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 In a July 31 online synopsis in JAMA Cardiology, senior author Dr.
Roger S. Blumenthal of the Johns Hopkins University, Baltimore,
Maryland, and colleagues emphasize, "Patient-centered care is a
foundational aspect of this guideline and an essential part of its
effective implementation."
As Dr. Blumenthal told Reuters Health by email, "Better lifestyle
habits are the cornerstone of prevention and good health. We all
should strive to increase the amount of fruits, vegetables, fiber,
fish and minimize fried foods, processed meats, foods with high
amounts of sugar, and sugar sweetened beverages."
Development of the guideline, which is directed toward care of
adults who are free of atherosclerotic cardiovascular disease,
involved an array of clinicians, cardiologists, health services
researchers, epidemiologists, nurses and others. An extensive
evidence review was conducted including randomized clinical trials,
systematic reviews, and meta-analyses.
Among their recommendations beyond team-based care and the general
need for a healthy diet, is to "replace saturated fat with
monounsaturated and polyunsaturated fats and reduce dietary
cholesterol and sodium."
In addition, body mass index should be calculated and a measurement
of waist circumference should be considered at least annually.
Patients who are overweight, say the investigators, "benefit from
counseling and comprehensive lifestyle interventions, including
caloric restriction, to achieve and maintain weight loss."
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Dr. Blumenthal added, "It is also so important to aim for more brisk
activity on a daily basis. It is best to aim for an average of 40
minutes a day." In particular, the guidelines suggest that for those
unable to meet such minimums, "engaging in at least some moderate to
vigorous activity can still be beneficial."
"Avoidance of tobacco products is also key to good health," Dr.
Blumenthal pointed out. In fact, the recommendations say, "All
adults should be assessed at every health care visit for tobacco
use, and those who use tobacco should be assisted and strongly
advised to quit. A combination of behavioral interventions plus
pharmacotherapy maximizes tobacco quit rates."
The benefits of these measures are in little doubt, but still, the
researchers write, "Further studies are also needed to determine
optimal strategies to enhance uptake of and adherence to physical
activity and nutrition recommendations."
SOURCE: http://bit.ly/2M9QXgB
JAMA Cardiol 2019.
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