A Rationale for the Development of Smart Start
Cardiovascular disease (CVD) is the leading cause of death for women in the United States. In 2017, it was responsible for 299,578 female deaths, which equates to approximately 1 in every 5 deaths (CDC, 2020). Traditional risk factors for CVD include obesity, poor diet, lack of physical activity, excessive alcohol consumption, diabetes, and smoking (CDC, 2020). However, women with diabetes and those who smoke are at a higher risk of CVD than their male counterparts (Young & Cho, 2019). Women are also susceptible to sex-specific risk factors such as pre-eclampsia, gestational diabetes, polycystic ovary syndrome, early menopause and autoimmune disease (Young & Cho, 2019).
While common perceptions associate chronic diseases with older adult populations, approximately 1 in 16 women age 20 and older have coronary heart disease and CVD mortality rates are on the rise in women ages 35-54 years old (CDC, 2020; Young & Cho, 2019). Although only about half of women in the United States recognize that heart disease is their number 1 killer, even less recognize the prevalence in younger populations (CDC, 2020). Many of the risk factors can be identified and modified at an early age, specifically poor diet (Young & Cho, 2019). While dietary recommendations have focused on decreasing saturated fat intake to lower CVD risk, studies have shown that replacing it with polyunsaturated fats even further reduces risk (Liu, et al., 2017).
These statistics have identified a need for an education program that provides young adult women with knowledge of how to reduce their risk of CVD by adjusting their diet. Smart Start will be a virtual program that will consist of 1 session a week for 6 weeks. The curriculum will be broken into three modules- Why: Risk Assessment and Motivation, What: Dietary Understanding, and How: Smart Goals. At the end of the program, participants will be able to develop a heart healthy diet by identifying the differences in types of fats and the importance of increased consumption of healthy fats. They will learn how to use SMART goals and action plans that will allow them to succeed in implementing long lasting dietary changes.
By adjusting their diets at an early age, these women can potentially reduce their risk of CVD, America’s costliest disease. Not only are medical costs related to CVD currently totaling $318 billion, but indirect costs are totaling $237 billion (AHA, 2020). These indirect costs present to the community as a loss of days of work by employed individuals, a loss of work by those who are too sick to work, and a loss of home productivity (AHA, 2020). Total costs are estimated to continue to increase, reaching over $1 trillion by 2035 (AHA, 2020).
This program will succeed because it emphasizes focusing on an underserved population. This group it is often left out of education programs since they are old enough to be considered educated and yet young enough to be excluded from being considered an at-risk population. It will provide awareness of the need for education, as well as nutrition and dietary knowledge, and teach the participants the skills needed to succeed in long term habit changes.
References
American Heart Association. (2020). Cardiovascular Disease: A Costly Burden for America, Projections through 2035. Retrieved from https://healthmetrics.heart.org/wp-content/uploads/2017/10/Cardiovascular-Disease-A-Costly-Burden.pdf
Centers for Disease Control and Prevention. (2020). Women and Heart Disease. Retrieved from https://www.cdc.gov/heartdisease/women.htm
Liu, A.G., Ford, N.A., Hu, F.B. et al. (2017) A healthy approach to dietary fats: understanding the science and taking action to reduce consumer confusion. Nutr J 16, 53 (2017). https://doi.org/10.1186/s12937-017-0271-4
Young, L., & Cho, L. (2019). Unique cardiovascular risk factors in women. Heart, 105(21), 1656-1660. doi:10.1136/heartjnl-2018-314268