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Nutritional Therapy and the Management of Cardiovascular Disease
Introduction
Cardiovascular diseases, CVDs, continue to cause deaths, despite improvements in medical research and clinical practices. CVDs mortality rates have continued to rise, such that in the next 20 years, CVDs are expected to cause more than 23 million deaths. As a result, numerous treatment methods have been developed. These include medication, regular physical exercises, and nutritional therapy. While medication and regular physical exercises provide prevention and cure for CVDs, nutrition-based treatment is a cost-effective and easy-to-implement treatment method. However, effective nutritional therapy requires the assessment of the patients nutritional and medical history, which helps in identifying the patients nutritional needs. In light of this, various medically acceptable standards govern nutritional assessment.
These standards seem to be necessitated by controversies surrounding research findings on nutritional therapy. This paper aims at evaluating medically acceptable standards on nutritional assessment. It also provides an assessment of medically acceptable nutritional therapy for the prevention and cure of CVDs.
Cardiovascular diseases; the background
The World Health Organization asserts that CVDs are the leading causes of death and disability in the world (WHO n.pgn). Cardiovascular diseases, CVDs, are a group of diseases that affect the human heart and related parts, such as the aorta, aortic valves, Endocarditis, among others (Maton 34 to 38). The World Health Organization further adds that for the last two decades, CVDs mortality rates in developed countries have dropped (WHO n.pgn). This implies that the prevalence of CVDs remains high in developing countries. Demographically, men are at a higher risk of CVDs than women (Maton 36).
While research identifies numerous causes of CVDs, the primary cause is thought to be an imbalance of the ratio between two lipoproteins namely LDL and HDL. Other causes of CVDs include a very high level of blood sugar, hypertension, and prolonged exposure to air pollutants such as mercury. It is also thought that the intake of unhealthy foods, as well as irregular eating habits, increases the risk of CVDs.
Nevertheless, debate still rages on about certain controversial research findings. For instance, some researchers claim that a moderate intake of alcoholic drinks reduces the risk of CVDs. These findings have elicited mixed reactions. Arguments to the effect that alcohol intake increases the intake of refined sugars associated with the occurrence of CVDs abound. Nevertheless, The World Health Organization offers medically acceptable standards on prevention and cure of CVDs.
Research on medically acceptable nutritional assessment standards
According to the World Health Organization 2010, CVD mortality is estimated to be 17.3 million. Despite improvements in medical research, the World Health Organization estimates that by the year 2030, CVDs will cause more than 23 million deaths annually (WHO n.pgn). One of the most effective methods for the management of CVDs is nutritional therapy. Current and past research works indicate that nutritional therapy is not effective unless certain nutritional assessment standards are adhered to. Nutritional assessment is a multidimensional approach aimed at identifying a patients nutritional requirements. Nutritional assessment leads to the development of patient-specific nutritional therapy. It involves the assessment of a patients diet and medical history as well as recording anthropometric patient measurements (Worthington 3).
According to Worthington (2), developing a nutritional therapy requires a thorough assessment of the type of CVD affecting each patient. This implies that in managing CVDs, the one-size-fits-all approach is not applicable. As Lee (646-653) asserts, major nutritional assessment involves the identification of the prevailing cardiovascular disease as well as its cause. Additionally, evaluating the medical history of patients and at-risk individuals is a prerequisite in designing a nutritional treatment plan. In light of these assertions, Charney (45) asserts that regulatory requirements have increased in scope, such that differentiating between nutritional screening and nutritional assessment is now possible. Research by Worthington asserts that nutritional screening is a major component of nutritional assessment (1).
Nutritional screening involves assessing a patients nutritional history as well as measuring a patients anthropometric data. Anthropometric data captures a patients mass, weight, sugar and fat levels, height as well as the level of the patients blood pressure. Thus, the National Center for Chronic Disease Prevention and Health Promotion identifies nutritional assessment as a major requirement in the management of CVDs. Assessing a patients nutritional requirements is based on thorough nutritional screening (Worthington 2). Additionally, research by the University of Washington reveals that nutritional screening and assessment works when closely monitored by physicians and dieticians. This implies that nutrition screening and assessment programs seem to be medically acceptable standards in the management of CVDs.
