What lifestyle modifications should I advise to patients with polycythaemia to

Advise patients with polycythaemia to adopt lifestyle modifications aimed at reducing cardiovascular risk, including:

• Healthy eating: Encourage a diet where total fat intake is 30% or less of total energy, saturated fats are 7% or less, and saturated fats are replaced by mono- and polyunsaturated fats such as olive oil or rapeseed oil. Tailor dietary advice to individual circumstances and comorbidities. This cardioprotective diet supports cardiovascular health.
• Regular physical activity: Recommend aerobic and muscle-strengthening activities in line with UK Chief Medical Officers' guidelines, aiming for 20 to 30 minutes daily to the point of slight breathlessness, increasing gradually as tolerated.
• Smoking cessation: Strongly advise stopping smoking to reduce cardiovascular risk.
• Alcohol consumption: Advise following UK government drinking guidelines to avoid excessive alcohol intake.
• Behaviour change support: Provide advice and support tailored to the patient’s readiness and confidence to change lifestyle factors, involving shared decision-making and clear communication about cardiovascular risk and benefits of lifestyle changes.

These lifestyle modifications are recommended to reduce cardiovascular risk in high-risk populations, including those with conditions like polycythaemia that increase thrombotic and cardiovascular risk.