Impact of diet and exercise on lipid management in the modern era.
Unfortunately, many patients as well as the medical community, continue to rely on coronary revascularization procedures and cardioprotective medications as a first-line strategy to stabilize or favorably modify established risk factors and the course of coronary artery disease. However, these therapies do not address the root of the problem, that is, the most proximal risk factors for heart disease, including unhealthy dietary practices, physical inactivity, and cigarette smoking. We argue that more emphasis must be placed on novel approaches to embrace current primary and secondary prevention guidelines, which requires attacking conventional risk factors and their underlying environmental causes. The impact of lifestyle on the risk of cardiovascular disease has been well established in clinical trials, but these results are often overlooked and underemphasized. Considerable data also strongly support the role of lifestyle intervention to improve glucose and insulin homeostasis, as well as physical inactivity and/or low aerobic fitness. Accordingly, intensive diet and exercise interventions can be highly effective in facilitating coronary risk reduction, complementing and enhancing medications, and in some instances, even outperforming drug therapy.
Preventive Cardiology and Cardiac Rehabilitation, William Beaumont Hospital, Royal Oak, MI, USA. Electronic address: bfranklin@beaumont.edu.
Barry A
BA
Franklin
The University of South Carolina, Columbia, SC, USA.
J Larry
JL
Durstine
Exercise and Metabolic Disease Research Laboratory, Translational Sciences Section, School of Nursing, University of California, Los Angeles, CA, USA.
Christian K
CK
Roberts
Department of Physiological Science, University of California Los Angeles, Los Angeles, CA, USA.
R James
RJ
Barnard
D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology / Q000517:prevention & control; D004032:Diet; D050171:Dyslipidemias / Q000097:blood / Q000266:history / Q000628:therapy*; D015444:Exercise / Q000502:physiology*; D049674:History, 21st Century; D006801:Humans; D008019:Life Style; D008055:Lipids / Q000097:blood*; D009043:Motor Activity / Q000502:physiology; D012307:Risk Factors
D008055:Lipids
cardioprotective medications; cholesterol; coronary revascularization; diet; lipoproteins; physical activity; primary prevention; risk factor; secondary prevention; triglyceride