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[Consensus document on healthy lifestyles]
1Sociedad Murciana de Hipertensión Arterial y Riesgo Cardiovascular. Cátedra de Riesgo Cardiovascular. Universidad Católica de Murcia.
Introduction:
Proteins are a group of macronutrients that are vital to our lives, as they perform various functions, including structural, defensive and catalytic. An intake of 1.0-1.2 g/kg/body weight per day would be sufficient to meet our needs. Carbohydrate requirements constitute 50 % of the total caloric value and should be obtained mainly in the form of complex carbohydrates. In addition, a daily intake of both soluble and insoluble fiber is necessary. Regular consumption of extra virgin olive oil is an effective strategy for the prevention of cardiovascular, metabolic and neurodegenerative diseases. Its inclusion in the Mediterranean diet strengthens its protective effect, positioning it as a key food in health promotion. Daily consumption is recommended as a substitute for saturated and processed fats to maximise its benefits. Salt is involved in the control and intensity of high blood pressure, kidney damage in the form of altered urinary albumin excretion, and damage to other target organs, especially in salt-sensitive patients. Potassium lowers blood pressure through its vasodilatory and natriuretic effects, which reduces events and mortality. The consumption of alcoholic beverages in general is harmful to health, although a certain protection against the development of acute myocardial infarction has been observed in association with low consumption and a pattern of intake with meals and from middle age onwards. The recommendation for total abstinence is essential among the young population. Among drinkers over the age of 50, consumption should be limited to one UBE per day (10 g of alcohol) for women and up to two for men. Moderate coffee consumption (up to 3-5 cups per day) is recommended from a cardiovascular point of view, as it has shown antioxidant and anti-inflammatory effects, which are associated with a lower risk of arrhythmias and cardiovascular diseases, including myocardial infarction and stroke, compared to not consuming it. To obtain this benefit, it should be consumed in the morning. Chocolate acts as an antioxidant and anti-inflammatory, improving endothelial function, blood pressure, lipid profile and platelet function. Consumed in excess, it can have negative effects on several levels, such as weight gain, stimulant effects and added sugar consumption. Mediterranean-type diets, with their variants (DASH, Atlantic and Nordic), have demonstrated cardiovascular benefits and advocate moderate and balanced food consumption. They all favour the use of fresh, seasonal and local foods, avoiding saturated fats, refined and processed products and sugary drinks. Vegetarian or vegan diets and intermittent fasting have demonstrated cardiovascular benefits, but can lead to nutrient deficiencies or pose risks during pregnancy, breastfeeding, growth or in patients with diabetes, so professional advice should be sought. Physical exercise has enormous benefits for individual and collective health. Regular exercise is associated with lower rates of cardiovascular disease, type 2 diabetes, metabolic syndrome, some cancers, depression, and cognitive decline. The minimum recommendations for physical exercise (150 min/week) should be met or exceeded. Social relationships are key determinants of health. Individuals are social agents capable of changing norms and behaviours in their environment. Family and partner support and interpersonal interactions are fundamental to the development of emotional skills, resilience and self-care. Adequate night-time rest is essential for maintaining good physical and mental health. Early detection and treatment of sleep disorders can improve patients' quality of life and prevent cardiovascular, metabolic, oncological and psychiatric diseases. Addictive behaviours have an impact on the cardiovascular health of those who suffer from them. Healthy lifestyle medicine is an essential tool, not only for treating these conditions, but also for preventing them. Sexual and reproductive health is closely linked to cardiovascular risk. Hypertension, diabetes, obesity, dyslipidaemia, smoking and stress negatively affect both fertility and sexual function, but advanced age also reduces fertility, and obesity and smoking aggravate reproductive and cardiovascular risks. Fertility treatment, in general, has not been shown to increase long-term cardiovascular risk, although it may increase short-term complications. Some drugs for cardiovascular disease can affect both sexual and reproductive function. Chronic stress can act as a trigger and amplifier of underlying cardiovascular processes. The deleterious effects of stress are exacerbated if they coexist with other risk factors, such as a sedentary lifestyle, poor sleep quality, or social isolation. It is important to identify whether the stress comes from work, family or financial circumstances. To control it, relaxation techniques should be applied, structured physical exercise should be encouraged, social support should be promoted, adequate sleep hygiene should be maintained, and limits should be set and tasks prioritised. Environmental pollution is one of the main environmental risks to human health, with a particular impact on the cardiovascular system. Air pollutants include particles and gases that, depending on their composition and size, can penetrate deep into the body. Fine (PM2.5) and ultrafine (PM0.1) particles are particularly dangerous because of their ability to induce systemic inflammation, oxidative stress and endothelial dysfunction.
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