The American Heart Association is urging doctors to take a prevention-based approach[1] to helping patients instead of only a treatment-based one.


In a policy statement published in the journal Circulation[2] outlining the organization's goals for 2020, the AHA noted that doctors should do more to help patients turn around unhealthy lifestyle behaviors, such as smoking or not exercising, and not just treat heart disease and the risk factors for it.


"We're talking about a paradigm shift from only treating biomarkers -- physical indicators of a person's risk for heart disease -- to helping people change unhealthy behaviors, such as smoking, unhealthy body weight, poor diet quality and lack of physical activity," Bonnie Spring, Ph.D., the lead author of the statement and professor of preventive medicine and psychiatry and behavioral sciences at Northwestern University, said in a statement.


Authors of the statement noted that the AHA's 2010 goal of cutting stroke, coronary heart disease and risk for the conditions by 25 percent was met by doctors treating the diseases.


But "to avoid bankrupting the healthcare system, we must improve the distribution of cardiovascular health levels across the population by preserving cardiovascular health from childhood and by treating health risk behaviors to help more individuals improve their cardiovascular health into older ages," they wrote in the statement. They said there are three ways to do this: promotion of a healthy lifestyle, treating unhealthy behaviors as well as risk biomarkers (like obesity and high blood pressure), and amping up public health promotion strategies.


The statement also noted best practices for doctors to connect their patients with other health specialists who can help turn around unhealthy behaviors. The practices involve looking at a patient's heart risks, suggesting changes, agreeing together on a plan for change, helping with treatment and arranging follow-up care.



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  • Salmon


    The American Heart Association recommends <a href="http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyDietGoals/Fish-and-Omega-3-Fatty-Acids_UCM_303248_Article.jsp#.TymfZePLzwc" target="_hplink">eating fish twice a week</a> -- especially fatty fish like salmon, which is rich in omega-3 fatty acids. Omega-3s can reduce the risk of arrthymias, slow plaque build up in the arteries, lower cholesterol and slightly lower blood pressure.


    <em>Flickr photo by <a href="http://www.flickr.com/photos/wallslide/3109583081/" target="_hplink">Jeremy Hall</a></em>




  • Olive Oil


    Switching from butter to olive oil (or even <a href="http://www.rd.com/health/the-great-olive-oil-misconception-dr-ornish-responds/" target="_hplink">olive oil to canola oil</a>) can <a href="http://www.huffingtonpost.com/eatingwell/healthy-foods_b_1199933.html" target="_hplink">lower cholesterol levels</a>. The "healthy" monounsaturated fats found in olive oil are still fats however, so use in moderation.


    <em>Flickr photo by <a href="http://www.flickr.com/photos/trixer/3799291822/" target="_hplink">Thomas Ricker</a></em>




  • Nuts


    A large 2011 study found that <a href="http://www.ncbi.nlm.nih.gov/pubmed/22207512" target="_hplink">swapping nuts for red meat</a> as a leaner source of protein resulted in a 17 percent lower risk of stroke. The unsaturated fat in nuts can help reduce cholesterol in comparison to eating red meat, but nuts are still high in fat and calories, so be aware of portion sizes.


    <em>Flickr photo by <a href="http://www.flickr.com/photos/s58y/4415406430/" target="_hplink">s58y</a></em>




  • Berries


    Berries are rich in a type of antioxidant called polyphenols, which can lower blood pressure and <a href="http://www.ajcn.org/content/87/2/323.abstract" target="_hplink">boost "good" HDL cholesterol</a>.

    A 2011 study focussed on blueberries found that they contain a compound called anthocyanins (also found in other dark fruits like raspberries) that can <a href="http://www.uea.ac.uk/mac/comm/media/press/2011/January/berries" target="_hplink">protect against high blood pressure</a>.


    <em>Flickr photo by <a href="http://www.flickr.com/photos/kimberlykv/4810740536/" target="_hplink">Kimberly Vardeman</a>
    </em>




  • Oatmeal


    The <a href="http://www.sciencedaily.com/releases/2012/01/120111103854.htm" target="_hplink">soluble fiber</a> in oatmeal (as well in other whole-grain foods, fruits and vegetables) <a href="http://www.mayoclinic.com/health/cholesterol/CL00002" target="_hplink">reduces the absorption of "bad" LDL cholesterol</a> into the bloodstream, <a href="http://www.health.com/health/gallery/0,,20307113,00.html" target="_hplink">helping to keep arteries clear</a>.


