Lifestyle changes necessary for mitigating cardiometabolic risk

Christos S. Mantzoros

PHILADELPHIA — Lifestyle modifications, such as adherence to a healthy diet, smoking cessation and adequate exercise, are a must to help reduce cardiometabolic disease risk, according to a presenter here.

“This is a very important topic that is often overlooked,” Christos S. Mantzoros, MD, professor of medicine at Harvard Medical School said, acknowledging that research on lifestyle changes for reducing cardiometabolic risk is not as robust as that for some medications.

“We now start understanding the mechanisms, … it’s cumbersome and time consuming for clinicians to give practical advice and so we prefer to outsource to dieticians,” Mantzoros told Endocrine Today.

However, with more than 30% of the U.S. population currently obese, and more than one-third overweight, patient and clinician apathy is not an option, Mantzoros said. He offered suggestions to share with patients to reduce their cardiometabolic risk:

Encourage adherence to Mediterranean, DASH and plant-based diets;
Consume more monounsaturated and polyunsaturated fats, and less trans and saturated fats;
Cease smoking, or never start;
Drink one alcoholic beverage or less per day for women, and two alcoholic drinks or fewer per day for men, and drinking the alcohol ideally with meals;
Engage in sedentary activities for less than 30 minutes at a time, and perform 150 minutes or more of moderate-intensity exercise per week, exercising most days of the week; and
Ensure BMI is between 20 kg/m² and 25 kg/m² or as close to normal as possible

These changes will not lower cardiometabolic risk and BMI overnight, but patients will see improvement over time, Mantzoros said.

“It is very important to realize it takes a long time to make changes to one’s lifestyle, but the benefits are so important,” he said.

Other changes to benefit cardiometabolic health can be made on a larger scale, Mantzoros said. He suggested encouraging municipal governments to create an environment that would allow physical activity (such as recreational facilities with walking trails and bike paths) and state and federal governments to consider public health measures, such as levying taxes on high-sugar drinks and high-salt foods, promoting applied clinical research on obesity instead of research in animals that do not resemble humans, and considering reimbursement of clinical care measures that would promote prevention and treatment of obesity.

“The way many of us currently live our lives, the way we eat, the way we exercise, leads to more obesity and cardiometabolic risk; but making changes … can lead to better outcomes later in life,” Mantzoros said. – by Janel Miller

Reference: Mantzoros CS. The role of lifestyle modification in the prevention and management of cardiometabolic risk: Clinical recommendations and underlying mechanisms. Presented at: Heart in Diabetes Clinical Education Conference; July 13-15, 2018; Philadelphia.

Disclosure: Mantzoros reports he receives grant support through his institution from NIH and is a shareholder of Pangea Inc.