NOTE: This outlines many of our approach and also as patient education. This is generalized and each patient’s treatment depends on individual patient & doctor

JIVAS consist of eternal system of care, where Life style modification is one of the important treatments for the patients. Vascular disease is a leading cause of death and disability, while it is preventable. Little is known about the feasibility or acceptability of implementing intervention to prevent vascular disease by promoting a life style modification program in general practice. Providing brief life style modification fitted well with routine health check consultation which help patient’s make life style changes. It consists of holistic approach to our patients. It is widely appreciated that modification of the risk factor profile can help reduce the disease burden of the atherosclerosis and its complication. However patients with peripheral arterial disease are usually advised to undergo life style changes as a part of secondary prevention. This usually refers to
 
  • Smoking cessation
  • Diet
  • Physical exercise/yoga??
  • Weight loss/control

SMOKING CESSATION:



Smoking – its association with PAD &atherosclerosis :
 
  • Related undoubtedly to development of atherosclerosis
  • Complete and permanent smoking cessation is by far the most clinically and cost effective intervention in patient’s with PAD
  • Smoking cessation has been associated with rapid decline in incidence of PAD.
  • Patient who has smoked at least 40packs in years required reconstructive vascular surgery over 3 times more frequently than those who smoke less.
  • Smoking cessation may not directly decreased BP but markedly reduces overall risk
  • AT JIVAS WE HAVE PROGRAMS FOR smoking cessation which eliminates a major risk factors for disease progression and lowers the incidence of rest pain and need of amputation. Also important for decreasing hear disease and stroke.
  • Special counseling through motivation enhances smoking cessation. Combination of exercise therapy and smoking cessation
  • Adjunctive treatments like nicotine replacement therapy are advised to help smoking cessation
  • Umambiguous advice/counseling to stop smoking each patient readiness to quit provides appropriate counseling
  • Pharmacotherapy is also considered for those who smoke more than 10 cigarates/day and have no contra indication.

DIET:

  • HIPPOCRATES (father of medicine) PREACHED: THY FOOD THY MEDICINE, THY MEDICINE THY FOOD
  • Healthy eating is a corner stone of healthy living. Diet is th amount of food consumed by a person and plays a major role in restoring the health by supplying the needed nutrition and recuperation of the organs
  • Increased fiber intake and decreased high fat intake is associated with lower incidence of PAD.
  • A healthy eating pattern includes mainly plant base diet, example fruit and vegetables. Selecting whole gram food, moderate amount of low fat/reduced fat/dairy products.
  • Moderate amount of lean unprocessed meats and fish.
  • DASH DIET (dietary approach to stop hypertension) rich in fruits, vegetables, low fat, sodium restriction and is reduced in total and saturated fat.
  • Choosing food which contains good amount of vitamins, minerals, proteins, fat and carbohydrates
  • One should also understand about good (HDL) and bad (LDL)cholesterol.
  • Soluble Fiber foods are those which absorbs water and helps cholesterol and fat from being absorbed through intestine to blood. They are green leafy vegetables, fruits, vegetables, oats, flax seeds, kidney beans, barley etc.
  • Insoluble fiber foods are those, which do not absorb water and essentially moves through the intestine undissolved, called ROUGHAGE. Helps maintain function of digestive system. And those are whole wheat, wheat brand, nuts, brown rice, broccoli etc.
  • Foods rich in Omega 3 fatty acids (fish, flax seeds) is more effective in decreasing PAD.
  • Life style changes and nutrition habits leads to fall in plasma triglycerides and raise in HDL
  • A healthy diet can help lower blood cholesterol and other lipid levels and help control blood pressure.

PHYSICAL ACTIVITY:

  • A SOUND MIND IN A SOUND BODY”
  • Activity requiring physical efforts carried out to sustain or improve health and fitness is called physical activity - include exercise, aerobic, gym, swimming, jogging, yoga, walking etc
  • Iis part of a comprehensive plan to control disease regardless of drugs. Physical activities improve blood pressure, calorie expenditure, increased HDL, reduced weight, reduced triglycerides.
  • Aim for 30 to 45 mins of moderate to intense activity on most, if not all days of week.
  • Regular exercise coupled with risk factor modification especially smoking cessation is corner stone of conservative therapy for intermittent claudication and is associated with the prevention and control of virtually every known modifiable risk factor.
Walk in more than 1km decreases smoking by as much as 13.1 – 77%.

WEIGHT CONTROL:

Improves macro vascular endothelial function and decreases selective maker of endothelial activation and coagulation in obese patients with insulin resistance syndrome regardless of the degree of glucose tolerance.

Weight loss often includes blood pressure, blood cholesterol and triglyceride levels and is effective therapy for decreasing risk of diabetes mellitus.

Fat plays an important role in the body; they serve as energy source for body. Cholesterol is a fat like substance that plays an integral role in cell membrane structure in addition it is required for production of bile acids (used in digestion) steroid hormones (estrogen and testosterone) but decrease in saturated and transfat intake helps in balance cholesterol intake.

To help manage body weight and prevent gradual unhealthy body weight gain in adulthood, engage in 45 mins of moderate to vigorous activity daily.

To sustained weight loss in adulthood 60-90mins of moderate to intense physical acitivity while not exceeding calorie intake under consultation provided by a health care provider before participating in the level of activity is needed.

Every one percent of reduction of body weight lowers systolic blood pressure by average of 1mmHg. Weight reduction decreases hypertension in large portion of over weight people.

Waist circumference less than 94cms (male), less than 80cms(female) BMI less than 25 is advised.


Lifestyle changes must be practical and able to be maintained for the lifetime.