HEALTH + WELLNESS
and cardiologists encourage imaging
and procedures at $70,000 to $200,000
a pop, since insurance companies
reimburse these procedures, instead of
considering preventative approaches.
Change is needed: 80% of cardio-
metabolic diseases are preventable
through diet and lifestyle. In fact,
clinical research shows that lifestyle
interventions are also successful in
reversing disease. Widening the lens
on risk factor interventions can per-
sonalize preventative approaches
and optimize outcomes.
Conventional screening modalities are
incomplete in identifying those individ-
uals at risk for developing heart disease.
Traditionally, risk factors for heart
disease have included elevated choles-
terol levels, smoking, diabetes, lack of
exercise and hypertension. By focusing
on these large categories, we miss the
chance to intervene effectively. In fact,
50% of patients who have a heart attack
or stroke have normal lipid levels—
the conventional cardiac risk screening
tool. Updated research suggests there
are possibly over 300 risk factors. Even
addressing the top 20 risk factors could
significantly affect outcomes.
Risk factors like fasting sugar, insulin
and leptin resistance, genetic factors
and measurements of inflammation
and oxidative stress are now believed
to be significant drivers of heart and
vascular issues. Once identified, these
risk factors can help personalize pre-
ventative and treatment protocols.
Lifestyle intervention is also powerful,
yet few providers stress this approach in
the care of heart disease. While address-
ing diet and nutrition should be first and
foremost, most physicians never receive
formal training in nutrition, and even
when nutrition/lifestyle intervention
is recommended, insurance companies
rarely reimburse these services. Accord-
ingly, there is little motivation to include
these interventions in treatment proto-
cols. Patients are left to “figure it out”
on their own using data that can be
conflicting and confusing.
“There is no such thing as a sudden heart attack.
It requires years of preparation.” —Unknown
SPRING 2019
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