As explained herein, proper diagnosis as well as conducting an accurate nutritional assessment enables physicians to design appropriate nutritional therapy. However, research by Olendzki, Speed, and Domino reveals that certain factors, such as patients attitudes towards dieting and certain diet components affect the effectiveness of nutritional therapy in the management of CVDs (264). In light of this, The U.S. Preventive Services Task Force has identified nutritional counseling as a major requirement (257). Nutritional counseling helps patients adjust negative attitudes towards certain dietary habits. It also helps patients adapt to, and accept healthy eating habits.
A discussion of medically acceptable nutritional therapy and the management of CVDs
According to the World Health Organizations statistics, the CVDs mortality rate is expected to rise in the next 20 years. By the year 2030, the World Health Organization estimates that CVDs are likely to cause more than 23 million deaths annually (WHO n.pgn). This is an alarming figure bearing in mind that research in the prevention and cure of CVDs has intensified. This indicates that CVDs are among the leading causes of death globally. The occurrence of CVDs is attributed to several causes, including unhealthy eating habits, exposure to air pollutants, an imbalance in the ratio between two lipoproteins namely LDL and HDL, among others.
The World Health Organization further suggests several methods through which CVDs can be prevented and cured. These include medication, regular exercise, and proper nutrition (WHO n.pgn; Maton 36). The term proper nutrition is synonymous with the term nutritional therapy. Nutritional therapy, according to the World Health Organization, is a cost-effective method for preventing and curing CVDs. It is a multidimensional approach in the management of CVDs and involves the intake of healthy foods as well as the avoidance of unhealthy diet components (WHO n.pgn). Effective nutritional therapy is discussed elsewhere in this essay.
Several factors affect the effectiveness of nutritional therapy in preventing and curing CVDs. As explained by Mason (34 to 38), CVDs are a group of ailments that affect the heart and related parts. Each ailment has its cause. This implies that in developing a treatment method, identifying the prevailing type of CVD seems to be an overarching requirement.
Since each patient requires a unique treatment plan, proper diagnosis helps physicians and dieticians to determine the most appropriate nutritional therapy for each patient.
It is evident that in designing nutritional treatment plan, the one-size -fits-all approach is inapplicable as far as managing CVDs is concerned. Effective prevention and treatment of CVDs requires nutritional assessment for each patient. Conducting thorough nutritional assessment is complicated process, which also requires accuracy in obtaining data on a patients nutritional needs. Therefore, nutritional screening seems relevant (Worthington 1, 2).
Nutritional screening precedes nutritional assessment and involves evaluating a patients medical and diet history (Worthington 2). This helps physicians identify links between a patient dietary habits and the prevailing CVD. Additionally, these results are correlated with a data from a patients anthropometric measurements. It is important to note that significant variations in these measurements indicate a patients health status, especially with regards to CVDs. Such correlations also enable physicians and dieticians to design a proper nutritional plan for each CVD patient.
As explained earlier, nutritional therapy is a cost effective method for treating and preventing CVDs. According to Olendzki, Speed and Domino, nutritional therapy is a two phase process (258). Most people believe that avoiding the intake of unhealthy dietary items eliminates the occurrence of CVDs. Unhealthy dietary habits include smoking and exposure to second hand tobacco smoke as well as sustained intake of alcohol (Jani and Rajkuma 357 to 362).
However, there are other unhealthy eating habits. These include sustained intake of foods rich in polyunsaturated fats, refined sugars as well as saturated fats. Additionally, intake of more than one tablespoonful of salt is highly discouraged. Foods rich in these components are associated with occurrence of certain types CVDs. Additionally increased intake of animal proteins, mostly found in red meat is also associated with occurrence of CVDs (Jani and Rajkuma 359).
From the assertions made above, one is likely to conclude that avoidance of the foods mentioned above eliminates the risk of CVDs. Jani and Rajkuma (359) warn against intake of animal proteins especially those found in red meat. This does not imply that proteins are necessarily unhealthy diet items. Olendzki, Speed and Domino assert this and further suggest that CVD patients ought to substitute animal proteins with plant proteins (259). Plant proteins are readily available from leguminous plants, vegetables and whole grain meals such as beans, walnuts, chickpeas, lentils, broccoli, among other food items.
