Walking the Talk of a Healthy Lifestyle in Cardiology
New research in the Journal of the American College of Cardiology tells us that walking the talk of a healthy lifestyle for preventing heart disease is not so easy.
Perhaps the most striking number from this research relates to dietary recommendations. The American College of Cardiology (ACC) recommends a whole-food plant-based diet for cardiovascular disease prevention. But only eight percent of 166 cardiologists surveyed for this research report actually following this recommendation in their own dietary patterns. However, that does not stop 41% of cardiologists surveyed from recommending it frequently to their patients.
Cardiologist Kim Williams and colleagues conclude:
“Despite recognizing the importance of lifestyle medicine as a foundation for CVD prevention, many respondents reported inconsistent personal compliance to key pillars, particularly dietary and physical activity recommendations. Bridging this gap between knowledge and behavior may improve physician well-being and model more effective, credible counseling for patients.”
Better Results on Physical Activity
Williams et al found somewhat better results on physical activity recommendations. Self-reported counseling practices by 91% of cardiologists were consistent with ACC guidance. Among the cardiologists they surveyed, most of them (69%) reported actually following that guidance in their personal lives. On sleep, stress management, social well-being, and substance use, the results were mixed. For instance, 71% reported getting six to eight hours of sleep nightly, but only 39% were satisfied that their sleep patterns were healthy.
Finally, only 12% reported any training in lifestyle medicine.
Now, we must take these findings with a grain of salt. Response bias is real. Williams et al note that responders to this survey research might be more interested in lifestyle medicine than the average cardiologist and thus skew the result toward more positive findings than might be reflected in real life. We also see the potential for social desirability bias to skew results in that direction as well.
Nonetheless, these findings are a reminder that glib reliance on recommending a healthy lifestyle to prevent heart disease (or obesity) might bear more careful thought. Perhaps a bit more empathy and pragmatism would be helpful and warranted.
Click here for the study and here for reporting on it. For perspective on the evolving role of lifestyle medicine in the era of GLP-1 therapies, click here.
Mural from the National Institute of Cardiology, Mexico, by Diego Rivera, licensed under CC BY 4.0 from the Wellcome Collection
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August 28, 2025
August 28, 2025 at 9:08 am, John DiTraglia said:
Or it could be that cardiologists as well as people who are not from
Mars understand that exercise is way more impactful than whatever diet.