A Healthier Heart through Lifestyle Medicine

In Malaysia, heart disease was the number one cause of premature deaths in 2022 ( deaths that occur from 30- 69 y/o). It is projected to be the leading cause of death for the years to come unless we take control of our health and make some changes. And if you look at the major risk factors, most if not all of it comes down to our lifestyle. 

Diet-induced risk continues to be one of the leading causes of CVD and disability, with suboptimal diet estimated to be responsible for 1 in 5 premature deaths worldwide. The foundation for a healthy diet is a whole food, plant- predominant, high fibre and low in total added fat like saturated and trans fat, sugar and salt. 

Guidelines suggest that adults should achieve 150 minutes of moderate intensity activity per week. A simple way to gauge moderate intensity is by the ability to talk but not sing during activity. Now if you break that down, it’s around 30 minutes per day for 5 days a week. There are a few different types of physical activity such as aerobic, resistance, flexibility and balance. Walking comes under aerobic/ endurance exercise. Of course other forms are also important, for example the guidelines also advise strength training 2-3 times per week. Moreover, studies have shown that people who were obese but met the recommended guidelines had the same years of life lost as those who were normal weight but didn’t exercise and regardless of weight loss outcomes, obese individuals who exercise regularly have lower cardiovascular risk and less loss of muscle mass. This shows that people who are fit experience a protective effect, independent of weight. In addition, regular physical activity has been shown to offer psychological, emotional, and social benefits. 

According to the CDC, 35% of adults report sleeping less than 7 hours per night. Short duration and disrupted sleep correlates with: elevated BMI, type 2 diabetes which are risk factors for heart disease. Another big factor in our society is stress. While stress serves as an adaptive and protective mechanism in the short term, helping individuals cope with perceived threats, prolonged exposure can result in chronic inflammation. This persistent stress response has adverse effects on both mental and physical health, contributing to mood disturbances and an elevated risk of cardiovascular disease. Notably, acute episodes of anger or hostility, as well as chronic anger, have been associated with an increased likelihood of heart diseases such as myocardial infarction (MI). Studies also indicate that, alongside other stressors, loneliness can trigger this physiological response in the body.

What about the impact of smoking and alcohol? The substances found in cigarettes and prolonged alcohol consumption have the potential to harm the inner lining of our blood vessels. When our vessels are injured, fat and cholesterol accumulate in those tears, which forms a plague that stiffens the inner arterial walls. This condition is referred to as atherosclerosis and poses serious risks such as myocardial infarction (MI) and stroke. Moreover, individuals who smoke have a higher likelihood of developing heart disease, stroke, and lung cancer compared to non-smokers. Estimates indicate that smoking elevates the risk of coronary heart disease by 2 to 4 times.

Now you might be thinking, ‘No doc, the risk runs in my family. There is nothing much I can do about it.’ Well good news is that your genes are not your destiny, your lifestyle is because they can influence the genetic switches and control gene expression.

References: 

• Reddy. (2022). Cardiovascular Disease and Lifestyle Medicine. The Journal of Family Practice, 71((1 Suppl Lifestyle)). https://doi.org/10.12788/jfp.0251

• Kelly, J., & Clayton, J. S. (2021). Foundations of Lifestyle Medicine Board Review Manual (3rd ed.). ACLM. 

• CDC. (2021). Centers for Disease Control and Prevention. Centers for Disease Control and Prevention. https://www.cdc.gov/index.htm