6 Takeaways from NYU Langone Health - Dietary and Lifestyle Strategies for Cardiovascular Risk Reduction Conference
Last week I attended NYU Langone Health course for continuing medical education, Dietary and Lifestyle Strategies for Cardiovascular Risk Reduction. It was a 6-hour conference highlighting current research regarding, you guessed it, how diets, certain foods, and lifestyle habits contribute to the development and prevention of heart disease. The conference was intended for cardiologists and other health care providers in the field, to stay up to date with appropriate clinical recommendations, and a good way for dietitians, like me, to keep up with emerging dietary research.
I’ve summarized the major key concepts below.
My 6 Biggest Takeaways:
1. Plants Matter
Our host, Dr. Eugenia Gianos of NYU Langone Center for the Prevention of Cardiovascular Disease, started the conference interpreting dietary literature and reviewing current research.
Research continues to strongly support plant-based diets, such as the mediterranean diet, the DASH diet, vegetarian & vegan diets, significantly reduce the risk of cardiovascular disease. These diets are 70% identical, with the common denominator being high intakes of fruits, vegetables, legumes and whole grains. Diets high in plants help to reduce blood pressure, plaque formation and lower cholesterol levels which are all factors that can increase the risk of a cardiovascular event, a.k.a. heart attacks and/or strokes.
2. Nutrient Rich Foods Matter
Beware of the difference between whole food vegan diets versus a processed food vegan diets. I wish this one was obvious at this point, but apparently it's not. Yes, you can technically stick to a vegan diet by just eating oreos, cheetos, pepsi, and other highly-processed foods; but it’s not the elimination of animal products that make vegan so beneficial, rather it’s the replacement of animal products with nutrient-rich foods such as fruits, vegetables, legumes, and whole grains.
3. Red Meat + Saturated Fats Matter
Research continues to strongly suggest red meat and diets high in saturated fats are linked to an increased risk of plaque formation. Dr. Stanley Hazen of Cleveland Clinic and his team of researchers found that the gut microbiome plays a role in plaque formation within the blood vessels. The microbiome in our guts oxidizes fat into trimethylamine N-oxide (TMAO). High levels of TMAO contribute to the development of what doctors call ‘the vulnerable patient.’ Which is a someone who develops diabetes, renal disease, high blood pressure and any other medical condition that increases the risk of a cardiovascular incident, such as stroke, heart attack or heart failure. I see this every day in the population I work with at GLWD. You DO NOT want to become the vulnerable patient. You actively want to do everything you can to prevent the development of these life-altering diseases. Reducing your intake of red meat and saturated fats (this includes cheese) is a great first step. The study Dr. Hazen conducted used choline supplements which was equivalent to 3 egg yolks. Suggesting limiting your egg intake and avoid having 3 eggs daily. Dr. Hazen did not provide a safe amount of red meat or egg consumption. Read more of Dr. Hazen's research here.
4. Shopping on a Budget Matters
If we’re going to improve our eating habits we need to eliminate any barrier that may stop us short of our goal, and one of the most frequently reported barriers to eating fruits and vegetables on a regular basis is cost. Eating more plants doesn’t have to break the bank. Emily Johnston, MPH, RD, CDE of Penn State University suggested planning ahead can improve diet quality without increasing cost. She offered the following tips for healthy eating on a budget.
Do NOT shop hungry - Have a healthy snack before you get to the store, and make a plan by creating a list.
Learn to read ALL the labels - Use the shelf tag for the cost per unit as a resource to determine which item gives you the most bang for your buck. Sometimes a 32oz container of yogurt is cheaper per unit ounce than individual 6oz containers.
Reduce waste - Don’t buy perishable food in bulk if you don’t have a plan to use it all before it may spoil. Utilize your freezer to store some fruits and vegetables to extend shelf life. Buying fruits and vegetables already frozen can be just as good as buying them fresh.
Get your protein - Eating more plant based proteins like beans, legumes, tofu and nut butter is a cost efficient way to stretch your money. Also consider buying canned meats like chicken, salmon and tuna.
Keep it simple - Don't over complicate your recipes with a ton of ingredients. Stick to your favorite sauces, herbs and spices that are versatile in many different types of recipes. Repurpose leftovers by tossing them in rice bowls, for example.
“Health” foods allowed, but not required - Organic junk food is still junk food. Don’t go crazy on buying “superfoods” like goji berries or matcha powders if you can’t afford it. A well balanced diet is more important.
5. Physical Activity Matters
Physical activity is critical for a long, healthy, independent life. Dr. Jonathan Whiteson, who specializes in Cardio-Pulmonary Rehabilitation at NYU Langone, stated consistent endurance training can significantly reduce the aging process, so much so that by the time you’re 80, you can have the body of a 50 year old. That’s insane! If that doesn't encourage you to sign up for a half marathon, I don’t know what else will. His workout prescription is FITT: frequency, intensity, type, and time.
- Frequency: 3-5 days of aerobic exercise and 2-3 times per week of resistance training. But of course, anything is better than nothing!
- Intensity: There are many equations to measure your ideal heart rate, but keep it simple. Aim to be at a level in between comfortable breathing and gasping for air. You should be able to hold a conversation during your workout with a couple breathing breaks in between. The more vigorous your exercise, the better.
- Type: Adding a variety of different workouts not only helps to minimize boredom but also strengthens ALL parts of the body. Dr. Whitesone recommends including aerobic (like cardio), muscle toning (like resistance training), flexibility (like yoga), functional, and goal specific.
- Time: The current exercise recommendation for Americans is 120 minutes per week. But Dr. Whitesone points out, this is actually the recommended minimum. He suggests for maximum benefits to double it and aim for 300 minutes per week. That breaks down to one hour, five days a week.
6. Sleep Matters
This was my favorite takeway! Dr. Azizi Seixas, an assistant professor of Population Health and Psychiatry at Langone, highlighted the association of short sleep (sleeping less than 6 hours) to a number of adverse health outcomes such as obesity, diabetes, poor mental health, inflammation, hypertension, and mortality. He strongly urged doctors to consider treating sleep disorders, like sleep apnea or insomnia. Being someone who can sleep 10+ hours (which apparently is also bad) I found it crazy to learn 50-70 million Americans chronically suffer from sleep disorders. Studies have shown, sleeping less than 6 hours can increase your risk of cardiovascular disease, diabetes, and obesity by 50%. Short sleep and long sleep (sleeping more than 8.6 hours) can contribute to high blood pressure, a risk factor for ischemic strokes. Sleep is important since it’s the only way your body can “reset” itself, this influences the production of many hormones, specifically the hormones that regulate hunger. Dr. Seixas recommends the sweet spot between 7-8 hours. Oh! And don't think you can cheat and catch up on the weekends. Dr. Seixas says the body doesn't work like that. We can't "catch-up" on sleep over the weekend. So maybe it's time to cut back on screen time and hit the sack an hour or two earlier.
In February, I wrote a series of heart healthy post. These posts help to put medical nutrition concepts into every day life, diet free.
Check them out: