Last November, The American Heart Association updated the guidelines on assessment of cardiovascular risk. These guidelines update the formally used National Cholesterol Education Program goals established by the National Heart Lung and Blood Institute. Within the new set of guidelines, there is specific guidance for healthcare providers to use to help patients estimate their 10 year and lifetime risks for heart disease (coronary death or fatal/nonfatal stroke).
Mark has already shared his lab values pre/post $3 diet with me and in the blog, so I used The American Heart Association’s CV Risk Calculator to determine his 10 year and lifetime risk for heart disease. The assessment tool uses the following factors to determine overall risk: total cholesterol, HDL (good cholesterol), systolic blood pressure (Mark shared this number with me), gender, age, race, treatment for hypertension, diagnosis of diabetes, and whether the individual smokes.
I entered Mark’s data into the risk calculator and here are the results:
Pre $3 diet
10-year risk = 1.2% (.3% higher than someone his age)
Lifetime risk = 46% (41% higher than someone his age)
Post $3 diet
10 –year risk = .5% (.4% lower than someone his age)
Lifetime risk = 5% (the same as someone his age)
During the $3 diet, Mark decreased his risk by 41%, mostly through diet and exercise, as the other factors in the risk calculation remained constant. Also worthy of mention, according to Mark’s pre $3 diet labs, he was experiencing impaired fasting glucose, a risk factor for diabetes, however, his post $3 diet labs revealed an improvement in fasting glucose, thus lowering his risk of developing diabetes.
For Mark, the $3 diet worked to his health benefit. But now that the financial restrictions have been lifted, where do we go from here? I would venture to bet that if Mark were to return to his previous habits, we would see a shift back to where we started in December. So how can we prevent that from happening on his now unlimited monetary budget diet?
One healthy option for him would be the DASH Diet, a way of eating originally developed by the National Institutes of Health to lower blood pressure without medication. Since then, studies have shown the DASH diet principles have been effective in not only reducing hypertension, but also the risk of heart disease, diabetes, and some forms of cancer. In general, it is a healthy way of eating. The diet emphasizes vegetables, fruits, whole grains, low-fat dairy, fish, poultry, and nuts. Read more about the DASH diet here: http://dashdiet.org/. Mark could also incorporate some of the principles of the Mediterranean Diet which include eating primarily a plant-based diet with fruits, vegetables, grains, legumes (beans), and nuts. It also emphasizes replacing butter with healthy fats such as olive oil, using herbs instead of salt, incorporating fish and poultry at least twice a week, and limiting red meat to no more than a few times a month.
As we reflect back on the $3 diet, Mark did incorporate principles from both of these ways of eating into his daily meal planning. For example, he made wheat bread, he consumed fruits and vegetables (whether frozen or fresh), he definitely limited red meats (I don’t remember any on the $3 diet), and poultry was only on an occasion when he found it on sale in the grocery store. Now, Mark’s challenge is to continue with his momentum and stick with the healthy changes he has made thus far, and add some recommendations above since cost is no longer a factor! Of note, since we know one of Mark’s vices is beer, and it has perhaps made its way back to Mark’s table, maybe he could trade one in every once in a while for some red wine!
Calculate your CV risk using the CV Risk Calculator: http://my.americanheart.org/professional/StatementsGuidelines/PreventionGuidelines/Prevention-Guidelines_UCM_457698_SubHomePage.jsp