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The Prevention Model

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LEXINGTON “You are what you eat!” Alison Bailey, MD, preventive cardiologist and associate professor of medicine at UK College of Medicine would agree with that age-old adage. According to Bailey, there is overwhelming evidence that healthy eating habits play a crucial role in the prevention and treatment of cardiovascular disease, as well as other lifestyle diseases that contribute to significant morbidity and mortality in Kentucky and in the US. As director of ambulatory cardiology and cardiac rehab at the UK Gill Heart Institute, Bailey focuses on the emerging specialty of preventive cardiology. “The specialty of preventive cardiology evolved from treating patients that were left debilitated from heart disease,” says Bailey. “With improvements in the diagnosis and treatment of cardiovascular disease, the principles of cardiac rehabilitation and lifestyle/dietary changes can be applied to patients with multiple risk factors and can keep patients from suffering multiple heart attacks over a lifetime.”

As evidence, Bailey cites a National Geographic article (June/July 2009: Longevity Expedition), which described populations with the highest longevity. While widely disparate in many other factors, the populations had the following characteristics: plant-based diet with little processed food, small intake of animal products, and an active lifestyle. The food in these cultures does not come in bags, boxes, and wrappers. The population remains active even into their 70s and 80s with physical activity, not structured exercise, as part of their daily routine.

The Role of the Preventive Cardiologist

Bailey sees patients from 20 years old to 80+. About two-thirds of her patients have already experienced a myocardial infarction or other adverse cardiac event; one-third of her patients have not, but generally have cardiac risk factors.

“The current health insurance model in the US is based more on treatment than prevention, and consequently, preventive cardiology services are often only paid for after a heart attack and/or cardiac bypass,” says Bailey. Through cardiac rehab, these patients learn the skill set to lead a healthier life. Bailey contends the link between risk factors and cardiovascular disease makes prevention a more desirable model both for improved patient health as well as lower health care costs.

For all of her patients, Bailey stresses the importance of lifestyle and diet over prescriptions and pills. Her advice in a nutshell:

Don’t smoke.
Consume a healthy, plant-based diet.
Get regular physical activity – walking 30 minutes a day or equivalent.
Control body weight.
Limit sugar intake.
Control blood pressure.

In her teaching role, Bailey works with medical students to provide nutritional and lifestyle counseling sessions for mothers and children at the Salvation Army Center in Lexington. Her goal is to empower the community with the primary message that it is possible to eat a healthy, plant-based diet on a budget.

Obesity and Eating Disorders

The latest statistics on the state of obesity in the US and Kentucky are well-known and distressing. Over a third of the adult population is obese with a BMI greater than 30. Kentucky is fifth highest in the nation for obesity rates, and the rates are increasing each year. Even more concerning, 20 percent of US children are obese, and this number has skyrocketed in the last 20 years.

Overeating and obesity show a definite link to cardiovascular disease, says Bailey. While this appears to be the most prevalent eating issue in the US and many developed countries, it is not recognized by the American Psychiatric Association (APA) as an eating disorder. This may be due to the difference between eating habits and eating disorders that are driven by obsession with dietary intake. Currently, anorexia and bulimia are the most common clinically diagnosed eating disorders recognized by the APA. As Bailey states, these disorders affect a small subset of the population, usually young females, and rarely lead to typical cardiovascular disease. However, cardiac effects such as cardiac scar tissue and arrhythmias secondary to electrolyte disturbances can occur in patients with eating disorders.


Bailey’s message for Kentucky physicians is to encourage their patients to “eat local,” incorporating as many fresh fruits and vegetables as possible while minimizing processed food. “If we incorporate more local food into our diets and more fresh vegetables into schools, it will lead to better health for Kentuckians and a boost for local agricultural economy,” says Bailey. She also advocates for Kentucky physicians to spend more time teaching healthy lifestyles than prescribing medicines. “I know that teaching and coaching take more time, but the end results are happier, healthier patients and decreased medical costs,” she concludes.

1 Trust for America’s Health and Robert Wood Johnson Foundation. (2015, February 18). The State of Obesity. Retrieved from The State of Obesity: