Prevention of cardiovascular diseases
Diet and physical activity are essential to counteract the risk of cardiovascular diseaseswhich represent the leading cause of mortality in all industrialized countries.
But if enormous progress has been made in terms of treatment, theto prevention still struggling to establish itself. A prevention that should, however, be customized according to the different stages of life: this very topic was at the center of the last congress of the SIPRECa scientific company founded twenty years ago to address – with a multidisciplinary approach – the various factors that contribute to the onset of cardiovascular diseases, from hypertension, to diabetes, to cigarette smoking, to dyslipidemias.
“Prevention – affirms the Professor Massimo Volpepresident of the Italian Society for Cardiovascular Prevention (SIPREC) – must be prescribed in a personalized way in all its chapters and for all its weapons, not only the pharmacological ones but also and above all those concerning the lifestyles, primarily diet and physical activity. For this reason, a truly personalized prescription can only be prepared by a team of specialists (dietician, sports doctor, diabetologist, psychologist, etc.) coordinated by the cardiologist ”.
Here, then, are the advice of the SIPREC experts declined for the different age groups (young people 20-45 years, middle age 45-65 years, over 65).
Diet and physical activity for the prevention of cardiovascular diseases
Eat well to live better. From body weight control. “At any age – explains the doctor Roberto Volpe, research doctor of the Prevention and Protection Unit of the CNR in Rome, SIPREC Board – the main objective is to maintain the right weight. Always starting from the typical foods of Mediterranean dietthe caloric intake must therefore be calibrated on the basis of the physical activity carried out which, generally, decreases with age “.
The prescription ofphysical exerciseinstead, it must be based on three basic criteria: intensity, weekly frequency and duration of the training session.
“With regard to weekly frequency and duration – remembers the Dr. Alessandro Biffimember of the board of directors of SIPREC, specialist in cardiology and sports medicine and sole director of the Medex company, medical partner of the Ferrari team – the international guidelines recommend a weekly number of hours of aerobic activity which has been extended from 150-300 minutes, up to 150-600 minutes per week ”.
In addition to aerobic activity, it is also very important toresistance training, the one done with weights or pull-ups or even free body with isometric exercises. Also important to improve flexibility and balance, especially in the elderly. In short, when prescribing physical activity, it is important to take into account all aspects, which especially in the elderly are fundamental for self-sufficiency and to counteract the sarcopenia (the depletion of muscle tissue), typical of this age “.
The intensity it must be carefully modulated according to the different age groups. “Exaggerating – continues the doctor – means increasing the risks, even on the cardiovascular side. Especially sedentary, they cannot throw themselves into a strenuous training program tout court. Excessive frequency or too long a duration can also lead, especially in the obese and the elderly, to incur in osteoarticular and muscular accidents, which then lead to a forced stop. A medical examination and a ECG before starting a physical activity they are always a good idea and I would recommend them to everyone, regardless of age “.
What to bring to the table? Physically active subjects in this age group – the SIPREC experts suggest – generally do not need particular indications, except for women of childbearing age in which, in order to prevent iron deficiencya reasonable consumption of meat is recommended (lean and unprocessed parts), but also the vegetable sources of this mineral such as legumes and vegetables, with the foresight to accompany them with foods containing C vitaminlike lemon, to improve absorption.
As far as physical activity is concerned, we can be as liberal as possible in prescribing – the experts recall – favoring personal tastes and preferences, enhancing the playful aspect. Well then the cyclingbrisk walking (at least 4 km per hour), jogging and running, rowing that combines aerobic and endurance training, working both arms and legs.
In this age group, the metabolism begins to slow down, so it may be useful to reduce the quantity and frequency of consumption of those foods which, although valid from a nutritional point of view, could bring a surplus of calories. We refer to the carbohydrates (wholemeal ones are preferred in any case), cheeses (choose the less fat ones, such as ricotta or cow mozzarella), dried fruit, oil which, even if EVO (extra-virgin olive), provides still about 100 kcal per tablespoon.
As for physical activity, we need to start thinking about intensity and leveling down. Recommendations are of do not exceed 85% of the heart rate theoretical maximum (it is measured by subtracting one’s age from 220 and calculating 85% of the number obtained. For example for a 50-year-old, 220-50 = 70, 85% of 70 = 140-150 which is the heart rate per minute not to be exceeded). For this it may be helpful to wear one smartwatch or a chest strap for heart rate calculation. As for resistance exercise, we prescribe exercises with weights, gradually increasing the weight (for example from 5 to 10 kilos) and gradually reducing the repetitions (for example 5 to 2).
In addition to reiterating and reinforcing the advice given for the 40-60 age group, at this age we must counter osteoporosisfavoring the contribution of soccer, which we find in cheeses (always choose the less fat ones), in milk, yoghurt and some mineral waters, but also in vitamin D, present not only in dairy products, but also in eggs and fish. As you age, protein intake should also be monitored to prevent excessive muscle loss (sarcopenia).
Which business? Excellent brisk walking, swimming, la exercise bikelow intensity.
Check-ups for cardiovascular prevention
Prevention also and above all means measuring risk factors and knowing one’s numbers. Here are the exams recommended by SIPREC experts in the different age groups:
Between 20 and 40 years old, even if you do not have ailments and are not familiar with cardiovascular disease, it is good to do first level exams and measure risk factors such as blood pressure, cholesterol, blood sugar; it may be helpful to have an ECG every 5 years.
Between 40 and 60 years oldthe screening of cardiovascular risk factors should be done every year, then associating second level examinations, in relation to the patient’s risk profile (for example a Exercise ECG, an echo-cardiogram). In patients with multiple risk factors, where there is suspicion of organ damage, more in-depth examinations (eg coronary CT) should be used. But everything must be managed judiciously and without waste, starting precisely from the patient’s risk profile. In short, no to second level exams just to ‘see how things are’.
And for women? The beginning of a cardiovascular prevention strategy, regardless of the rules of a virtuous lifestyle that must be followed throughout life – conclude the SIPREC experts – provides for a cardiological check-up and the possible use of drugs for prevention, between 45 and 55 years.
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The diet good for the heart: what to eat according to age
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