Dietitian for Cardiovascular Health Brookline MA
Janel Ovrut, LDN, MS, RD
Alexis M Beck, LDN, MPH, RD
1051 Beacon StSte 510
Frances Konstatilakis, LDN, RD
Johanna T Dwyer, RD
31 Lakeville RdApt 1
Jamaica Plain, MA
Leigh P Van Dusen, MS, RD
1 Mifflin PlaceSuite 260
Jan Pauline Hangen, LDN, MS, RD
1101 Beacon StSte 8E
Nancy Clark, CSSD, MS, RD
Chestnut Hill, MA
Anne Manion, RD
50 Slocum Rd
Jamaica Plain, MA
Laura Foresta, LDN, RD
51 Boylston StFl 4
Jessica Jones Hughes, LDN, MS, RD
Jamaica Plain, MA
BASICS OF A HEALTHY DIET
I recently attended an interesting conference on the effects of diet on cardiovascular risk facotrs. I was impressed with both the benefits of diet on vascular disease risk factors as well as the data that demonstrated diet to be even more effective than many "high powered" prescription medications in reversing the metabolic changes of abnormal glucose and lipid metabolism. I thought it would be fun to summarize a few of the ideas and then to speculate on what lifestyle changes one might easily make to keep themselves healthy. But before we go further, I want to stress again that this is about a baseline healthy lifestyle - and all evidence continues to point towards carbohydrates alone as the underpinning for the energy needs of the cyclist on their bike.
Abnormal lipids, probably as a result of abnormal glucose metabolism (insulin resistance or pre diabetes) are a significant factor in the development of cardiovascular disease. There are proven dietary and life style strategies that are proven to help pts with severe vascular disease (prior MI, stroke, etc.), so it would seem safe to speculate that the same strategies would be beneficial for everyone (but especially if they had undiagnosed insulin resistance). The current presumption is that this "prediabetic" condition can be present for years before full fledged diabetes with an elevated blood sugar is diagnosed - and the entire time blood vessel damage is ongoing.
Here is another way to look at this. There are multiple risk factors:
- Sedentary lifestyle which are factors in aggravating insulin resistance. And the more severe the insulin resistance the greater the odds of
- Dyslipidemia (decreased HDL, increased LDL and triglycerides)
- Atherosclerosis Improve any of the multiple risk factors and the odds of developing blood vessel disease decreases.
In reviewing the literature, it is extremely common to note that certain dietary changes improve both the risk of DM and risk of heart disease in the same direction and by the same relative amount. Again, strong suggestive evidence that it is insulin resistance that is the common factor for both development of overt diabetes mellitus and cardiovascular disease. In fact, I heard one lecturere say that if one followed all the dietary and life style recommendations that follow, the chances of developing diabetes type 2 were almost nil.
The dyslipidemia CV risk factors include
- an increase in the LDL (or bad cholesterol) levels
- a decrease in HDL - HDL functions to clear cholesterol from the periphery and transport it back to the liver. (a 1 mg/100ml increase in HDL = 2-4% lower risk of a cardiac event)
- and an increase in triglycerides. Focusing on changing the balance of these three is the goal. Statin drugs will lower the LDL, but have no effect on the other two. Dietary changes will affect the balance in a way that is actually more effective than statins alone, an...
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