on is sleep. That’s the place I always go to. I look to determine, is the person getting adequate sleep? Are they getting enough hours of sleep? And is there any sign of sleep apnea? If there’s any signs of sleep apnea, we need to test for sleep apnea and treat it because we know sleep apnea causes an increase in inflammation in the body, it increases tumor necrosis factor, and that inflammation is such a concern in terms of heart disease.
So I always start with those lifestyle factors first.
- Herrington W, Lacey B, Sherliker P, Armitage J, Lewington S. Epidemiology of atherosclerosis and the potential to reduce the global burden of atherothrombotic disease. Circ Res. 2016;118(4):535-546. doi:10.1161/CIRCRESAHA.115.307611
- Torres N, Guevara-Cruz M, Velázquez-Villegas LA, Tovar AR. Nutrition and atherosclerosis. Arch Med Res. 2015;46(5):408-426. doi:10.1016/j.arcmed.2015.05.010
- Nahrendorf M, Swirski FK. Lifestyle effects on hematopoiesis and atherosclerosis.?Circ Res. 2015;116(5):884–894. doi:10.1161/CIRCRESAHA.116.303550
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Assessing cardiometabolic risks has evolved over time. Simultaneously, primary care is still the proposed central hub for evaluating cardiometabolic risks and intervening.1-3 In the video below, Shilpa P. Saxena, MD, IFMCP, an IFM educator, explains the shift in her thinking for addressing cardiometabolic risk in her patients since medical school.Read More
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