Lifestyle and dietary changes in a nutshell

Lifestyle and dietary modifications are the cornerstone in CVD prevention. Here you find a summary (see Table 14) of the different lifestyle and dietary approaches which are recommended1,6 to manage the major modifiable CVD risk factors and hence CVR risk:

Table 14: Recommendations for a healthy diet and lifestyle

Recommendations for a healthy diet
Use a foods group approach
Diet patterns like the DASH, the Portfolio diet, or the Mediterranean diet, are more likely to meet balanced nutrient requirements than those diets that are selectively restricted in calories or nutrients.
Reduce saturated fats by replacing them with mono- and polyunsaturated fats
Saturated fat should be replaced with MUFA or PUFA to reduce LDL-cholesterol.
Consider foods with added plant sterols/stanols
Foods with added plant sterols/stanols are effective in reducing LDL-cholesterol when consumed in recommended amounts (1.5-3 g/day).
Increase dietary fibre intake especially intake of foods rich in soluble fibres
Consume 25-45 g of dietary fibre per day including ≥ 7-13 g of soluble fibres for a cholesterol-lowering effect.
Limit salt intake
Salt intake should be reduced below 5 g/day by avoiding table salt and limiting salt in cooking and by choosing foods low in added salt.
Limit sugar intake
The intake of beverages and foods with added sugars, particularly soft drinks, should be limited, particularly for patients with hypertriglyceridemia. Sugar intake should not exceed 10% of total energy.
Recommendations on lifestyle changes
Keep being physically active
Physical activity should be encouraged, aiming at 3.5-7 h moderately vigorous physical activity per week or 30-60 min most days.
Reduce body weight if overweight/obesity occurs
A BMI of < 25 kg/m2 is associated with favorable effects on BP and dyslipidemia.
Moderate alcohol intake
For those who drink alcoholic beverages, moderation should be advised (no more than 1 drink/day or equivalent of 10 g alcohol) and patients with hypertriglyceridemia should abstain.
Avoid tobacco and quit smoking
Use and exposure to tobacco and even passive smoking has to be avoided.

Table adapted from 2019 ESC/EAS Guidelines for the management of dyslipidemias6 and the 2021 Guidelines on CVD prevention in clinical practice1.

Test your knowledge
From the list below identify three lifestyle options that can help in reducing CVD risk:
  1. Quit smoking
  2. Occasional physical exercise
  3. Weight loss in presence of obesity or overweight
  4. Weight loss in presence of obesity but not in presence of overweight
  5. Regular physical exercise
  6. Moderate or moderate-heavy alcohol consumption
Check your answer