Together with fruits, these foods also provide CVD patients with low fat diet, which further reduces the intake of unhealthy fats. Bearing in mind that intake of foods rich in polyunsaturated and saturated fats causes most types with CVDs, a proper nutritional therapy ought to contain as sufficient amounts of plant proteins. CVDs are not only aggravated by polyunsaturated and saturated fats, but also by omega-6 fatty acids. To mitigate the influence of omega-6 fatty acids, Olendzki, Speed and Domino suggests that patients ought to increase intake of vegetables and soybeans (259. These foods are, rich in omega-3 fatty acids. Intake of these foods corrects the imbalance of omega-3 and omega-6 fatty acids , which reduces the risk of CVDs (Olendzki, Speed and Domino 260).
Fruits contain very high levels of sugar. Suggestions made to increase intake of fruits seem to contradict earlier assertions that increased intake of fruits reduces the risk of CVDs. Intake of fruits increases the intake of sugars. Increased intake of sugars, according to the World Health Organization, is unhealthy and causes CVDs. However, Olendzki, Speed and Domino explain that only refined sugars pose significant threat (260). As such, intake of sweetened beverages including alcohol is highly discouraged (Olendzki, Speed and Domino 261).
Designing a nutritional therapy may not necessarily work, due to the fact that each patient has unique nutritional requirements. In addition to this, a patients attitude towards certain nutritional component affects the effectiveness of nutritional therapy. However, as indicated by Lee (646-653) and Worthington (2), nutritional assessment involves identifying specific nutritional requirements for each patient.
Based on data derived from each patient, physicians and nutritionist are able to design an individual-specific nutritional treatment plan containing essential nutritional components. To improve the effectiveness of nutritional therapy especially for patients with maladjusted attitudes, nutritional counseling seems to be the most effective course of action (Olendzki, Speed and Domino 257). Nutritional counseling helps patients and at-risk individuals adjust their attitude appropriately as well as adapt to new dietary habits. This further increases the effectiveness of nutritional therapy.
Conclusion
It is unfortunate that CVDs continue to cause deaths, despite advancement in research and medical technology. Most of these deaths are preventable through readily available solutions such as medication, regular exercises and proper nutrition. Yet CVDs mortality rates continue to rise. While the increase in CVD mortality rates is attributed to poor lifestyles, inaccessibility to crucial information on the effects of nutrition seems to be a risk factor. Most people are unaware of the fact that CVDs can be adequately managed through proper nutrition. Additionally, patients nutritional attitudes seem to affect the effectiveness of nutritional.
Therefore, an effective nutritional therapy is preceded by nutritional counseling. The occurrence of CVDs is attributed to various causes, each requiring different solution. Each patient has unique treatment needs. This implies that nutritional therapy is only effective if designed for individual patients. Nutritional therapy is a cost effective method of preventing and curing CVDs. Nevertheless, each patient requires a nutritional plan based on the patients nutritional and medical needs. Additionally, nutritional counseling improves the effectiveness of nutritional therapy. Thus an effective nutritional therapy for CVD patients is patient -specific as well as proceeded by nutritional counseling.
Recommendations
Designing a nutritional therapy calls for collaboration between nutritionists and physicians. Nutritional counseling is a major requirement if success is to be attained. Nevertheless, nutritionists and physicians lack basic communication and counseling skills. This is a major barrier for physicians and nutritionists counseling CVD patients (Olendzki, Speed and Domino 257). As such, physicians and nutritionists require basic training on communication and counseling skills. Additionally, nutritional assessment relies on data from a patients diet history. Obtaining such data is prone to errors since it relies on memory. Accuracy in data gathering improves clinical decision making. As such, this is an area that requires urgent attention.
Works Cited
Charney, Pamela. Nutrition Screening vs Nutrition Assessment: How Do They Differ? Nutritional Clinical Practice. 2008. Web.
Jani Brani, and Chris Rajkumar. Ageing and vascular ageing. Postgraduate Medical Journal. 82 (2006):357-362. Print.
Lee, Clark. Indices Of Abdominal Obesity Are Better Discriminators Of Cardiovascular Risk Than BMI: A Meta-Analysis. Journal of Clinical Epidemiology. 61(2008): 646-653. Print.
Maton, Anthea. Human Biology and Health. Englewood Cliffs, New Jersey: Prentice Hall. 1993. Print.
Olendzki, Barbara, Christopher Speed and Frank Domino. Nutritional Assessment and Counseling for Prevention and Treatment of Cardiovascular Disease . America Family Physician. 2006. Web.
WHO. Cardiovascular Disease. 2012. Web.
Worthington, Patricia. Nutritional Assessment and Planning in Clinical Care. n.d. Web.
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