Behavior Change Plan to Prevent Coronary Heart Disease

Maintaining a Healthy Lifestyle Behavior to Prevent a Reoccurrence of Coronary Heart Disease

James J. Speen

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Introduction

Justification for choosing the health behavior

I am a 57 year old male, diagnosed with diabetes mellitus II, and cardiovascular disease stemming from atherosclerosis. In March of 2006, I experienced an acute angina pectoris attack while testing for a brown belt in Tae Kwon Do. The angina attack led to an emergency department visit at a local health facility and ultimately culminated in a quadruple coronary artery bypass graph (CABG). My healthcare providers are continually stressing the importance of making healthy choices and maintaining a healthy lifestyle in order to prevent a reoccurrence of coronary heart disease (CHD). Further, supporting my physician’s opinion, Ferris, Kline, and Bourdage (2012) state that “biopsychosocial health displayed no direct relationship to CHD risk, but positively predicted a healthier lifestyle. A healthier lifestyle was related to lower levels of CHD risk.”

Over the past 6 months, I have strayed from my regimen of healthy eating and daily exercise and am beginning to feel the negative effects of weight gain, sore joints, and decreased endurance during physical activity. It is now behavior modification time. This will be accomplished by discontinuing my current unhealthy behaviors and resuming a healthy lifestyle consisting of a regimen of eating heart healthy foods and exercise.

Justification for the behavior change plan

I used the Theory of Planned Behavior (TPB) model, as outlined in our textbook, Health Psychology A Biopsychosocial Approach (Straub, 2012) to evaluate my current behavior. First, I determined that continuing my behavior would eventually lead to another CABG or even worse my death. Secondly, after considering my doctor’s views regarding CHD prevention through lifestyle modification; I chose to comply with my healthcare provider’s advice. And finally, I realized that I am the only one who can manage my controllable health risk factors.

Method

Materials and Procedure

I monitored my pre-change caloric intake, blood glucose, and physical exercise levels for seven days. My caloric intake and amount of exercise was recorded using the MyFitnessPal mobile application. Blood glucose levels were measured each day with a OneTouch Ultra 2 blood glucose meter. Glucose measurements were performed twice each day at 6:00a.m. and at 10:00p.m.. This data was used to establish my base line cardiac healthy lifestyle compliance.

After this period, I enacted a behavior change plan to regain control over my controllable cardiac health risk factors. I added the use of a HoMedics model KS-701 digital dietary scale to accurately measure my food portions and increased the amount of water that I consumed daily. Additionally, 1 hour of cardiovascular and strength training exercises was added to the daily regimen. Caloric intake and exercise activity were recorded using the MyFitnessPal mobile application and blood glucose was measured with the OneTouch Ultra 2 blood glucose meter. Nutritional data consisting of caloric intake, carbohydrates, fat, protein, cholesterol, sodium, sugar, and fiber from the MyFitnessPal application along with blood glucose data, was imported into an Excel spread sheet for data comparison and analysis. Average daily values for each category were computed for both the pre-behavior change and behavior change periods.

Results

The pre-behavior change average nutrition information showed that I was consuming too much fat, cholesterol, and sodium. Additionally, both my a.m. and p.m. average blood glucose readings exceeded the National Institute of Health (NIH) blood glucose recommendations of pre- meal: 70–130mg/dL and 2-hours post meal: <180mg/dL (see Table 1 for a more detailed depiction of pre-change health behavior).

The modified behaviors showed significant improvements across the scope of all values monitored when compared to my behavior change goal. Refer to Table 2 for a more detailed comparison of behavior change to the behavior change goal. Additionally, Table 3 demonstrates the effect that positive health risk behavior modification has on un-healthy controllable health risk behaviors.

Discussion

What worked and what didn’t work with my change plan

This behavior intervention was successful from the standpoint that the cycle of unhealthy lifestyle choices I was making, was interrupted. Furthermore, a modest improvement in controllable cardiac health risk factors was realized. Even though, I was unable to implement the cardiovascular and strength exercise portion of my plan; I experienced a 6 pound weight loss attributable to overall daily caloric reduction.

External and internal factors that contributed to the effectiveness of my change plan

External factors affecting my change plan were the abundance of family support and the inability to implement the exercise component of my plan due to a severe lower lumbar sprain requiring a lengthy time to heal.

Internal factors that helped motivate me to make change were the chronic joint pain and decreased physical endurance I was experiencing. Another positive motivator was being able to see the real-time qualitative results of my daily nutritional choices.

Shortaˆ?term and longaˆ?term consequences of not changing my behavior

According to the South Australian Department of Health (2012),”the short-term consequences of not changing [my] behavior may include impairment of [my] daily health and wellbeing and reduce [my] ability to lead an enjoyable and active life”. Additionally, continued un-healthy nutrition choices can contribute to stress, fatigue, and can affect my ability to work. Furthermore, poor nutritional choices have been associated with increased incidences chronic medical conditions, such as obesity, diabetes, hypertension, and hypercholesterolemia.

The long-term consequences of not making healthy lifestyle changes to reverse the abovementioned chronic medical conditions lead to serious life-ending diseases. Uncontrolled hypertension causes thickening of the heart muscle which reduces the heart’s pumping efficiency. Kidney failure is also caused by unmanaged high blood pressure in diabetics. Furthermore, uncontrolled hypercholesterolemia leads to increased plaque buildup in the arteries, which may form blockages, and induce a heart attack.

The adverse effects of diabetes are immense. According to WebMD (2012), “complications from diabetes are caused by damage to the body’s blood vessels, nerves or both”.

Damage to the vascular system causes blindness from diabetic retinopathy. Retinopathy is caused by the retina dying from insufficient blood flow. Peripheral neuropathy is damage to the nerves in the feet and can lead to open wounds that will not heal. Over time, these open wounds become infected. Left untreated, the wound develops gangrene and the limb needs to be amputated.

Eventually, the cumulative negative long term effects of living an unhealthy lifestyle void of heart healthy nutrition and a regime of exercise will culminate to that moment we sometimes hear about — where we are lying on our deathbed and the most prominent thought in our mind is, — “I wish I would have…”.

References

Ferris, P.A., Kline, T.J., & Bourdage, J.S. (2012). He Said, She Said: Work, Biopsychosocial, and Lifestyle Contributions to Coronary Heart Disease Risk. Health Psychology, 31(4), 503-511.

Straub, R.O. (2012). Staying Healthy: Primary Prevention and Positive Psychology. In Health psychology: A biopsychosocial approach (pp.167-169). New York, NY: Worth Publishers.

National Diabetes Education Program (U.S.),. (2014). Know your blood sugar numbers. Author. United States Centers for Disease Control and Prevention

Derrher/WebMD, D. (2012). Effects of Uncontrolled Diabetes on Eyes, Kidneys, Heart, and More. Retrieved from http://www.webmd.com/diabetes/risks-complications-uncontrolled-diabetes

South Australia Department of Health. (2012, July 6). The Risks of Poor Nutrition :: SA Health. Retrieved from http://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/healthy+living/is+your+health+at+risk/the+risks+of+poor+nutrition

Table 1

Pre-change Health Behavior

Table 2

Behavior change compared to behavior change goal

Table 3

The effect of positive health risk behavior modification on un-healthy controllable health risk behaviors

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