Primary prevention of cardiovascular disease—how to promote healthy eating habits in populations?
- C. von Schacky
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The obesity epidemic brings with it an increase in related diseases, like diabetes mellitus, and subsequently cardiovascular disease. Traditional dietary guidelines have focused on food composition rather than energy balance.
To identify promising approaches towards promoting healthy eating and lifestyle patterns. Implementation strategies were also sought.
A review of the pertinent literature based on MEDLINE searches.
Weight loss subsequent to gastric surgery reduces mortality and morbidity in obese persons. Other approaches seem promising. Studies in children and adolescents demonstrate the feasibility of maintaining a healthy lifestyle pattern taught in school. In epidemiological studies, a healthy lifestyle is associated with lower mortality and morbidity; intervention studies with surrogate and intermediate, but not with clinical, endpoints support this concept in primary prevention. Secondary prevention studies with clinical endpoints, however, lend support to the Mediterranean diet and to increasing intake of marine omega-3 fatty acids. Primary prevention guidelines largely reflect the current data. Implementing a healthy lifestyle is possible, with the magnitude of effect reflecting the intensity of the intervention. Cost-effectiveness partly remains to be demonstrated.
Primary prevention of cardiovascular disease by promoting a healthy eating and lifestyle pattern seems feasible. The best strategies, their cost-effectiveness and other practical problems remain to be clarified.
- Adams TD, Gress RE, Smith SC, Halverson C, Simper SC, Rosamund WD et al (2007) Long-term mortality after gastric bypass surgery. N Engl J Med 357:753–761 CrossRef
- Beresford SA, Curry SJ, Kristal AR, Lazovick D, Feng Z, Wagner EH (1997) A dietary intervention in primary care practice: the Eating Patterns Study. Am J Public Health 87:610–616 CrossRef
- Burr ML, Fehily AM, Gilbert JF, Rogers S, Holliday RM, Sweetnam PM et al (1989) Effects of changes in fat, fish, and fibre intakes on death and myocardial infarction: diet and reinfarction trial (DART). Lancet 2:757–761 CrossRef
- Chiuve SE, McCullough ML, Sacks FM, Rimm ED (2006) Healthy lifestyle factors in the primary prevention of coronary heart disease among men. Benefits among users and nonusers of lipid-lowering and antihypertensive medication. Circulation 114:160–167 CrossRef
- De Backer G, Ambrosioni E, Borch-Johnsen K, Brotons C, Cifkova R, Dallongeville J et al (2003) European guidelines on cardiovascular disease prevention in clinical practice. Third Joint Task Force of European and Other Societies on Cardiovascular Disease Prevention in Clinical Practice. Eur Heart J 24:1601–1610 CrossRef
- de Lorgeril M, Salen P, Martin JL, Monjaud I, Delaye J, Mamelle N (1999) Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study. Circulation 99:779–785
- Eriksson MK, Westborg CJ, Eliasson MC (2006) A randomized trial of lifestyle intervention in primary healthcare for the modification of cardiovascular risk factors. Scand J Public Health 34:453-461 CrossRef
- Esposito K, Marfella R, Ciotola M, Di Palo C, Giugliano F, Giugliano G, D’Armiento M, D’Andrea F, Giugliano D (2004) Effect of a mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome: a randomized trial. JAMA 292:1440–1446 CrossRef
- Gaede P, Vedel P, Larsen N, Jensen GV, Parving HH, Pedersen O (2003) Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes. N Engl J Med 348:383–393 CrossRef
