Food for thought

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 - Mary Tierney

Cardiologists know that eating right combats cardiovascular disease—but having the time and knowledge to council patients on nutrition can be challenging.

Nursing teams are challenged too. I remember a conversation with a cath lab nurse a couple of years ago when the Affordable Care Act brought a flood of newly insured patients into the system. She and her team were frustrated by the surge of patients, many of lower socioeconomics, whom did not know what eating healthy was.

We know the effects of cardiovascular disease are more significant on populations with lower socioeconomic status. Everyone needs to shop the outside aisles of the grocery store for protein and produce, but many can’t because they can’t afford to. A recent study in PLOS Medicine found that a 10 percent subsidy of fruits and vegetables for all Americans could prevent or postpone 150,500 cardiovascular disease (CVD) deaths by 2030. A 30 percent subsidy for fruits and vegetables for “food stamp” participants could reduce CVD deaths by 35,100 in the next 15 years.

They advocate for improving dietary quality by reducing the price of healthy foods for food program participants, as well as continuing the push to reduce sugar-sweetened beverage consumption nationally through taxes and a media campaign.

Education from cardiologists and cardiovascular team members will help too. Another recent study found gaps between what is known about nutrition and lifestyle among cardiologists and what is shared with patients. Few had received nutrition education during fellowship or internal medicine training and many physicians reported spending three minutes or less per visit discussing nutrition with patients.

An interesting fact emerged. The survey showed that cardiologists who prioritize their own eating habits are more likely to discuss such lifestyle changes with patients. Only 20 percent of respondents claimed to eat the recommended five daily servings of fruits and vegetables, roughly the same proportion as the public.

"Cardiologists with the most vegetable and fruit consumption were also more likely to believe it was their responsibility to discuss detailed dietary information with their patients," said study author Stephen Devries, MD. "Therefore, one way to possibly improve patient counseling and health is for physicians to first optimize their own diet."

We need to look forward and make changes now that will dividends for patients later.