Take a hard look inside America's dietary habit. Every day 47 million hot dogs, 3 million gallons of ice cream, 6 million pounds of chocolate and 1.2 million gallons of hard liquor are an astonishing statistic: More than 140 million Americans are now overweight or obese.

Joseph Piscatella, an expert on lifestyle habits and cardiac health
and guest speaker at the Center for Human Nutrition's annual spring
meeting, stands as a rock against this bloated flood of bad dietary choices. He recently consumed. This type of diet has contributed mightily to helped 650 people lose 4,200 pounds in a 1 2-week period.

But if you think his first strategy was diet and exercise, you're wrong.
"Stress management is crucial to cardiac well-being," said Mr. Piscatella. "You can't expect people — including cardiac patients — to stick to an exercise and diet plan if they're under chronic stress."

In his latest book, Tofce a Load Off Your Heart, Mr. Piscatella and co-author Dr. Barry Franklin note that stress often is the trigger for eating. Since life itself presents pressure, they say, people don't have the luxury of running away from stress. "The secret is not to avoid stress, but to manage it; not to react to stress, but to respond to it," Mr. Piscatella said.

Following a three-month regimen that included stress management, effective exercise and following a balanced diet, the weight-loss program touted by Mr. Piscatella was such a huge success that it was awarded the "best community education program" by the Michigan Hospital Association. Each member of the group lost six and one half pounds on average and also had a 75 percent compliance rate one year after the weight-loss program. The only non-medical member of the National Institutes of Health Cardiac Rehabilitation Expert Panel, Mr. Piscatella came to a personal understanding of the link between lifestyle habits and cardiovascular disease after undergoing coronary bypass surgery when he was 32 years old. Mr. Piscatella set out to defy the prediction that he would not live to see his 4- and 6-year-old children graduate high school. And he did.

Establishing healthy living habits for himself, Mr. Piscatella now has
heart tests that show regression of coronary disease. More importantly, the 57-year-old has seen both his son and daughter graduate from high school, college, graduate school and law school. In his latest book — which Mr. Piscatella calls a manual for preventing, stabilizing and reversing heart disease — he notes that stress management is "crucial to cardiac well-being" and equally important as exercise and cardiac health.

"I've had 25 years of experience in making lifestyle changes, enough time to sort out what is effective and what is not, what is a fad and what is trusted information, what works on paper but breaks down in practical application," Mr. Piscatella said. Now more than two decades removed from his bypass surgery, Mr. Piscatella has developed "The Piscatella Protocol" to help others stick to healthy lifestyle habits. The steps include:

Assess your cardiac risk
"Some markers including low-density lipoprotein (LDL) cholesterol, blood pressure and smoking are well established," he notes. "Others such as homocysteine, C-reactive protein, clotting and personality /behavior are only now emerging. Each marker is independently important to your cardiac risk."

Daily stress
"Stress is a natural byproduct of change and change is constant," Mr.
Piscatella notes. "People who can cope well with stress are in a better position to institute and maintain healthy exercise and eating habits."

Make exercise a habit
"We suggest exercise before dietary change because regular,
moderate exercise is easier to achieve." Mr. Piscatella writes. "Building up to a 45-minute walk four times a week is easier than giving up your morning doughnut."

Balance your diet -
"It's important not to base your dietary decisions on pop science or the latest fad. My recommendations are not extremely high or extremely low in fat; instead, they call for balance and moderation."

Also, the author notes, those wanting to embrace a healthier lifestyle need to realize it's a constant rather than a temporary measure.
"The best way to gain weight is to go out and get every crash-diet weight-loss book," Mr. Piscatella said. "I've incorporated stress management as a tool to dietary compliance. If someone is under stress they are more likely to run to the refrigerator. Stress management puts individuals in a better position to eat a healthy diet."

Some of Mr. Piscatella's stress management tips include:

• Take time to relax
• FOCUS ON concerns, not ironies
• Practice positive self-talk
• Clarify your goals and values
• Get enough sleep
• Keep a journal

Said Mr. Piscatella: "If you will not take the time for your health today, you will have to make time for your illness tomorrow."