Optimum nutritional strategies for cardiovascular disease prevention and rehabilitation (BACPR)

Abstract

Nutrition has a central role in both primary and secondary prevention of cardiovascular disease yet only relatively recently has food been regarded as a treatment, rather than as an adjunct to established medical and pharmacotherapy. As a field of research, nutrition science is constantly evolving making it difficult for patients and practitioners to ascertain best practice. This is compounded further by the inherent difficulties in performing double-blind randomised controlled trials. This paper covers dietary patterns that are associated with improved cardiovascular outcomes, including the Mediterranean Diet but also low-carbohydrate diets and the potential issues encountered with their implementation. We suggest there must be a refocus away from macronutrients and consideration of whole foods when advising individuals. This approach is fundamental to practice, as clinical guidelines have focused on macronutrients without necessarily considering their source, and ultimately people consume foods containing multiple nutrients. The inclusion of food-based recommendations aids the practitioner to help the patient make genuine and meaningful changes in their diet. We advocate that the cardioprotective diet constructed around the traditional Mediterranean eating pattern (based around vegetables and fruits, nuts, legumes, and unrefined cereals, with modest amounts of fish and shellfish, and fermented dairy products) is still important. However, there are other approaches that can be tried, including low-carbohydrate diets. We encourage practitioners to adopt a flexible dietary approach, being mindful of patient preferences and other comorbidities that may necessitate deviations away from established advice, and advocate for more dietitians in this field to guide the multi-professional team.

Mediterranean-Type Dietary Pattern and Physical Activity: The Winning Combination to Counteract the Rising Burden of Non-Communicable Diseases (NCDs)

“…Moreover, the adoption of a Mediterranean-like nutritional pattern has been recently shown to be important also in cardiac rehabilitation (CR), which is included, together with PA, in the secondary prevention strategies employed to reduce recurrent cardiovascular events and to improve the quality of life in patients with CVD [ 79 , 80 ]. Large cohorts of patients with a history of CVD, from the Health Professionals Follow-Up and the Nurses’ Health studies, were followed for a median of 7.7 years, for men, and 5.8 years, for women.…”

Mens sana in corpore sano: Does the Glycemic Index Have a Role to Play?

“…Moreover, low-GI diets are also prone Diet interventions are used in physiological conditions, and are also used in sports for weight management, to lose fat mass or gain lean mass. In addition, metabolic disorders are commonly associated with nutritional recommendations to induce weight loss, control glucose levels, or manage dyslipidemia [4]. Most notably, specific diets have also been used in non-metabolic conditions for centuries.…”

High Vegetables Intake and Response to COPD Rehabilitation Treatment. The Role of Oxidative Stress, Inflammation and DNA Damage

“…Lower levels of DNA damage have been associated with lower levels of several inflammatory diseases severity and moderate exercise training (Figure 1) [9,20,21]. High consumption of fruit and vegetables has been associated with a lower risk of lung diseases [22,23], is considered a key intervention for the prevention and treatment of cardiovascular diseases [24], and is associated with a lower risk of cancer and all-cause mortality [25]. Vegetables, and especially green leafy and beetroot, are the primary dietary nitrate source in our diet.…”