[Management of behavioral risk factors for cardiovascular disease (CVD)]

Changes in many patterns of individual risk behaviors (unhealthy diet, smoking, sedentary lifestyle) are necessary in a large majority of patients with established CVD or at high risk of CVD. Make healthy food choices. Energy intake must be adjusted to maintain ideal body weight. Eating from each major food group will ensure dietary balance. The consumption of fruits and vegetables, whole grain cereals and bread, low fat dairy products, fish and lean meat should be encouraged. Oily fish and omega-3-fatty acids are specially recommended. Saturated and trans fatty acids should be replaced with MUFA's or PUFA's of vegetable and seafood origins. Totalfat intake should account for no more than 30% of energy intake, and intake of saturated fats should not exceed a third of total fat intake. The intake of cholesterol should be less than 300 mg/day. Stop smoking tobacco. All smokers should be professionally encouraged to permanently stop smoking all forms of tobacco. Increase physical activity. A lack of regular physical activity may contribute to the early onset and progression of Cardiovascular Disease. Regular physical activity and the maintenance of physical fitness is beneficial in all age groups and should be promoted as an integral part of cardiovascular prevention. Healthy people should be advised to choose enjoyable activities, which fit into their daily routine, preferably 30-40 min, 4-5 times weekly at Borg 13 or at 60-75% of the average maximum heart rate. For patients with established CVD, advice must be based on a comprehensive clinical judgement including the results of an exercise test.