    <em>Flickr photo by <a href="http://www.flickr.com/photos/nate/359386784/" target="_hplink">Nate Steiner</a></em>




  • Soy


    While the <a href="http://www.webmd.com/cholesterol-management/features/low-cholesterol-soy-protein" target="_hplink">cholesterol-lowering claims</a> of soy protein <a href="http://www.webmd.com/heart/news/20060123/soys-heart-benefits-questioned" target="_hplink">have been debated</a>, there's no question that it's a low-fat source of protein when compared to fattier options, like red meat.


    <em>Flickr photo by <a href="http://www.flickr.com/photos/ev0luti0nary/6746428573/" target="_hplink">Adriane Dizon</a></em>




  • Dark Chocolate


    Thanks to compounds called <a href="http://www.huffingtonpost.com/2011/10/11/chocolate-stroke-prevention_n_1004426.html" target="_hplink">flavonoids that operate like antioxidants</a>, satisfying that sweet tooth can actually lower bad cholesterol, reduce blood pressure and prevent blood clots.


    <em>Flickr photo by <a href="http://www.flickr.com/photos/chocolatereviews/4724615475/" target="_hplink">Lee McCoy</a>
    </em>




  • Popcorn


    When air-popped (read, not drenched in butter and smothered in salt), popcorn is actually a surprisingly <a href="http://abcnews.go.com/Health/WellnessNews/story?id=8356993#.TymrBuPLzwc" target="_hplink">good source of heart-healthy antioxidants and fiber</a>, according to a 2009 study, because it's technically a whole grain.


    <em>Flickr photo by <a href="http://www.flickr.com/photos/superiphi/2521340333/" target="_hplink">Joelle Nebbe-Mornod</a></em>




  • Tomatoes


    Tomatoes are the <a href="http://www.sciencedaily.com/releases/2011/03/110301091338.htm" target="_hplink">biggest source of lycopene</a> (a powerful antioxidant) in the American diet, according to a 2011 review of literature on the topic. While more research is needed still, preliminary experiments suggest that lycopene could play a role in <a href="http://www.ncbi.nlm.nih.gov/pubmed/21291369" target="_hplink">preventing cardiovascular problems</a> due to its <a href="http://www.ncbi.nlm.nih.gov/pubmed/22076972" target="_hplink">anti-inflammatory properties</a>.


    <em>Flickr photo by <a href="http://www.flickr.com/photos/33909700@N02/3158937163/" target="_hplink">Dave Stokes</a></em>




  • Seaweed


    Just like their leafy, green, land-grown counterparts, seaweeds pack some impressive benefits for the heart, including <a href="http://www.sciencedaily.com/releases/2011/09/110913184059.htm" target="_hplink">antioxidants and even some good fats</a>.


    <em>Flickr photo by <a href="http://www.flickr.com/photos/khawkins04/5473790679/" target="_hplink">Ken Hawkins</a></em>




  • Potatoes


    Sweet potatoes are packed with disease-fighting antioxidants, and both sweets and regular <a href="http://shine.yahoo.com/healthy-living/5-foods-that-are-surprisingly-good-for-your-heart-2450980.html" target="_hplink">spuds contain fiber and potassium</a>, <a href="http://www.webmd.com/heart-disease/potassium-and-your-heart" target="_hplink">key in keeping your heart functioning</a> its best.


    <em>Flickr photo by <a href="http://www.flickr.com/photos/22280677@N07/2201327206/" target="_hplink">Svadilfari</a></em>




  • Coffee


    A 2011 study suggests that coffee is one of the <a href="http://www.sciencedaily.com/releases/2011/05/110504095630.htm" target="_hplink">biggest sources of antioxidants</a> in the average person's diet, and that caffeine is actually behind the heart-healthy effects of that morning (or afternoon) pick-me-up. Although more research is still needed to more clearly understand the process of how caffeine counteracts free radicals in the body, it seems to help fight heart disease, Alzheimer's and more.


    <em>Flickr photo by <a href="http://www.flickr.com/photos/dyobmit/18588671/" target="_hplink">Timothy Boyd</a></em>




  • Alcohol


    A 2011 review published in the "British Medical Journal" found a 14 to 25 percent <a href="http://www.bmj.com/content/342/bmj.d671" target="_hplink">drop in heart disease</a> in moderate alcohol drinkers compared to teetotalers.

    For years, research has flip-flopped on the healthy or not debate over alcohol. While once-heralded <a href="http://www.huffingtonpost.com/2011/10/19/red-wine-health_n_1018934.html" target="_hplink">resveratrol might not be worth all the hype</a>, a recent Spanish study suggests it's <a href="http://www.ajcn.org/content/95/2/326.abstract" target="_hplink">alcohol itself that has cardiovascular benefits</a>, not just the compounds in red wine.


    <em>Flickr photo by <a href="http://www.flickr.com/photos/dinnerseries/5958666230/" target="_hplink">Dinner Series</a></em>




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