Submitted by John Reed, MD, Augusta Health Primary Care
Most physicians know that changes in lifestyle can provide benefits to patients. What they don’t know is just how drastic those benefits can be and how bad a typical American lifestyle is for your health. In the 1940s, before most blood pressure medicine was available, Dr. Walter Kempner prescribed a rice and fruit diet for patients with malignant hypertension with very impressive results (9, 4). With only diet changes he was able to reverse 70% of malignant hypertension patients (up to 240/150) and bring BPs down to healthy levels (9). With the other tools available to lifestyle medicine, it is not uncommon to take patients who are 100 lbs overweight with diabetes, heart failure, hypertension and hyperlipidemia and on 3 or more medications and cure them of their chronic diseases, get them off all their medications and help them lose 100 lbs in a year (6). It really should be standard of practice to write a lifestyle change prescription for our patients with chronic disease. Click here for a printer-friendly lifestyle prescription you can give to your patients.
You may not know it but in many cultures around the world heart disease is virtually nonexistent (1, 4), especially in areas where populations have little or no access to processed foods, meats, dairy or eggs and where they live an active outdoor lifestyle without tobacco use. With that in mind, why is lifestyle change not promoted more strongly in the United States since heart disease is the #1 killer (2)? The answer is simple, most physicians are not properly educated in how to direct and encourage patients to change their lifestyle. In the end, there are 3 simple steps you can take (not easy, but they are simple) to improve your heart health.
- Quit smoking or other drug abuse (3)
- Exercise routinely (5)
- Improve your diet (3).
Most people know that if you quit smoking your risk of cancer declines drastically. The same is true of death related to heart disease (3). Ask your primary doctor for help in this area.
Exercise is known to reduce cardiac death risk and risk of heart disease in general (5). But what is exercise? It does not have to mean going to the gym or jogging but it does have to mean raising the heart rate and getting a little out of breath. Strolling does not count. Walking rapidly in hilly terrain that leads to an elevated heart rate (>110 beats per minute) and difficulty chatting with your walking partner definitely does. Similarly, good tried and true exercises at home like jumping jacks, push ups, sit ups and pull ups are terrific and convenient ways to improve heart health. Overall the goal is simple, exert yourself to the point of a heart rate greater than 110 and some mildly labored breathing at least 150 minutes weekly. If you are in better shape and can do vigorous exercise like all out sprinting or fast swimming for brief intervals (at least 15-30 seconds) with 60-90 seconds rest in between (interval training) then 75 minutes weekly is just as good for the heart (5). Remember to consult your physician before embarking on any exercise routine.
Some of the diet changes that impact heart health are well known, but others are not. Most of us know that you need to avoid processed fast foods, fried foods and junk foods, especially those with trans fats, saturated fats and cholesterol (4, 7). Two things patients often do not realize is how pervasive processed foods are (virtually every packaged food in the grocery store and most restaurant foods are processed) and how harmful to your heart meats of all kinds (including poultry and possibly fish), dairy and eggs are. Studies by Dr. Esselstyn, a cardiothoracic surgeon with the Cleveland Clinic, clearly showed that plaque in the coronary arteries leading to stenosis (clogging) and eventual heart attacks could be reversed with a whole foods, plant based vegan diet (8). No other therapy has been shown to accomplish this. Even if you cannot bear to give up your meat, cheese, milk or eggs, cutting way down on consumption of these foods helps immensely with control of heart disease (3, 4, 6). Many patients ask me after hearing all the foods they need to avoid, “well, what can I eat?” Try to eat 10 servings of fruits and vegetables daily and healthy portions of beans, whole grains and a small amount of nuts and seeds daily. Take the above advice and you have the recipe for long life and a healthy heart.
- Berzlanovich AM, Keil W, Waldhoer T, Sim E, Fasching P, Fazeny-Dorner B. Do centenarians die healthy? An autopsy study. J Gerontol A Biol Sci Med Sci. 2005; 60(7): 862-865.
- American Heart Association. “Heart Disease and Stroke Statistics – 2003 Update.” Dallas: American Heart Association, 2002.
- Campbell TC, Campbell TM. The China Study. BenBella Books, Inc.; Dallas, TX 2016.
- Greger M, Stone G. How Not to Die. Flatiron Books, NY, NY 2015. – See also the author’s excellent web site https://nutritionfacts.org.
- American Heart Association. AHA Recommendations for Physical Activity in Adults. http://www.heart.org/HEARTORG/HealthyLiving/PhysicalActivity/FitnessBasics/American-Heart-Association-Recommendations-for-Physical-Activity-in-Adults_UCM_307976_Article.jsp#.WnoKoWnwaM8, 2014.
- Fuhrman J, The End of Heart Disease. Harper One, NY, NY 2016.
- Trumbo PR, Shimakawa T. Tolerable upper intake levels for trans fat, saturated fat, and cholesterol. Nutr Rev. 2011; 69(5): 270-8.
- Esselstyn CB. Is the present therapy for coronary artery disease the radical mastectomy of the 21st century? Am J Cardiol. 2010; 106(6): 902-904.
- Kempner W. Treatment of heart and kidney disease and of hypertensive and arteriosclerotic vascular disease with a rice diet. Ann Intern Med. 1949; 31(5): 821-56.