Although a majority of cardiologists recognize the importance of lifestyle medicine in cardiovascular disease prevention, many do not personally adhere to these recommendations, especially surrounding diet and exercise, according to results from an ACC CardioSurve survey published Aug. 25 in JACC.

Kim Allan Williams Sr., MD, MACC, et al., report responses from 166 survey participants from June 14, 2024, to July 11, 2024. The survey had a response rate of 31% and centered around cardiologists' knowledge and compliance with lifestyle recommendations on the following six pillars: physical activity, diet, stress resilience, restorative sleep, positive social connections and avoidance of risky substances.

They found that while 41% of respondents recommended a whole-food plant-based diet to their patients, only 8% reported adhering to such a diet themselves. The most common issues cited in making these dietary recommendations were patient compliance (63%), cultural challenges (40%) and concerns over protein adequacy (28%).

When asked about physical activity, 91% of respondents reported counseling patients on incorporating regular exercise. Around 69% of cardiologists met physical activity guidelines, and 49% participated in strength training at least twice per week.

Other notable insights from the other lifestyle medicine pillars include the following: 35% of cardiologists were dissatisfied with their sleep patterns; few reported participating in formal stress management programs; and 69% cited challenges in maintaining social connections due to the demands of their work schedules. Most cardiologists did not use tobacco; however, 69% reported alcohol use, with 34% consuming alcohol every week.

The authors caution that there may be selection bias due to the optional nature of the survey. Responses of cardiologists with more interest in lifestyle medicine may be overrepresented.

They recommend integrating more formal training in lifestyle medicine into cardiology education, writing, "Bridging this gap between knowledge and behavior may improve physician well-being and model more effective, credible counseling for patients."