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Coronary Heart Disease - prevention

Lifestyle modifications

NUTRITION

  • Adopt a Mediterranean diet or similar diet (1)

  • Saturated fats: < 10% of daily calorie intake. Replace saturated fats with unsaturated fats and/or unrefined carbohydrates (1)

  • Salt: < 5g/day. Reduced salt intake reduces blood pressure and risk of cardiovascular disease (1)

  • Adopt a more plant based diet rich in fibre, that includes fruits, vegetables, nuts, legumes, and whole grains (1)

  • Fruits: > 200g/day

  • Vegetables: > 200g/day

  • Fibre: 30-45g/day, preferrably from whole grain

  • Nuts: 30g/day (unsalted)

  • Keep alcohol intake below 100g per week (1)

  • Fatty fish at least one time a week (1)

  • Reduce intake of (processed) meat to below 500g/week (1)

  • Sugar: Keep intake below 10% of daily calorie intake (1)


PHYSICAL ACTIVITY

  • For all age groups: 150-300 min a week of moderate intensity  (eg. brisk walking) or 75-150 min a week of vigorous intensity (eg. jogging, running) aerobic physical activity (1)

  • When 150 min a week can not be achieved the person should strive to be as active as possible. Physical activity accumulated in bouts of 10 min or less has favorable outcomes (1)

  • Reduce sedentary time (1)

  • Perform resistance training 2 times a week to reduce risk of cardiovascular events and all cause mortality (1)


SMOKING

  • Smoking is a strong and independent risk factor for atherosclerotic cardiovascular disease (1)

  • Smoking cessation reduces the risk of cardiovascular disease and also improves mental health (1)


MENTAL HEALTH

  • Patients with mental disorders need more support in order to make lifestyle changes (1)


STRESS

  • If significant stress, stress reduction may improve cardiovascular disease outcomes (1)

References

Resources

Evidence Pyramid

EXPLANATION TO EVIDENCE PRESENTATION

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Evidence based on guidelines and evidence based Clinical Decision Systems is written in BOLD

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Evidence based on meta analysis or systematic reviews is written in BOLD and CURSIVE

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Evidence based on randomized controlled trials is written in plain font

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Evidence based on observational / cohort studies is written in CURSIVE

Figure: Evidence pyramid

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