Behavioral Medicine Review: Strategic Management of Diabetes Risk

There is widespread public health concern about the upsurge in diabetes and its cardiometabolic comorbidities. Unfortunately, too many patients still do not receive best practices care. This review discusses some key contributing dynamics as well as considerations for progress toward the more comprehensive, strategic management of diabetes and its associated risks.

Cardiovascular Risk Reduction: We Have the Will, But Do We Have the Way?

As Rippe, Angelopoulos, and Zuckley pointed out, coronary heart disease “represents the quintessential lifestyle disease of developed countries,” offering both opportunities and challenges for the routine practice of lifestyle medicine. Although the empirical evidence provides a compelling rationale for the modification of preventable cardiovascular risks, their review prompts discussion of the continuing tendency for practice to lag behind knowledge, the persisting challenges to narrowing this knowledge-practice divide, and the emerging trends that may further advance cardiovascularrisk reduction efforts.

Behavioral Medicine Review: Strategic Management of Diabetes Risk

There is widespread public health concern about the upsurge in diabetes and its cardiometabolic comorbidities. Unfortunately, too many patients still do not receive best practices care. This review discusses some key contributing dynamics as well as considerations for progress toward the more comprehensive, strategic management of diabetes and its associated risks.

A Commentary on Lifestyle Medicine Strategies for Risk Factor Reduction, Prevention, and Treatment of Coronary Artery Disease

Lifestyle medicine is the study and practice of how simple lifestyle measures such as proper diet, proper exercise, and stress reduction are thoughtfully and comprehensively integrated into conventional Western medicine practices. This includes promoting health through prevention and therapeutic strategies. Through the use improved assessment tools, such as coronary computed tomography calcium scoring and exercise capacity, and underused treatment strategies, such as thoughtful diet and exercise interventions coupled with appropriate statin use, practicing clinicians can integrate these lifestyle medicine strategies and significantly decrease the morbidity and mortality of coronary heart disease.

Fitness, Antioxidants, and Moderate Drinking: All to Lower Cardiovascular Risk

Inadequate physical activity has been recognized as an independent risk factor for the development of coronary heart disease. The cardiovascular benefits of exercise and fitness have been found in both men and women. Survival following myocardial infarction and risk of sudden death appear to significantly diminish in those individuals who follow a fitness regimen of 30 to 60 minutes of exercise, 4 to 6 times per week, with the exercise having the following endpoints of fatigue, breathlessness, and sweating. In regard to the role of antioxidants in primary and secondary prevention of coronary hear disease, this article addresses vitamins C and E and beta-carotene, with the conclusion that supplementation with beta-carotene and vitamin E, either alone or in combination, does not appear to be efficacious in either primary or secondary prevention of coronary heart disease, with the exception of patients receiving hemodialysis. Data on vitamin C are conflicting. The author recommends a good multivitamin supplement, which has been shown to reduce all-cause mortality. Finally, in the Health Professionals Follow-Up Study, in >8000 men free of cardiovascular disease who followed a healthy lifestyle, cardiovascular risk appeared lowest in men who reported daily alcohol consumption ranging from 5 to 30 gm, which corresponded to one half to 2 drinks.

Rationale for Intervention to Reduce Risk of Coronary Heart Disease: A General Internist's Perspective

Coronary Heart Disease (CHD) is the most deadly disease in the United States and the one whose risks are most modifiable by lifestyle measures. The rationale for CHD risk reduction is clear, well studied and outlined in this article. From aggressive assessment with a history and physical, basic laboratory studies, nutritional assessment and a physical activity assessment, CHD risks can be adequately quantified. The challenge now is in defining how to fully implement the effective strategies; both pharmacologic and nonpharmacologic (lifestyle) that have been proven to reduce the risks.