How can I determine the amount of change needed in my diet?

If you’re trying to reverse heart disease or prevent the recurrence of cancer, you may need the “pound of cure”- that is, bigger changes in diet and lifestyle than someone who just wants to lower his or her cholesterol level a few points or lose a few pounds. If you have a strong family history, or if genetic testing shows you to be at higher risk, this information can be a powerful motivator to make bigger changes in diet and lifestyle than you might otherwise have made. Also, it may be possible to tailor pharmacologic interventions more effectively and efficiently. If you’re like me, basically healthy, you can thrive on the “ounce of prevention.” And if you’re somewhere in between - if you have some worrisome risk factors for heart disease (high cholesterol, high blood pressure) - you can begin by making moderate changes in diet and lifestyle, progressively more intensive as needed. If that’s enough to achieve your goals, great; if not, you may want to consider making bigger changes. For example, most people in this country have elevated cholesterol levels. They are initially advised to follow a diet based on the National Cholesterol Education Program or American Heart Association guidelines - less red meat, more skinless chicken, and so on. For some people, that’s sufficient to lower their cholesterol levels enough, but not for most. Many are then told, “Sorry, it looks like diet didn’t work for you” or “You failed diet.” Then they are usually prescribed cholesterol-lowering drugs, which they are told they will need to take for the rest of their lives. In reality, most people can make progressively bigger changes in nutrition and lifestyle to achieve their goals - often without medication. If moderate changes in diet and lifestyle aren’t sufficient to lower your cholesterol sufficiently, bigger changes in diet and lifestyle usually are. How much you want to change is up to you; I just want to make sure you know what your options are so you can choose intelligently and wisely. In the book The Spectrum, I’ll show you how. If you don’t have a serious illness such as coronary heart disease, it usually doesn’t matter if you indulge yourself on occasion. However, if you do have heart disease, even a single meal that’s high in saturated fat may cause acute changes in how stickily your blood clots and how constricted your arteries may become, both of which may increase the risk of chest pain or even a heart attack.