[Life style changes for prevention of coronary heart disease]

In developed countries arteriosclerosis is responsible for the majority of all deaths. With growing prosperity the life expectancy is increasing, and cardiovascular disease is becoming the primary cause of premature death. Most complications of arteriosclerosis occur unexpectedly. Because of the severe morbidity and high mortality prevention is the only true solution.

Unhealthy nutrition, physical inactivity, overweight and smoking have been identified as the primary causes of arteriosclerotic vascular disease. Central obesity is responsible for the risk factors characterizing the metabolic syndrome. This is the result of inappropriate caloric intake and expenditure. In addition, the nutrients themselves can bear harmful consequences either indirectly by deteriorating risk factors like lipid parameters or by affecting directly the vessel wall. This can add to the deleterious effects of smoking. Evidently saturated fat is the single most decisive nutrient for atherosclerotic vascular disease. Cholesterol and trans fatty acids act additive, while unsaturated fatty acids appear to be beneficial. However, total fat intake is an important determinant of the energy supply, which again influences body weight and composite. Physical activity can counteract, but appears to be beneficial by several additional ways. Quitting smoking is highly effective already within few years. Together with physical activity and healthy nutrition more than 80% of all cardiovascular events can be prevented.

Preventive medicine needs to focus on lifestyle changes because they are feasible and highly effective. A nutrition low in total fat primarily by avoiding saturated and trans fatty acids, but rich in carbohydrates and fiber is recommended. Daily physical activity in any preferred way should be encouraged, and quitting smoking needs to be strongly emphasized.