Published 1:06 PM EST Feb 11, 2019
In a sunny, cheerful room at Tallahassee Memorial HealthCare, Dr. David Smith smiles as he observes patients on treadmills, stationary bikes, and rowing machines. He is in the cardio rehab center, and the reason for his smile is a triangle.
“I like to think of health like a triangle,” he says, placing his hands together to form the shape with his thumbs and index fingers. He explains that the base of health is lifestyle, or how we manage our health. Then comes understanding the physiology of our bodies, then incorporating wellness habits to support our physiology, and at the top using interventions like surgeries and medical procedures to respond when things go wrong.
“Most of us have the triangle upside down,” he says, recalling the wisdom of over 30 years in cardiovascular medicine.
David Smith, MD, FACC, is a cardiologist at Tallahassee Memorial HealthCare who is also one of the first medical professionals globally to be certified in Lifestyle Medicine by the American Board of Lifestyle Medicine (ABLM).
Dr. Smith is an expert on how the use of lifestyle therapeutic approaches – such as a predominantly whole food, plant-based diet, physical activity, adequate sleep, stress management and tobacco cessation – can help prevent, treat and even reverse chronic disease. Essentially, putting our healthy triangle back on a firm foundation.
As an advocate of lifestyle medicine, Smith sees commonality among the variety of patients he treats, citing hypertension, diabetes, high cholesterol, and cigarette smoking as the main reasons for chronic heart disease.
Also shared are the benefits experienced by patients who adopt a holistic lifestyle approach to heart health. Nutrition, activity, and stress management are all elements of his prescription for a healthy heart. “Developments in cardiology medicine like new diagnostic tools and advanced technology are exciting,” he shares. “The low-tech side of medicine is also gaining ground as we learn more about lifestyle medicine.”
Smith’s prescription for heart health starts in the kitchen, with a focus on plant-based nutrition. “A diet with a strong component of fruits and vegetables is naturally low in salt, which is perfect for cardiac patients,” he explains. He has transitioned away from animal products and towards more plant-based nutrition in his own diet, and advocates the same for his patients. “I’m about 70 percent there,” he says with a twinkle in his eye.
Exercise and movement is also part of building and maintaining a healthy heart. “Don’t be a spectator in life,” he encourages, “Be a participant!”
As a triathlete and avid swimmer, he encourages patients to take advantage of Tallahassee’s many trails, parks, and increased walkability, which leads him to another critical element — a strong support network. “Conditions like heart disease and diabetes can be stressful,” he cautions. “We all need to feel connected to people we can turn to for guidance and support.”
Sharing his enthusiasm for prevention through lifestyle is Lucinda J. Graven, Ph.D, APRN, an assistant professor in the College of Nursing at Florida State University. She conducts research in rural communities, working with patients who have experienced heart failure and are in the process of learning how to create and manage healthy lifestyles.
“We know that heart failure is chronic and progressive,” she stresses, “so learning self care for preventing recurrence is critical.” In rural communities, she explains, access to fresh fruits and vegetables can be challenging.
An emphasis on learning how to read nutrition labels, understanding the role of sodium in food, and using workarounds like rinsing canned vegetables to lower the salt content begin to lay the foundation for a healthy lifestyle. “When you are buying food at the gas station or Dollar General, options for fresh food are limited,” Dr. Graven explains. “We have to learn how to identify possible options for these challenges so we can be healthy in any setting.”
Heart health affects everyone; the Centers for Disease Control and Prevention reports that about one in four deaths each year, approximately 610,000 people, are from heart disease. Heart disease is the leading cause of death for both men and women, and even more are caring for family members experiencing cardiovascular illness.
Dr. Smith sees the possibilities, however. “After World War II,” he said, “Finland was number one for heart disease in the world.” One health administrator noticed that and began a community approach to wellness, among the schools and neighborhoods. “Within 30 years, the country had experienced an 80 percent reduction in heart disease. The entire country decided to make it a priority.”
At the front lines of heart health in Tallahassee is a strong network of health care providers, leading the charge for health education and care that promotes wellness as a lifestyle.
And as he observes the cardiac rehab patients walking on treadmills and chatting with each other on a sunny February morning, he can’t hide his smile. “This is where people get moving,” he says. “This is where it all comes together.”
Heart Month Series
February is American Heart Month. Throughout the month, the Tallahassee Democrat will be spotlighting stories on heart health in conjunction with our sponsor Tallahassee Memorial HealthCare.