Dietary interventions with heart disease patients
Dyslipidemia is a primary risk factor for cardiovascular disease, peripheral vascular disease, and stroke. Current guidelines recommend diet as first-line therapy for patients with elevated plasma cholesterol concentrations. However, what constitutes an optimal dietary regimen remains a matter of controversy. Large prospective trials have demonstrated that populations following plant-based diets, particularly vegetarian and vegan diets, are at lower risk for ischemic heart disease mortality.
PURPOSE: To determine whether a multicomponent nutrition intervention program at a corporate site reduces body weight and improves other cardiovascular risk factors in overweight individuals. DESIGN: Prospective clinical intervention study. SUBJECTS/SETTING:Employees of the Government Employees Insurance Company (GEICO) (N = 113), aged 21 to 65 years, with a body mass index > or =25 kg/m(2) and/or previous diagnosis of type 2 diabetes. INTERVENTION: A 22-week intervention including a low-fat, vegan diet.
BACKGROUND: Animal experiments and epidemiological studies have suggested that coronary disease could be prevented, arrested, or even reversed by maintaining total serum cholesterol levels below 150 mg/dL (3.88 mmol/L). In 1985, we began to study how effective one physician could be in helping patients achieve this cholesterol level and what the associated effect of achieving and maintaining this cholesterol level has on coronary disease. METHODS: The study included 22 patients with angiographically documented, severe coronary artery disease that was not immediately life threatening.
This supplement to The American Journal of Cardiology presents the proceedings of the Summit on Cholesterol and Coronary Disease: Second National Conference on Lipids in the Elimination and Preven tion of Coronary Artery Disease presented by the Cleveland Clinic Foundation in cooperation with the Walt Disney Company in Lake Buena Vista, florida, September 4--5, 1997.
[There is] an unreasonable gap between the medical enthusiasm devoted to acute interventions and the meager efforts currently devoted to secondary prevention. -- Rene C. Favaloro, MD Pioneer of Coronary Artery Bypass Grafting Interventional cardiology is symptomatic treatment. The late Dr. Lewis Thomas referred to this ap proach as "half-way technology," meaning that basic mechanisms of disease were not identified or treated. The bypass operation has significant mortality and morbidity, including further heart damage, stroke, and brain dysfunction.
Coronary artery disease is essentially nonexistent in cultures whose nutrition assures cholesterol levels <150 mg/dl. Patients with advanced coronary artery disease may abolish disease progression through a plant-based diet and cholesterol-lowering medication to achieve and maintain a total cholesterol <150 mg/dl.
The high-fat American diet is responsible for an epidemic of coronary artery disease. A plant-based diet with less than 10% fat will prevent coronary disease from developing, halt the progress of existing disease, and even reverse the disease in many patients. Given proper support and education, motivated patients with a history of coronary disease can follow this diet and prevent future cardiac events.
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