Commonly accepted lifestyle factors (healthy diet, no obesity, regular exercise and not smoking) can prevent disease, disability and premature death. They have a greater impact than common interventions, such as drugs and surgery. The Institute of Medicine estimates that behavioral and environmental factors cause 70% of avoidable deaths in the United States(1). Chiuve and associates found that attention to five factors (obesity, smoking, inactivity, moderate alcohol consumption and healthy diet) can reduce the death rate by 57-62% (2).
Several diets have been proposed by Conventional Medicine, including the Mediterranean, LEARN, and DASH diets. The Ornish and vegetarian diets have lowered cardiovascular risk. Often, integrative practitioners advocate reduced carbohydrate diets, which are more effective for losing weight, reducing triglyerides, raising HDL’s and lowering high blood pressure than other diets.(3). A low carb diet is also beneficial for patients with a yeast imbalance. Patients with multiple food allergies benefit from an elimination or rotation diet. No one diet is good for everyone, but there are some common features. There should be 5-7 servings of fruits and vegetables a day with an emphasis on the latter. The fresher the better. One should avoid harmful fats, trans-fatty acids, processed foods, and simple sugars. Excessive alcohol is harmful.
Moderate aerobic exercise of 150 minutes per week is usually recommended by conventional and integrative practitioners, along with stretching and low-impact weight lifting. There is no doubt that exercise helps people feel better, and there is some effect on longevity as well. Exercise can help prevent fractures in the elderly, and it can facilitate detoxification, especially if sweating takes place. The PACE exercise program has been proposed more recently. It involves shorter bursts of exertion interspersed with periods of walking.
Excessive stress must be dealt with, one way or another, or there will be consequences. The best ways to deal with stress include meditation, progressive relaxation, biofeedback, and prayer. The ARIC study showed that if anger and excessive stress are present, it is more likely that prehypertension will lead to hypertension, coronary artery disease and cardiovascular deaths(4).
Conventional medical journals have recently published several important articles about the toxicity of low levels of lead and other heavy metals. Blood levels of lead have declined for the past 3 decades, but even low levels of lead in the body remain a “major public health problem.”(5). These levels have been associated with increased mortality from heart attacks, strokes and cancer. Heavy metals do damage by increasing free radicals. Virtually all patients should be tested for heavy metals. If even low levels of metals are found, they need to be removed with some form of chelation therapy. Other toxins permeate the environment as well. Science News reported that virtually everyone has huge chemical cocktails in their various body fluids, consisting of metals, hormones, plastics, pesticides and herbicides(6). Detoxification in the form of exercise, sauna, herbs, colon cleansing and hydrotherapy can be very helpful in ridding the body of this chemical burden.
EDTA chelation therapy has been touted by Integrative Medicine not only for its approved use of removing toxic metals but also to improve circulation throughout the body. Chappell and associates looked at a 3-year follow-up on 220 patients treated with intravenous chelation therapy and routine medications(7). A meta-analysis of comparable groups treated with conventional drugs and surgery predicted that the study group treated with chelation would have 15 MI’s, 6 deaths, 31 new angioplasties, and 16 new bypass procedures during the follow-up period. The chelation group had zero MI’s and no deaths. There were only 2 angioplasties and 6 bypass procedures required. This indicates that chelation therapy is highly effective in preventing cardiac events, probably in large part by removing toxic metals. A large randomized, controlled trial with similar end points, called the Trial to Assess Chelation Therapy(TACT), confirmed the benefits of chelation therapy in patients with known heart disease.
Integrative Medicine often works better, is cheaper and much safer than Conventional Medicine. Lifestyle factors are the basis for most Integrative Medicine, whereas they are less comprehensive and not emphasized to the same degree in Conventional Medicine.
1. Woolf SH. Potential health and economic consequences of misplaced priorities. JAMA 2007; 297:523-6.
2. Chiuve SE, McCullough ML, Sacks FM, Rimm EB. Healthy lifestyle factors in the primary prevention of coronary heart disease among men: benefits among users and nonusers of lipid-lowering and antihypertensive medications. Circulation 2006; 114:160-67.
3. Volek JS, et.al. Low-carb better than low-fat diet for lipids. Reported in Family Practice News Feb. 1, 2007, p. 11.
4. Player M, et.al. Stress and anger fuel progression to hypertension. Reported in Family Practice News Dec. 13, 2006; p. 13.
5. Menke A, Muntner P, Batuman V, et.al. Blood lead below 0.48 micromol/L(10 microg/dl) and mortality. Circulation 2006; 114:1388-94.
6. Harder B. Proof of burden: scores of contaminents course through people’s veins. Science News 2003; 163:120.
7. Chappell LT, Shukla R, Yang J, Blaha R, Born T, Hancke C, Mitchell W, Olszewer, van der Schaar P, Ventresco J. Subsequent cardiac and stroke events in patients with known vascular disease treated with EDTA chelation therapy. Evidence-Based Integrative Med 2005; 2:27-35.
Lifestyle Factors for Cardiovascular Disease-- A Closer Look
L. Terry Chappell, M.D.