- Goldstein LB, Adams R, Alberts MJ, Appel LJ, Brass LM, Bushnell CD et al (2006) Primary prevention of ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council: cosponsored by the Atherosclerotic Peripheral Vascular Disease Interdisciplinary Working Group; Cardiovascular Nursing Council; Clinical Cardiology Council; Nutrition, Physical Activity, and Metabolism Council; and the Quality of Care and Outcomes Research Interdisciplinary Working Group: the American Academy of Neurology affirms the value of this guideline. Stroke 37:1583–1633
- Hayman LL, Reineke PR (2003) Preventing coronary heart disease: the implementation of healthy lifestyle strategies for children and adolescents. J Cardiovasc Nurs 18:294–301
- Hayman LL, Williams CL, Daniels SR, Steinberger J, Paridon S, Dennison BA et al (2004) Cardiovascular health promotion in the schools: a statement for health and education professionals and child health advocates from the Committee on Atherosclerosis, Hypertension, and Obesity in Youth (AHOY) of the Council on Cardiovascular Disease in the Young, American Heart Association. Circulation 110:2266–2275 CrossRef
- Heymsfield SB, Harp JB, Rowell PN, Nguyen AM, Pietrobelli A (2006) How much may I eat? Calorie estimates based upon energy expenditure prediction equations. Obes Rev 7:361–370 CrossRef
- Hooper L, Griffiths E, Abrahams B, Alexander W, Atkins S, Atkinson G et al (2004) Dietetic guidelines: diet in secondary prevention of cardiovascular disease (first update, June 2003). J Hum Nutr Diet 17:337–349 CrossRef
- Howard BV, Van Horn L, Hsia J, Manson JE, Stefanick ML, Wassertheil-Smoller S et al (2006) Low-fat dietary pattern and risk of cardiovascular disease: the Women’s Health Initiative Randomized Controlled Dietary Modification Trial. JAMA 295:655–666 CrossRef
- Kafatos I, Manios Y, Moschandreas J, Kafatos A; Preventive Medicine and Nutrition Clinic University of Crete Research Team (2007) Health and nutrition education program in primary schools of Crete: changes in blood pressure over 10 years. Eur J Clin Nutr 61:837–845 CrossRef
- Klein S, Burke LE, Bray GA, Blair S, Allison DB, Pi-Sunyer X et al (2004) Clinical implications of obesity with specific focus on cardiovascular disease: a statement for professionals from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism: endorsed by the American College of Cardiology Foundation. Circulation 110:2952–2967 CrossRef
- Kristal AR, Curry SJ, Shattuck AL, Feng Z, Li S (2000) A randomized trial of a tailored, self-help dietary intervention: the Puget Sound Eating Patterns study. Prev Med 31:380–389 CrossRef
- Kuller LH, Simkin-Silverman LR, Wing RR, Meilahn EN, Ives DG (2001) Women’s Healthy Lifestyle Project: a randomized clinical trial. Circulation 103:32–37
- Lichtenstein AH, Appel LJ, Brands M, Carnethon M, Daniels S, Franch HA et al (2006) Diet and lifestyle recommendations revision 2006: a scientific statement from the American Heart Association Nutrition Committee. Circulation 114:82–96 CrossRef
- Luepker RV, Perry CL, KcKinlay SM, Nader PR, Parcel GS, Stone EJ et al (1996) Outcomes of a field trial to improve children’s dietary patterns and physical activity. The Child and Adolescent Trial for Cardiovascular Health (CATCH). JAMA 275:768–776 CrossRef
- McMurray RG, Harrell JS, Bangdiwala SI, Bradley CB, Deng S, Levine A (2002) A school-based intervention can reduce body fat and blood pressure in young adolescents. J Adolesc Health 31:125–132 CrossRef
- Mozaffarian D, Katan MB, Ascherio A, Stampfer MJ, Willett WC (2006) Trans fatty acids and cardiovascular disease. N Engl J Med 354:1601–1613 CrossRef
- National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) (2002) Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 106:3143–3421
