Healthy eating plays a role in decreasing the risk for cardiovascular disease and other chronic illnesses.
Widespread use of electronic health records can potentially make it easier for physicians to ask and follow up with patients about eating patterns.1
U.S. healthcare costs are growing, with nearly half of annual expenditures attributable to obesity-related conditions.1
A quick, simple questionnaire in the doctor's office can help fight one of the leading risks for cardiovascular disease — a poor diet.
Many people have heard about healthy diet recommendations: Eat plenty of fruits, vegetables, and whole grains. Choose fat-free and low-fat dairy products. Eat fewer foods with added sugars and salt.2
It’s also important to talk about healthy eating patterns based on an individual’s lifestyle and preferences. “A primary care physician can get this conversation started,” said Alice H. Lichtenstein, D.Sc., senior scientist and director of the Cardiovascular Nutrition Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University in Boston.
An American Heart Association scientific statement co-authored by Lichtenstein calls for some form of dietary assessment, counseling, and follow-up during routine medical visits.
“Once a healthcare professional understands the foods and beverages someone is regularly consuming, it’s possible to consider small achievable tweaks that will result in an improvement,” Lichtenstein said.
“There are a lot of heart-healthy dietary patterns out there, there is no need to feel deprived or give up one’s favorite foods,” she added. “Sometimes it’s a matter of cutting down on portion size or frequency and replacing it with healthier options.”
Expanding screening
Sometimes quality screening is overlooked during an office visit because of competing demands and lack of training, knowledge, time, and reimbursement.3 Today’s widespread use of electronic health records could potentially make it easier for healthcare professionals to incorporate a rapid diet screening tool into routine clinical practices, the AHA statement noted. It didn’t endorse specific screening tools but pointed out some that are available and highlighted criteria such as reliability, brevity, ease of use, and application to diverse racial and socioeconomic backgrounds.1
“Asking a few succinct questions in a checkup might reveal whether a patient’s eating pattern is filled with sugar-sweetened beverages,” Lichtenstein said, “or whether a diet is heavy in processed, meat-based meals."
“Advice for healthier eating may be different for someone who is the ‘gatekeeper’ choosing food for their household versus someone who tends to eat what’s available,” she explained.
Checking on the progress of dietary goals would happen in a future medical visit or, in some cases, through referral to a dietitian, according to the AHA statement. “There has not been a large-scale scientific study on the effectiveness of rapid dietary assessment tools, but it’s time to find out,” Lichtenstein added.
Researchers do know that unhealthy diets are costly. About 11 million deaths, or half the heart disease deaths worldwide, can be blamed on a poor diet. Furthermore, as of 2016, U.S. healthcare spending had reached 17.9% of the gross domestic product, with nearly half of that attributable to obesity-related conditions ($1.42 trillion/year).1
Keys to healthy eating
It helps to think about diet beyond individual foods or nutrients and consider overall patterns.4 A healthy eating pattern includes a variety of fruits and vegetables; foods made with whole grains rather than refined grains; and healthy sources of protein from plants, seafood, and low-fat or fat-free dairy products. Meat or poultry should come from lean cuts and in unprocessed forms.4
Try to limit consumption of foods and beverages with added sugars and buy and prepare foods with little or no salt. If you don’t drink alcohol, don’t start. If you do drink, limit alcohol intake.4 Make sure to get enough physical activity to maintain a healthy body weight.
“It’s not usually feasible to change all eating habits at once,” Lichtenstein said. Begin improving your diet by reducing your intake of sugary foods or those high in salt, and try to limit portion sizes.
“Including more fruits and vegetables in your eating plan can be done with frozen forms. They are readily available, don’t spoil, and are especially handy for soups and stir fry dishes or adding to yogurt or cereal,” Lichtenstein explained. They usually cost less than fresh produce and favorites are available year-round. “Frozen veggies are great for cooked dishes, yet the myth persists that nutritionally they aren’t as good as fresh when in reality they are as good or better,” she said.
Long-term benefits
Healthy eating aids in reducing risk or managing cardiovascular disease and other chronic illnesses. A healthy dietary pattern may lower the risk of high blood pressure, cardiovascular disease, and glucose levels, help prevent weight gain and maintain the body’s main organs, including the brain, eyes, heart, and kidneys.5
A nutritious eating pattern is one of the American Heart Association’s Life’s Essential 8™, which are health measures intended to lower the risk for heart disease, stroke, and other major health problems. The other factors are maintaining a healthy weight, being physically active, getting enough sleep, controlling cholesterol, managing blood sugar, controlling blood pressure, and eliminating inhaled nicotine from cigarettes, vaping, and second-hand smoke.6
If a diet discussion isn’t part of your routine medical checkup, ask your primary care physician for a quick evaluation. “Ideally, the healthcare professional should engage with the patient, pointing out that healthy eating is not too overwhelming or expensive,” Lichtenstein said.
Following up is crucial. “If there’s reinforcement for even small changes during the next visit,” she said, “that’s going to communicate that the physician thinks diet is important.”
Things to consider
Switching to a healthier dietary pattern can begin with a few improvements, such as finding alternatives to sugary beverages and controlling food portion size.
Consider asking your healthcare professional for a quick diet evaluation if it’s not part of your regular checkup.
Eating more fruits and vegetables doesn’t have to be expensive; choosing those in season or using frozen fruits and vegetables are just as healthy as fresh produce and usually cost less.
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