In last month’s article, we looked at the devastating effect atherosclerosis has on global wellness (or lack thereof) and what some of the common causes are of this pandemic. The SAD (Standard American diet) has now been exported globally. Walk down the aisles of any supermarket, and we will find row after row of processed, or highly processed foods. These have been denuded of natural fibre, and have been stripped of natural vitamins, minerals, antioxidants and a host of health-giving phytochemicals. Although some vitamins may have been replaced, we have lost far more than have been added. On top of impoverishing our foods of their natural goodness, often a multitude of substances have been added to enhance flavour, improve appearance, and prolong shelf-life. But this must not be done to the detriment of our health, by adding excess saturated fat, salt and sugar. Highly processed foods are energy dense and thus are an important contributor to obesity.
Lack of physical activity is another compounding factor. It is strange how we drive around and around the parking area at the mall to find a parking close to the entrance, so we don’t have to walk so far, when walking is such an important part of staying healthy. We spend far too much time sitting at the desk, or on the couch, or in the car. We need to keep moving to keep our atherosclerosis (and diabetes, hypertension and dementia) at bay.
The good news is that it has been proven that narrowed arteries can open up with intensive lifestyle behaviour change. Angina often subsides within weeks, and the risk of further cardiac events becomes much less. Dr Dean Ornish was the first to publish the results of his randomised controlled trial in 1998 in the prestigious JAMA (Journal of the American Medical Association). His rehabilitation programme is now supported by American Medicare (Medical Aid), because it is as effective in the long term, or more so, as stents for non-emergency situations, and has even shown promise instead of bypass procedures. Dr Caldwell Esselstyn from Cleveland Clinic has shown equally dramatic results. It is time that this approach should be offered as a scientifically acceptable option to management of atherosclerotic disease, if not the first line of treatment, except in life-threatening situations.
Dr Dave Glass
MBChB, FCOG(SA), DipIBLM
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