‘I’m a Preventive Cardiology Nutritionist, and These Are the 5 Questions I Ask Patients During Their First Visit’

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Food and lifestyle habits that support heart health are, of course, beneficial to everyone. Forty-eight percent of American adults suffer from some form of cardiovascular disease and heart disease is the leading cause of death in the country. While anyone might experience a heart attack, stroke, or cardiovascular disease, some people are at increased risk because of family history, genetics, preexisting conditions, or other social determinants of health.

While any nutritionist or registered dietitian can offer helpful guidance about eating habits that support overall health goals, preventive cardiology nutritionists (part of the larger field of preventive cardiology) specialize in heart health. "As a preventive cardiology nutritionist, I focus on managing the risk factors associated with cardiovascular disease," says Julia Zumpano, RD, an expert in disease prevention and management at Cleveland Clinic.

Experts In This Article
  • Julia Zumpano, RD, Julia Zumpano, RD, is a preventive cardiology nutritionist at Cleveland Clinic.

How To Make an Appointment With a Preventive Cardiology Nutritionist

The Academy of Nutrition and Dietitians is a good place to find a preventive cardiology nutritionist in your area through the website's "Find an Expert" tab. Many providers are also offering virtual appointments as well as in-person. These appointments may or may not be covered by your insurance. "It depends on your plan and also what your risk factors are," says Zumpano. "For example, some insurance providers cover appointments if you have high cholesterol, but it may not cover it if you are overweight. And some insurance providers cover virtual appointments while other providers only cover in-person providers."

Besides figuring out insurance and payment, many people wonder what to expect when scheduling an appointment. While Zumpano says appointments always vary by individual, there are some general questions she always asks of her patients.

Questions To Expect From a Preventive Cardiology Nutritionist

1. What is your family health history?

People with a strong family history of heart disease, high blood pressure, diabetes, elevated triglycerides, or weight metabolic syndrome are at a higher risk of cardiovascular disease. If anyone in your family has experienced any heart problems, she wants to know.

Zumpano will of course ask about your health history, too. Are you on any medications? Do you have diabetes? Have you had a stroke or any other cardiovascular issues before? This is the appointment where you want to bring it up.

2. What do you like to eat?

Here's the good news about heart disease: It's largely preventable. One way to prevent heart disease is choose a healthy diet. "I generally focus on a whole food diet or a Mediterranean diet," Zumpano says, namechecking the eating plan with hundreds of scientific studies linking it heart-health benefits.

Zumpano says the principles of a whole foods diet (which focuses on unprocessed or unrefined foods without unnecessary additives like salt, sugars, oils, or preservatives) and the Mediterranean diet (which includes foods high in omega-3s and unsaturated "healthy" fats, including fish, extra-virgin olive oil, nuts, grains, legumes, fruits, and vegetables) can be implemented by people with various food interests; it's about the nutrient principles, not the specific region. This is why Zumpano asks what people like to eat. From there, she can help clients brainstorm heart-healthy meal ideas that they're sure to enjoy eating.

Watch the video below to learn more about the Mediterranean diet:

3. How much time do you have and what's your food budget?

What you eat isn't just about preferences; it's also about how much time and money you have to devote to groceries. That's why Zumpano says she asks for more details on what a client's daily routine is and what mealtime looks like for them. A heart-healthy meal plan for someone who lives alone and loves to cook is going to look vastly different from a parent pressed for time because they're also working full-time. "If someone tells me they're super busy, we come up with quick and easy meals together that they can try at home," says Zumpano. "Convenience is a strong factor for someone when figuring out what they are going to eat, so it's important." Similarly, a person's income and food budget also shape Zumpano's recommendations.

But Zumpano has more good news: You can stick to a heart-healthy diet even if your time and income are limited. Inexpensive, heart-healthy foods include beans, chickpeas, canned tuna, and frozen vegetables.

4. What is your favorite way to stay active?

Preventing cardiovascular disease isn't just about food; physical activity is important, too. "We make appropriate exercise goals based on where they are at, what they like, and what is attainable for them," says Zumpano. "Then, we come up with concrete ways to meet these goals."

If someone expresses interest in yoga, for example, she may share with them some yoga videos on YouTube. Or if someone is a parent with young kids, they may discuss a type of physical activity they can do together, or alternatively, figuring out a plan for when he or she can get a 45-minute break from caregiving to focus on doing something solo. "Again, it really depends on the individual," Zumpano says.

5. How are you managing the stress in your life?

High levels of psychological stress directly increase the risk for cardiovascular disease. "I ask patients what they are doing to manage the stress in their life and how they're sleeping," she says. "If someone doesn't have a stress management plan in place, often I start by teaching them some deep breathing exercises. I also often recommend journaling or meditation," she says. If someone's stress levels are so high that they can't manage them on their own, Zumpano may refer them to a therapist who can offer more in-depth and on-going support.

What happens next?

The initial appointment helps your preventive cardiology nutritionist learn more about you before laying the groundwork of new heart-healthy habits. The follow-up appointments are used to determine what's working and to make any necessary changes to the plan. Over time, a variety of circumstances or health needs may change, which means the plan will need to be adjusted as well.

Most important to remember is that we have a lot of control over our cardiovascular health. Scheduling time with a preventive cardiology nutritionist can be an important step in figuring out how to use that control. Keeping in mind your family history, income level, and time constraints, a preventive cardiology nutritionist can help you address your individual needs.

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