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Following our first May blog, and in honor of National Stroke Awareness Month, our clinical team asked us to compile some information here about dietary best practices to reduce the risk of heart disease and stroke.

Heart disease and strokes are two of the deadliest and most costly health conditions facing Americans today. According to Centers for Disease Control and Prevention, when accounted “together, heart disease and stroke kill more Americans each year than any other cause.”

Coincidentally, and not without a bit of good fortune, they are also two of the most preventable health conditions. A few of the more manageable heart disease and stroke risk factors include diabetes, cholesterol and high blood pressure. The common denominator between these risk factors is that they can all be managed with proper diet and exercise. Nevertheless, managing risk factors associated with heart disease and stroke is a difficult challenge both at the individual and population level.

Without continued support, education and a proper frame of reference, the constant internal struggle to make healthy eating choices becomes a difficult challenge to overcome. Making matters worse, the negative emotions associated with non-adherence to healthy eating – like depression, stress and anxiety – only serve to compound these risks. Dr. Una McCann, Professor of Psychiatry and Behavioral Sciences at Johns Hopkins School of Medicine believes anxiety in specific plays a larger role in the development of heart disease than is currently believed, expressing her concern that “a really careful look at anxiety would reveal the ways it can severely impact heart disease, both as a contributing factor and as an obstacle in recovery.”

Would you be willing to make the necessary dietary changes if your life depended on it? Life-threatening heart failure becomes a reality for thousands of people every year, and beyond that, many more individuals suffer from the often-devastating repercussions of sustaining a major stroke – which likely could have been avoided through better mental health awareness, diet adherence and exercise. Had somebody detected the risks, warned the individuals and guided them through prevention steps in a timely manner, then perhaps even heart disease could have been avoided altogether.


Keys To Minimizing Risks

Healthy eating habits, proper sleep and exercise are among the few proven methods for maximizing health outcomes while minimizing health risks.

Most people acknowledge this fact, and understand that a consistent and healthy diet is paramount for preventing health complications, such as heart disease and stroke, from developing. Yet, according to, “at least 48 percent of all adults in the United States have some form of cardiovascular disease.” Meaning that the diet of almost half of U.S. adults is falling short of fostering a healthy heart.

As a result, obesity rates (a major heart disease contributor and risk factor) in America are high. “According to the most recent Behavioral Risk Factor Surveillance System (BRFSS) data, adult obesity rates now exceed 35% in seven states, 30% in 29 states and 25% in 48 states.” Considering the prevalence of contributing risk factors, and the ineffective efforts to mitigate them, it is not surprising then that heart disease deaths have been on the rise – with a 4% increase from 2011 to 2017.

Though there may not be a magic pill guaranteed to fix health problems or prevent looming health risks from actualizing, there is good news. According to Dr. Mariell Jessup, Chief Science and Medical Officer at the American Heart Association, “The good news about cardiovascular disease and stroke is that 90% of cardiovascular disease is preventable.” Below are some helpful tips and recommendations that can reduce the risk of heart disease and stroke.

  • Eat slowly, breaking food down for easier digestion

  • Cook for yourself – using as many fresh ingredients as possible

  • Consume less than or equal to 2,300 mg of sodium per day

  • Seek mental health support, and participate in activities that reduce stress levels such as meditation, yoga or a relaxing hobby

  • Limit alcohol consumption

  • Monitor and manage blood pressure

  • Maintain physical activity

Additionally, heart-healthy diets are effective at reducing the risk of heart disease. A great example of an effective heart-healthy diet is the DASH (Dietary Approaches to Stop Hypertension) diet. This plan was originally designed to help individuals manage blood pressure, a major contributing risk factor of heart disease and stroke. Our clinical team was inspired to read that it was also recently proven to reduce the risk of developing heart failure by almost half. “A study of 4,500 people over 13 years and published in the American Journal of Preventive Medicine comes to some surprising conclusions.” “A diet that helps people reduce high blood pressure or hypertension may also reduce the risk of heart failure in people under the age of 75, according to research published in the latest edition of the American Journal of Preventive Medicine.” The article mentions that prior research either didn’t examine the effects of the DASH diet on heart failure, or weren’t conclusive. This time the research was conclusive – adding more benefits to an already very beneficial eating plan.

The DASH diet recommends:

  • Eating vegetables, fruits, and whole grains

  • Including fat-free or low-fat dairy products (and cutting out full cream), fish, poultry, beans, nuts, and vegetable oils

  • Limiting foods that are high in saturated fat, such as fatty meats, full-fat dairy products, and tropical oils such as coconut, palm kernel, and palm oils

  • Limiting sugar-sweetened beverages and sweets

  • Limiting alcoholic beverages

Click here to access a pdf of the complete DASH eating plan.


Another important area of focus is reducing artificially sweetened beverage intake. The seven-year Framingham Heart Study, found that consumption of one artificially sweetened beverage per day potentially makes the event of a stroke 2.96 times more likely. According to, participants in the study “who said they drank at least one artificially sweetened soda a day were about twice as likely to have a stroke over the following decade when compared to those who drank less than one a week. Drinking regular, sugar-sweetened sodas or beverages did not appear to raise stroke risk.” Furthermore, the study results indicate that people who consumed more than one soda a day had a higher risk of stroke regardless of sweetening method. An important detail to note from this study is that beverages marketed as healthy with words like diet can still contribute to stroke and heart disease risks. Also, of note, the study does not prove or claim causation, but rather a correlation between artificially sweetened beverages and risk of stroke. For maximum health outcomes its best to limit intake of sugar-sweetened and artificially sweetened beverages altogether.

Cooking at home with as many fresh ingredients as possible, and avoiding snacking, restaurant foods (including fast food and take-out food) is also highly recommended because people don’t control what goes into their meals when they don’t prepare it themselves. This results in the consumption of more processed foods and foods higher in fat, sugar and sodium. According to the American Cancer Society, people eat an average of 200 calories more per meal when they eat food from restaurants.


Healthcare Industry’s Role

Combining as the leading cause of American deaths, heart disease and stroke are dangerous, rampant and persistent. Healthcare industry professionals are working diligently to provide as much support as possible for the American public relative to heart disease prevention.

Initiatives like consistent research and innovations in technology use are great tactics healthcare industry leaders employ in the fight against heart disease. However, according to there is room for improvement when it comes to “defining and measuring overall cardiovascular health, assessing and communicating lifetime risk for cardiovascular disease, and addressing anxiety” and depression as risk factors. A few key objectives the healthcare industry should further aim to improve are listed below, per

Identifying risk is key for health prevention initiatives, and innovations are being made in this area. As an example, USA Today recently ran an article titled, “How many push-ups can you do? Study finds men who can do 40 have lower risk of heart disease” which covered a study by researchers at the Harvard T.H. Chan School of Public Health. The study determined that for men, “push-up capacity could be an easy, no-cost method to help assess cardiovascular disease risk in almost any setting.”

Health analytics technology is making great strides in identifying individuals with and at-risk for heart disease, heart attacks, strokes and more. Thanks to significant advances in predictive analytics technology, those at-risk individuals can be identified earlier, and provided the support they need. Analytics have proven particularly adept at helping to identify those who are slipping through the cracks of existing case, disease and chronic condition management programs.

This technology can further help prioritize screening initiatives, track cardiovascular health at the individual and population levels, identify individuals in need of behavioral health support and can assist case managers in communicating pertinent cardiovascular disease education to the right individuals in a timely manner.

Click here to schedule time to learn more about how our Poindexter’s predictive analytics are helping clients to proactively identify those in their population predicted to have heart attacks and strokes so that they may offer proactive intervention and support.


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