Diet Underappreciated in Reducing CVD Risk

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Diet Underappreciated in Reducing CVD Risk

pmk3's blog / Exercise and Nutrition / Diet Underappreciated in Reducing CVD Risk

Diet Underappreciated in Reducing CVD Risk

Nov 30, 2010

6 comments Exercise and Nutrition

Exercise and Nutrition

At the Lewis A. Conner Memorial Lecture presented at the AHA Scientific Sessions 2010, Dr. Larry Appel, Director of the Welch Center for Prevention, Epidemiology and Clinical Research at Johns Hopkins Medical Institutions, called on all clinicians to provide simple advice to their patients. The message - eat less, eat right and move more. In 2005, 1.1 million preventable deaths could be attributed to diet-related factors. Most Americans (about 99%) fall short (and way short) of meeting current dietary recommendations. Dr. Appel served on the AHA 2020 Goals for Reducing Heart Disease Risk by 20% in the next decade. Simple strategies for implementing these goals can be found at Life's Simple 7 at AHA.

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Comments

By bedwards1951 507 Days Ago

What is the level of the evidence for this?
I am reading Good Calories Bad Calories and the author states that negative trials are often ignored.
In Lipid spin, Dr. Kris-Etherton stated there were six meta-analysis studies that support lowering saturated fats.
Could you tell us what you think is the best evidence based trial for a diet?
Thanks
By bedwards1951 507 Days Ago

Life's Simple 7: reduce cholesterol

"LDL cholesterol is produced naturally by the body, but many people inherit genes that cause them to make too much. Eating saturated fat, trans fats and dietary cholesterol also increases how much you have."

What is the evidence for the last sentence?

I was at the Washington Lipid conference in August. Dariush Mozzaffarian showed a slide from Siri-Tarino. AJCN 2010 meta-analysis that showed a null effect with SFA and heart disease.
It was the 3rd one in the last five years.

I thought the liver will make more cholesterol if you eat less cholesterol?
By bedwards1951 507 Days Ago

Life's Simple 7: Lose weight

"It’s a matter of balancing healthy eating (caloric energy) with the (molecular) energy that leaves your body through a healthy level of exercise."

Doesn't this go in the face Thomas A Wadden and Adam Gilden Tsai of the University of Pennsylvania?
"the evidence that commercial and self-help programs are sub-optimal. People who diet often regain more than they lose."

Decreased metabolic rates and multiple other factors confound the simple math of calories in the long run of weight loss maintenance.
By bedwards1951 507 Days Ago

Life's Simple 7: Get active
"The facts are clear: By exercising for as little as 30 minutes each day you can reduce your risk of heart disease. Without regular physical activity, the body slowly loses its strength and ability to function well."

I believe this is Class I, level C ?

Level C: Based on expert opinion, case statistics, or standard of care.

Hard to argue that patients should walk 10 minutes after each meal.

My argument is they already know that. Time in the office should be spent on statins which have the strength of multiple prospective random control studies with double blinds to reduce mortality.
By bedwards1951 507 Days Ago

Life's simple 7: Get active

"American Heart Association Guidelines
We suggest at least 150 minutes per week of moderate exercise or 75 minutes per week of vigorous exercise. Or a combination of moderate and vigorous."

I know there is evidence for diabetics to excercise this much and there might be some evidence that exercising this much prevents weight gain but as general advice? Where is the evidence for that?
By bedwards1951 507 Days Ago

?From Case presentation at Lipid clinic in Washington, DC.
Treatment strategies to Reduce risk in our "Intermediate Risk"/"At risk woman"
"Diet: rich in fruits, vegetables, choose whole grain, high-fiber foods, consume fish at least twice a week; limit intake of saturated fat to , 10% of energy and if possible < 7%, cholesterol to < 300 mg/d, alcohol to no more than one drink per day, and sodium < 2.3 g per day. consumption of trans-fatty acids should be as low as possible(eg