SoCal-based health program targets 6 lifestyle areas to improve cardiovascular outcomes

Francisco Garcia used to commute to Los Angeles daily for his job as a supervisor of a janitorial and maintenance department, which required him to be on his feet for hours. But all of that changed when he fell ill with COVID-19 in 2020.

The illness left Garcia in a coma for three weeks and in various hospitals in the Coachella Valley and San Diego for three months. One of his lungs was collapsed, which had him hooked up to a ventilator, and doctors were worried about him possibly having a heart attack as well.

The 53-year-old still gets emotional remembering that difficult time, which included his wife having to decide whether to keep him on medical support. Once his health was on the mend, it took time for his strength to return, recalling it would take three people about 45 minutes to help him sit up in his hospital bed.

"It's not easy to remember," he said. "There were very hard moments, very hard days in the hospital. ... I don't wish it upon anyone."

After he was discharged, the Desert Hot Springs resident was referred to cardiologist/electrophysiologist Dr. Hetal Bhakta at Desert Heart Rhythm Consultants, who recommended he start a nutrition-focused program through Nudj Health. The Pasadena-based company aims to deliver whole-person and continuous care for patients with chronic disease by targeting six lifestyle areas: nutrition, stress management, physical activity, sleep, social support and risky behaviors.

Garcia said he would often feel dizzy, get headaches and experience stomach pains from eating in the past. Since starting the program, he has learned how to balance his meals so that there's proteins, grains, fruits and vegetables incorporated into each meal, and he has focused on eating fewer sweets. He said he feels "very, very strong" and that he lost nearly 10 pounds.

"I'm very lucky. This program helped me a lot — a lot, a lot," Garcia said.

Change in lifestyle

Prior to Nudj Health's founding, Chief Medical Officer Dr. Katie Hill said many of its founders worked for a cardiology company. They could tell how engaged a patient would be in their treatment based on what was going on in their lives. So, if a patient was experiencing a lot of stress, depression or anxiety, Hill said they were less likely to participate.

As a result, they formed Nudj Health with the aim of focusing on mental and behavioral health to help improve cardiovascular disease outcomes as well.

"We help people find behavioral changes they can make in a sustainable way in their own lives that fits with their own cultural history, family traditions, likes and dislikes to move them toward greater health," Hill said.

Nudj Health’s treatment is based on the collaborative care model, which is described as a patient-centered, team-based approach to managing chronic medical and mental health conditions. The six treatment pathways address the American College of Lifestyle Medicine’s essential pillars to improve and maintain cardiovascular health.

Nudj Health partners with referring physicians and essentially acts as an extension of their clinic. Care managers work with patients, via telephone or video visits, to better understand their circumstances, tailor pathways to their lifestyles and monitor their progress.

Patients tackle one of the lifestyle areas at a time at their physician's recommendation. Each program is individualized, but generally the nutrition pathway is focused on building sustainable and healthy eating habits that gradually move toward a more plant-based and whole-foods diet, while the fitness pathway focuses on a mix of strength training, balance training and aerobic activities, according to the company.

It takes about 12 weeks to complete a program. Hill said they are typically covered by insurance, especially if recommended by a health care provider.

More than 6,000 patients have taken part of Nudj Health's programs since its founding in 2021, according to the company. Data from a Medicaid cohort enrolled between August to November 2022 showed reductions in blood pressures and improvements in measures of depression, anxiety and insomnia. For example, patients with high blood pressure (greater than 140/90 mm Hg) who were enrolled in remote patient monitoring, which has them closely monitor physical and objective signs of cardiovascular disease, experienced a mean decrease in systolic blood pressure of 1.32 mm Hg and a mean diastolic blood pressure decrease of 0.58 mm Hg per month.

Those who participated in a lifestyle pathway on top of remote patient monitoring saw their systolic blood pressure decrease by 6.98 mm Hg and diastolic blood pressure decrease by 3.87 mm Hg.

In general, making positive changes to lifestyle habits have led to better health for a number of people. Getting enough quality sleep can reduce the risk of many diseases and disorders, from heart disease and stroke to obesity and dementia. Exercise and physical activity, which doctors encourage all able patients to do, can improve brain health, help manage weight, reduce the risk of disease, strengthen bones and muscles, and improve your ability to do everyday activities.

Social connectedness can also improve mental health, and those with stronger social bonds have a 50% increased likelihood of survival than those who have fewer social connections, according to the Centers for Disease Control and Prevention.

"By taking good care of those six pillars ... you will have a healthy life," she said.

Bad habits and psychosocial factors often contribute to medical conditions and can worsen them, Bhakta said, but some patients might not truly consider how much they're impacting them. He was interested in partnering with Nudj Health when he realized its pathways could help them address their health issues beyond medical care.

"You can do a bypass surgery and fix the plumbing, but can we prevent that thing from being necessary in the first place? That starts with managing blood pressure, weight, sugar and a lot of those are rooted in our behaviors and habits," Bhakta said. "If we start correcting those early on, then you don't need the more aggressive things."

When he first met Garcia, Bhakta said he was experiencing chest pain, which turned out to be atypical. But the more time he spent with his patient, the more he learned about Garcia's underlying issues with blood pressure and post-traumatic stress disorder that was related to his COVID-19 diagnosis.

Bhakta recommended the nutrition pathway for Garcia because "that was the root of a lot of his issues," he said. Since then, Bhakta said Garcia's blood pressure is "much better controlled." He added that Garcia would have also benefited from the stress management pathway.

Garcia said his quality of life "better now" since he's participated in the program, and he's even taken additional classes to learn more about nutrition and healthy changes he can continue to make.

"It's something I would recommend to everyone, not only people like me that are sick," Garcia said. "We need more programs like this."

How to get connected

If a patient wants to join Nudj Health, they can email info@nudjhealth.com. The company will either connect them with a local participating doctor or explain other options for participation.

Ema Sasic covers entertainment and health in the Coachella Valley. Reach her at ema.sasic@desertsun.com or on Twitter @ema_sasic.

This article originally appeared on Palm Springs Desert Sun: Nudj Health programs target 6 lifestyle areas to improve patient lives