- Obarzanek E, Kimm SY, Barton BA, Van Horn LL, Kwiterovich PO, Simons-Morton DG et al; DISC Collaborative Research Group (2001) Long-term safety and efficacy of a cholesterol-lowering diet in children with elevated low-density lipoprotein cholesterol: seven-year results of the Dietary Intervention Study in Children (DISC). Pediatrics 107:256–264 CrossRef
- Okie S (2007) New York to trans fats: you’re out! N Engl J Med 356:2017–2021 CrossRef
- Pignone MP, Ammerman A, Fernandez L, Orleans CT, Pender N, Woolf S et al (2003) Counseling to promote a healthy diet in adults: a summary of the evidence for the U.S. Preventive Services Task Force. Am J Prev Med 24:75–92 CrossRef
- Pomerleau J, Lock K, McKee M (2005) Interventions designed to increase adult fruit and vegetable intake can be effective: a systematic review of the literature. J Nutr 135:2486–2495
- Schuit AJ, Wendel-Vos GC, Verschuren WM, Ronckers ET, Ament A, Van Assema P et al (2006) Effect of 5-year community intervention Hartslag Limburg on cardiovascular risk factors. Am J Prev Med 30:237–242 CrossRef
- Schwandt P, Geiß HC, Ritter MM, Ublacker C, Parhofer KG, Otto C et al (1999) The prevention education program (PEP). A prospective study of the efficacy of family-oriented life style modification in the reduction of cardiovascular risk and disease: design and baseline data. J Clin Epidemiol 52:791–800 CrossRef
- Simkin-Silverman LR, Wing RR, Hansen DH, Klem ML, Pasagian-MacAuley AP, Meilahn EN, Kuller LH (1995) Prevention of cardiovascular risk factor elevations in healthy premenopausal women. Prev Med 24:509–517 CrossRef
- Singh AS, Chin A, Paw MJ, Kremers SP, Visscher TL, Brug J, van Mechelen W (2006) Design of the Dutch Obesity Intervention in Teenagers (NRG-DOiT): systematic development, implementation and evaluation of a school-based intervention aimed at the prevention of excessive weight gain in adolescents. BMC Public Health 6:304 CrossRef
- Sjöstrom L, Narbro K, Sjöstrom D, Karason K, Larsson B, Wedel H et al (2007) Effects of bariatric surgery on mortality in Swedish obese persons. N Engl J Med 357:741–752 CrossRef
- Skender ML, Goodrick GK, Del Junco DJ, Reeves RS, Darnell L, Gotto AM, Foreyt JP (1996) Comparison of 2-year weight loss trends in behavioral treatments of obesity: diet, exercise, and combination interventions. J Am Diet Assoc 96:342–346 CrossRef
- Smith SC Jr, Allen J, Blair SN, Bonow RO, Brass LM, Fonarow GC et al (2006) AHA/ACC guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 update: endorsed by the National Heart, Lung, and Blood Institute. Circulation 113:2363–2372 CrossRef
- Stampfer MJ, Hu FB, Manson JE, Rimm EB, Willet WC (2000) Primary prevention of coronary heart disease in women through diet and lifestyle. N Engl J Med 343:16–22 CrossRef
- von Schacky C, Harris WS (2007) Cardiovascular benefits of omega-3 fatty acids. Cardiovasc Res 73:310–315 CrossRef
- World Health Organization (2000) Obesity: preventing and managing the global epidemic (WHO Technical Report Series No. 894). World Health Organization, Geneva
- Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F et al (2004) Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet 364:937–952 CrossRef
- Zahner L, Puder JJ, Roth R, Schmid M, Guldimann R, Pühse U et al (2006) A school-based physical activity program to improve health and fitness in children aged 6–13 years (“Kinder-Sportstudie KISS”): study design of a randomized controlled trial [ISRCTN15360785]. BMC Public Health 6:147 CrossRef
- Primary prevention of cardiovascular disease—how to promote healthy eating habits in populations?
Journal of Public Health
Volume 16, Issue 1 , pp 13-20
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Myocardial infarction
- Coronary artery disease
- C. von Schacky (1)
- Author Affiliations
- 1. Preventive Cardiology, Medizinische Klinik und Poliklinik Innenstadt, University of Munich, Ziemssenstr. 1, 80336, Munich, Germany