Nutrition and Cardiovascular Disease: One Piece of a Multi-Disciplinary Approach

Every 33 seconds, someone in the United States dies from cardiovascular disease (National Center for Health Statistics). As the leading cause of death for both men and women, preventing and managing cardiovascular disease is a top health priority (National Center for Health Statistics). Managing cardiovascular disease requires a multidisciplinary approach, including a nutrition professional (Diab et al., 2023). The American Heart Association recommends addressing cardiovascular disease and its risk factors with Life’s Essential 8: (1) healthy diet, (2) participation in physical activity, (3) avoidance of nicotine, (4) healthy sleep, (5) healthy weight, and healthy levels of (6) blood lipids, (7) blood glucose, and (8) blood pressure (Lloyd-Jones et al., 2022).

While one of these essentials is healthy diet, weight, lipids, glucose and blood pressure also directly impacted by nutrition. Much information exists examining diets for cardiovascular disease. Three diet patterns have the most evidence for preventing cardiovascular disease: the Mediterranean diet, the DASH diet, and the plant based diet (Diab et al., 2023).

• Mediterranean Diet: This dietary pattern emphasizes whole grains, vegetables, fruits, legumes, nuts herbs and spices. Lean proteins such and fish and poultry are consumed in moderation. Alcohol is also consumed in moderation. Compared to other patterns, extra virgin olive oil has a greater emphasis. Saturated fats, red meat, sweets, and highly processed foods are limited or eliminated. This dietary pattern provides anti-inflammatory properties, supports a healthy gut microbiome, and has been shown to support a healthy blood pressure, prevention of metabolic syndrome and diabetes, and lower rates of cardiovascular diseases.
• DASH Diet: The Dietary Approaches to Stop Hypertension emphasizes fruits, vegetables, whole grains, poultry, fish, nuts, seeds and low fat dairy. Meats high in saturated fats, sweets, sugar sweetened beverages and full-fat dairy is limited. Salt intake is reduced to less than 2,300 mg per day and in some cases less than 1,500 mg per day. This diet pattern is associated with reduced blood pressure, diabetes, heart failure and cardiovascular disease rates.
• Healthy Plant-Based Diet: This diet includes many variations including vegan, vegetarian, lacto-vegetarians, and lacto-ovo-vegetarians. It can also include pescatarians and semi-vegetarians. The many variations on this diet all focus on plants, specifically, whole grains, fruits, vegetables, nuts, and legumes. To get maximize cardiovascular benefit, foods such as sugar sweetened beverages, sweets, and refined grains are also limited. This pattern is associated with reduced blood pressure, blood glucose, and cardiovascular mortality. However, care is needed to meet the protein needs as well as needs for specific micronutrients such as vitamins B12 and D, calcium, and zinc.

For all 3 dietary patterns there is an emphasis on the consumption of vegetables, fruit, legumes, nuts, and whole grains while avoiding ultra-processed foods. Nutrition professionals can help support the incorporation of these patterns while considering the preferences and needs of the individual. Any recommendations should consider patient lifestyle and cultural background, socioeconomic status, and the availability of the recommended foods (Diab et al, 2023). As one of Life’s Essential 8, nutrition is a key part of a multidisciplinary approach to prevent and manage cardiovascular disease. (Lloyd-Jones et al., 2022).

References

Diab, A., Dastmalchi, L. N., Gulati, M., & Michos, E. D. (2023). A Heart-Healthy Diet for Cardiovascular Disease Prevention: Where Are We Now?. Vascular health and risk management, 19, 237–253. https://doi.org/10.2147/VHRM.S379874

Lloyd-Jones DM, Allen NB, Anderson CAM, Black T, Brewer LC, Foraker RE, Grandner MA, Lavretsky H, Perak AM, Sharma G, Rosamond W; on behalf of the American Heart Association. Life’s essential 8: updating and enhancing the American Heart Association’s construct of cardiovascular health: a presidential advisory from the American Heart Association. Circulation. 2022;146:e18–e43. doi: 10.1161/CIR.0000000000001078

National Center for Health Statistics. Multiple Cause of Death 2018–2021 on CDC WONDER Database. Accessed February 2, 2023.

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