Why nutrition matters to your patients with hypertension

Sara Berg, MS , News Editor

Poor nutrition is among the top health risk factors that lead to disability and premature death in the U.S., according to the Centers for Disease Control and Prevention. These risk factors can cause the development of chronic conditions such as heart disease and type 2 diabetes, which are some of the most common, costly and preventable health problems. Unfortunately, many physicians feel uncomfortable providing diet and nutrition advice for their patients.

To help physicians improve their knowledge and understanding of nutrition and lifestyle recommendations for their patients, the AMA partnered with suburban Chicago-based Gaples Institute for Integrative Cardiology. The institute provides an interactive, self-paced, three-hour online course that begins with a module on the magnitude and rapidity at which dietary changes can impact patient health.

“[The institute] came about through my realization as a cardiologist with over 25 years in academic university-based practice that nutrition and lifestyle played far too little of a role in every day medical decisions,” Stephen Devries, MD, a cardiologist and executive director of the nonprofit Gaples Institute for Integrative Cardiology, told AMA Wire®.

“Twenty-five years ago, I received very little education along the lines of nutrition—not in medical school, internal medicine residency, or cardiology fellowship,” he said. “I can see today there is really no more emphasis on nutrition education than there was 25 years ago.”

Inadequate training in medical school and residency prevents physicians from providing proper nutrition counseling for their patients—something the Gaples Institute aims to improve.

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There is strong evidence that the adoption of a whole food diet not only can improve wellness, but reverse disease too.

“As a cardiologist I see so many missed opportunities for using nutrition and lifestyle in health care,” said Dr. Devries. “There is strong data to support the importance of nutrition for both prevention and treatment of disease, but sadly, dietary interventions are seldom utilized to full advantage.”

The Lyon Mediterranean Diet study in the journal Circulation randomized patients with heart disease into a control or a Mediterranean-style diet. After five years, the patients using a Mediterranean-style diet experienced a 72 percent cardiovascular reduction for secondary prevention, including cardiac death and non-fatal myocardial infarction, compared to controls.

And a study in The New England Journal of Medicine that focused on Mediterranean diet as a primary prevention of cardiovascular disease was stopped prematurely because of overwhelmingly positive results. These patients exhibited a 30 percent reduction in cardiac death, stroke and nonfatal myocardial infarction.

Benefits of changing a patient’s nutrition habits and diet can be seen immediately. After just two weeks, patients with hypertension in the Dietary Approaches to Stop Hypertension (DASH) trial in The New England Journal of Medicine experienced a significant drop in blood pressure, which was sustained throughout the entire study period and averaged 11 mmHg.

“I don’t think most physicians realize that dietary changes can make that magnitude of difference,” said Dr. Devries.

AMA members are eligible for a 20 percent discount on the Gaples Institute's CME modules. Contact the Unified Service Center for the discount code at (800) 262-3211 or [email protected]AMA PRA Category 1 Credit™ is available.