Healthy diet & CVD: recommendation for practioners

Key position of plants and fruit and vegetables in prevention and treatment of chronic and cardiovascular diseases

A recent U.S. study1 published in the Journal of Geriatric Cardiology describes the diet to adopt for better health and offers physicians and healthcare professionals nutritional advice to help patients follow a healthy diet.

Cardiovascular disease (CVD) is the leading cause of death worldwide

According to an analysis over a 20-year period (1990-2010) published in 2013, the major cause of early death in the USA is diet. Conclusion: “The most important nutritional risk factors are diets low in fruit and vegetables, nuts and seeds, and high in sodium, processed meats, low in vegetables, and trans fats.”
In consultation, every physician should ask himself or herself what has promoted the occurrence of a disease and whether it could have been prevented. The time dedicated to nutrition is estimated at five minutes. Medications are easier to prescribe than dietary changes!

Health benefits of a plant-rich diet

The accumulation of scientific evidence confirms the health benefits of a diet rich in plants and whole foods (fruit and vegetables, legumes, whole grains, nuts, seeds, herbs and spices).

Recommended food groups and servings

Food groups Recommended servings per day
Vegetables, including starchy vegetables Ad libitum, with a variety of colours represented
All fruit 2 to 4 portions
Whole grains and bread 6 to 11 portions
Legumes (beans, lentils, peas, soy-based foods) 2 to 3 portions
Leafy green vegetables (cabbage, lettuce) At least 2 to 3 portions
Nuts (almonds, pecans, walnuts, etc.) 30 to 60 g
Seeds (chia, flax, etc.) 1 to 3 tablespoons
Fortified plant milks (almond, soy) Optional (2 to 3 cups)
Herbs and spices Optional, ad libitum

Half of the plate made up of fruit and vegetables

According to the American Heart Association and the American Institute for Cancer Research, half of the plate should be made up of fruit and vegetables, to ensure the necessary amounts of fibre, potassium, magnesium, folic acid, iron, vitamins A and C, insufficient in current diets.
This diet is associated with a reduction in overall and cardiovascular mortality, medication needs, maintaining a healthy weight, a reduction in at-risk conditions such as obesity and obesity-related inflammatory markers, hyperglycaemia, HTN and dyslipidaemia, and can even reverse CVD and diabetes.

This beneficial effect is due to 2 factors:

  • An increase in health-promoting compounds largely found in fruit and vegetables
  • A reduction in exposure to health-damaging compounds from products of animal origin and processed meats (saturated fats, polycyclic aromatic hydrocarbons [PAHs], heterocyclic amines, and advanced glycation end products, salt, sugars, additives, etc.), which contribute to inflammation, oxidation and carcinogenesis and promote the onset of various diseases.

The health-promoting compounds of plants, including fruit and vegetables, are essentially represented by fibre (which protects the gastrointestinal, cardiovascular, and immune systems) and numerous micronutrients (glucosinolates, carotenoids, flavonoids, etc.), which work synergistically to reduce inflammation and oxidation.

Key role of nutrition in the prevention and treatment of CVD

Numerous studies have proven that nutritional intervention is effective for preventing and treating CVD, especially in the elderly. In elderly individuals with dental issues, a plant-rich diet can be facilitated in the form of green smoothies (vegetables, fruit, nuts and seeds), soups and purées. Food preparation can be simplified by using fruit and vegetables that are frozen, canned or dehydrated and user-friendly kitchen tools (microwave, mixer, electric fruit press, automatic opener, etc.).
The focus should be the overall quality of nutrition (well illustrated by the Mediterranean model). Best sources of carbohydrates: fruit and vegetables, whole grains and legumes. Sweet potato and cassava are rich in vegetable protein, with a low caloric density. Many essential amino acids can be provided by legumes, nuts, whole grains and leafy green vegetables. For lipids, α-linolenic acid (ALA)—precursor of polyunsaturated fatty acids (EPA, DHA)—can be provided by flax or chia seeds, leafy green vegetables, soy-based foods, nuts and their respective oils. Monounsaturated fats? From olives and their oil, avocados, etc. Finally, plant phytosterols reduce intestinal absorption of cholesterol.

A diet rich in fruit and vegetables exposes the body to a wide variety of protective antioxidants (polyphenols, flavonoids, stilbenes, curcuminoids), which affect CVD and other diseases (cancers, neurodegenerative diseases). It also provides It also provides many vitamins and minerals vitamins and minerals.

Life-long beneficial nutrition

A diet rich in plants, especially in fruit and vegetable, offers lifelong benefits, including in the elderly. It reduces the risks of CVD through the interaction of multiple micronutrients. Physicians play an essential role in consultation, to give their patients nutritional advice based on these recommendations.

  1. 1J. Hever et al. Plant-based nutrition for healthcare professionals: implementing diet as a primary modality in the prevention and treatment of chronic disease. Journal of Geriatric Cardiology (2017) 14: 355-6368
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