According to the American Heart Association, there is a strong correlation between cardiovascular disease (CVD) and diabetes. At least 68 percent of people aged 65 or older with diabetes die from some form of heart disease; 16 percent die of stroke. Adults with diabetes are two to four times more likely to have heart disease or a stroke than adults without diabetes.

How does that impact you? Well, if you suffer from diabetes, there's a chance that some simple lifestyle changes could save your life, preventing the progression of chronic heart disease. The American Heart Association outlined the seven major controllable risk factors for cardiovascular disease, which include:

• Hypertension
• High Cholesterol/Triglycerides
• Obesity
• Diabetes
• Inadequate Exercise
• Smoking
• Non-compliance with Medications

As a clinical educator, I see all seven of these every single day. In the Cardiac Rehabilitation Department at the hospital, these are the key issues, beside or in conjunction with diabetes, that bring individuals to us for Cardiac Rehab.

My approach to helping them turn these things around is sometimes different than that of their practicing physician. It's an approach I wish had been offered to them from the very beginning, especially since so many of them are taking medications that are not only expensive, but come with painstaking side effects.

1. Hypertension

When patients come to see me, I ask them series of questions to gauge knowledge and awareness of their condition:

• Are you taking medications for your hypertension? Please name your blood pressure medications.
• What are your blood pressures running?
• Aside of your medications, what are you doing to help reduce your blood pressure?
  • Exercise?
  • Sodium Reduction?
    • If so, what is the restriction?
    • Are you counting it? How?

Knowledge is the first step in helping reverse a condition, and when patients show me that they are in tune with their health and their bodies, they're much more likely to successfully overcome their condition.

2. Cholesterol

Cholesterol usually rises when the diet is low in vegetables and fruits and high in meats, starches, and/or processed foods. Cholesterol issues have usually been met with statins. The research is varied on the use of CoQ10, folic acid, aspirin, medication timing, etc., but one thing is certain: my patients are not on soluble fibers like psyllium fiber or oat bran and their doctor has not discussed either with them. Nutrition is number one when it comes to cholesterol control and adding soluble fiber like psyllium or oat bran fiber is the nutrition component that will make the biggest difference when basic nutrition falls short.

3. Triglycerides

Another important factor of your health that should be addressed through nutrition before prescriptions! It is well known that triglycerides rise when an excess of carbohydrate is being stored as fat when there is a lack of physical activity. The first line defense is to reduce the amount of carbohydrates you eat. Next, ensure you are consuming enough omega-3 fatty acids, specifically eicosopentanoic acid (EPA), often found in fish, algae, or fish oil and algae supplements. Then, ensure adequate fiber consumption, and, finally, get exercising!

4. Obesity

Obesity is a taboo topic in most physicians' offices, unless they're selling you some sort of quick diet program. It doesn’t seem to get addressed unless the patient wants it addressed. This is especially true if the physician is overweight or obese. Rarely is a referral given to a Dietitian who specializes in Adult Weight Management or Children’s Weight Management. Obesity is a sign of significant issues that, if left unresolved, are going to lead to costly financial, emotional, and physical issues.

Talk to a weight specialist to get started on a diet and exercise routine that will help you live long and happy!

5. Inadequate Exercise

Sadly, not getting enough exercise is a common theme these days. Teaching a 3-5 minute isometric regimen in my office has become a regular part of my day. Every patient should be able to demonstrate one set of quick exercises they do on a daily basis; if not, let the teaching begin! Using the stairs instead of the elevator, standing instead of sitting, taking a walk around the block, it all counts. But if you aren't moving, something has to change. Being sedentary won't get you anywhere.

6. Smoking

Simply must stop! It is a no brainer, yet millions of individuals continue to add this vice to their long list of health issues. There are zero positive outcomes linked to smoking. Those who choose to smoke must get at least 100mg of vitamin C a day to help their tissues regenerate. The smoke rings actually bind to the body’s vitamin C supply, preventing it from doing its jobs throughout the body.

7. Non-Compliance with Medication

The list of reasons why people don't take their medications ranges from forgetfulness to trading off which bills to pay each month. Often times, as the educator, a schedule of every pill, meal, snack, break, job, and exercise that happens during each 24 hour cycle is planned for the patient to ensure there are no gaps in the medication regimen. If paying for medication is an issue, time may be spent looking for alternative medications, rebate programs, combinations that offer the same outcomes with lower doses, and more.

Overall, these controllable risk factors are just that: controllable! The biggest and toughest part is that they require attention and dedication on your part. Often times it is very helpful to have a dietitian or health educator who will sit with you and help schedule everything out so you can see how each day will go. Some days are easy and some days are difficult – but your health is worth it!

And you're already one step ahead of the game. Use your NutriBullet to get more fruits and vegetables into your system and start controlling your future and your health. It's all up to you!