Patient Stories

A 57-year-old male farmer was referred by his GP for a lifestyle medicine assessment to a Lifestyle Medicine certified GP to address hypertension, obesity and hypercholesterolemia. The patient expressed a desire to discontinue antihypertensive medication.

Lifestyle Medicine prescription

• Sodium reduction: Avoiding added salt and checking food labels, with a goal of <200mg sodium per serving.
• Dietary cholesterol reduction: Replacing cheese with hummus to increase fibre intake, which helps bind and eliminate cholesterol. Additionally, he was encouraged to lower meat intake and consume more plant-based proteins such as legumes.
• Plant-based nutrition: Investigate whole food plant-based meals via meal kit services and introduce plant-based alternatives like oat milk instead of dairy to further reduce saturated fat intake.
• Physical activity: A graduated walking program was recommended as he recovered from knee joint replacement surgery.

One-month review

• Knee steadily improving. Weighted walking in a hilly area, and biking with dog for 15 minutes daily.
• Avoiding extra added salt. Enjoying hummus and oat milk. Moderating cheese.
• Lowering meat, adding more legumes.
• Cholesterol down to 3.85.
• BP down to 136/83.
• Weight loss: 1.4kg.
• Plan for next few months: add two cups of dark leafy greens to increase nitrates and relax blood vessels.

Four-month review

• Enjoying extra greens most days.
• Walking briskly most days for 30 minutes.
• Finding it difficult to keep up with healthy eating away from home.
• Blood pressure reduced to 118/64.
• Cholesterol slightly rose from last checkup to 4.78. It is suspected that the rise in cholesterol may be due to the takeaway food he indulged in when travelling.
• Weight loss: 3kg total.
• Waist reduced by 5cm total and now in healthy range.
• Plan for next few months: quiet deep breathing for 2 minutes daily; wean off BP medication.

Six-month review

• Cholesterol down to 4.73.
• BP at home after walks: 114/76. Had been off medication for 2 months by this stage.
• Weight loss: another 2kg from last checkup.
• Had reduced his meat portions and been eating fish plus hummus and wholegrain crackers or bread for lunch.
• Plan for next few months:
  • Keep sodium to under 2000 mg per day (0.5 tsp added salt);
  • Check sauces for sodium levels;
  • Maintain daily greens;
  • Maintain fruit, oat milk and oats for breakfast;
  • Try baked beans for lunch (tip off excess sauce);
  • Use peanut butter, nut butter and avocado for fat sources and nuts, seeds and dried fruit for snacks.

Outlook

As the patient continues to adopt more elements of a whole food plant-based diet, reducing consumption of animal products further, and maintaining regular physical activity, further reductions in cholesterol and weight are anticipated. This case highlights the potential for targeted lifestyle interventions, particularly plant-based nutrition, to effectively manage and even reverse chronic conditions like hypertension and hypercholesterolemia, reducing reliance on medication.

Due to medical board regulations, we have removed the clinician's name from this story. However, we understand that clinicians may want to discuss similar cases with each other. If you’d like to connect with the clinician involved in this case, please contact us. With their permission, we’d be happy to provide their details.