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Managing Dyslipidaemic Patients â€“ Improving Adherence with Lifestyle Intervention
European Cardiology, 2011;7(4):246-250
AbstractOn 27 June 2011, during the European Atherosclerosis Society (EAS) Congress 2011, Danone hosted an educational symposium entitled â€˜Nutritional Behaviour and Reduction of Cardiovascular Risk: From Basic Science to Clinical Practiceâ€™. The symposium was co-chaired by Professor M John Chapman, EAS President and Director of the Dyslipidaemia and Atherosclerosis Research Unit at the French National Institute of Health and Medical Research (INSERM), PitiÃ©-SalpÃªtriÃ¨re Hospital, Paris, and Professor John Deanfield, British Heart Foundation Vandervell Professor of Cardiology, University College Hospital, London, UK. The focus of the four presentations and discussions was whether the incorporation of functional foods in the diet of dyslipidaemic patients might improve adherence to lifestyle changes, and the implications of such an approach.
Speakers: Philippe Besnard, Professor and Head of the Nutrition Physiology and Toxicology Research Unit, INSERM, University of Bourgogne, Dijon; Eric Bruckert, Medical Doctor, Professor of Endocrinology and Director of the Endocrinology-Metabolism and Prevention of Cardiovascular Disease Department, PitiÃ©-SalpÃªtriÃ¨re Hospital, Paris; John Deanfield, Professor of Cardiology and Head of Cardiovascular Prevention, University College London; Lluis Masana, Professor of Medicine and Head of the Vascular Medicine and Metabolism Unit, Institut d'InvestigaciÃ³ SanitÃ ria Pere Virgili, Rovira i Virgili University, University Hospital San Joan, Reus.
Support: The publication of this educational symposium report was sponsored by Danone.
Phytosterol, lifestyle, hypercholesterolaemia, cardiovascular risk, lipid sensing
Phytosterol, lifestyle, hypercholesterolaemia, cardiovascular risk, lipid sensing
Received: August 05, 2011 | Accepted August 18, 2011 | Citation European Cardiology, 2011;7(4):246-250
Focus on Lifestyle to Reduce Cardiovascular Risk
Pharmacotherapeutic intervention, in particular targeting elevated cholesterol, has undoubtedly been successful in reducing the mortality and morbidity of patients with cardiovascular disease.1 However, these gains have now been largely overtaken by escalating rates of obesity and cardiometabolic disease, driven by the adoption of energy-dense diets and a sedentary lifestyle. The INTERHEART study, a global case-control study, previously showed that a Western high-fat diet, a driver for the development of hypercholesterolaemia, is associated with increased coronary risk.2 As seen in China, an increasingly Westernised diet and associated increase in total cholesterol have contributed to marked increases in coronary heart disease mortality (by 50 % in men and by 27 % in women) despite improved access to better treatment.3
Clearly, improved lifestyle is a key component of modern preventive cardiology, as recognised by the recently published European Atherosclerosis Society (EAS)/European Society of Cardiology (ESC) joint guidelines for management of dyslipidaemia.4 These new guidelines also place emphasis on nutritional approaches, either alone or complementary to pharmacotherapy, in managing hypercholesterolaemia to reduce cardiovascular risk. As highlighted by Eric Bruckert, Director of the Endocrinology-Metabolism and Prevention of Cardiovascular Disease Department at the PitiÃ©-SalpÃªtriÃ¨re Hospital in Paris, in his presentation, adherence to a healthy diet from an early age has been shown to translate to a reduction in the risk of coronary heart disease and diabetes.5 However, the biggest challenge in implementing lifestyle advice is sustaining change in the long term.
Are there Practical Tools that can Help in Adherence to Dietary Changes?
Bruckert reviewed data showing that preventive programmes for managing cardiovascular risk factors that include both education and a self-monitoring component, such as measuring blood glucose or blood pressure, were beneficial in helping patients sustain improvements in lifestyle.6,7 Furthermore, the use of a pedometer8 not only increased physical activity but also improved other cardiovascular risk factors, suggesting that simple practical tools might help in promoting a lifestyle change.
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