Multifactorial Risk Reduction with Nutrition and Exercise Intervention: A Case Report and Review of Mechanisms

Abstract

The practice of cardiology by recent guidelines includes assessment and management of cardiovascular risk with lifestyle first, followed by medications when lifestyle changes do not produce sufficient results or high risk is present. However, in clinical practice, the assessment of diet and exercise followed by meaningful intervention in these areas are not often emphasized by physicians, and implementation by patients is often less than optimal. In this case, there was a dramatic improvement in cardiovascular risk factors, including a profound degree of weight loss, along with a fall in systolic pressure, serum triglycerides, low-density lipoprotein cholesterol (LDL-C) and total cholesterol, possibly driven by the improvement in the microbiome induced by the patient’s exercise and dietary change to a whole food, plant-based diet. These remarkable changes represent an unusual response in terms of the degree, but not the direction, of improvement with exercise and a plant-based diet. The patient’s prospects of sustained weight loss and lifelong lower cardiovascular risk appear to be best with his adopted lifestyle changes, particularly the whole food, plant-based diet.