Recognizing that using drugs and surgery to manage existing heart disease will not go nearly far enough to meet its goal of improving Americans' cardiovascular health by 20% and reducing cardiovascular disease-related deaths by 20% by the year 2020, the American Heart Association now advises lifestyle interventions in order to reduce the cardiovascular disease burden in the United States. In a new "call to action" published on October 7, 2013, in Circulation, AHA members state, "It is abundantly clear that cardiovascular health is being lost from childhood through young adulthood and that the major reasons are adverse health behaviors related to diet, physical activity, healthy weight maintenance, and smoking." They further advise, "Health risk behaviors warrant concerted intervention."
Members of the AHA have apparently realized that people can change bad behaviors: "The old folklore that 'behavior can't be changed' has been dispelled by numerous randomized controlled trials of effective behavioral interventions." One of the research articles cited by the AHA, published in 2004 by the Bayer Institute for Health Care Communication, demonstrates that "There is evidence for the efficacy of interventions to reduce smoking and risky / harmful alcohol use in unselected patients, and evidence for the efficacy of medium- to high-intensity dietary counseling by specially trained clinicians in high-risk patients." MG Goldstein and his co-authors go on to state that "There is fair to good evidence for moderate, sustained weight loss in obese patients receiving high-intensity counseling." Anyone who watches The Biggest Loser could have told the researchers that!
In its 2013 update of the guide to improving cardiovascular health at the community level, the AHA outlines a three-dimensional conceptual framework of vectors and factors to improve cardiovascular health at the national level. Perhaps the AHA should focus less on multi-dimensional conceptual frameworks and spend its effort on developing a fast and frugal heuristic for cardiovascular health -- something like exercise for 60 minutes each day, reject any "food" with more than eight ingredients, and spend no more than 10% of daily caloric intake (which would be 200 of 2000 Calories) on junk food (sweets, chips, non-water beverages).