Prioritizing Our Health Efforts - July 6, 2010 Newsletter

Prioritizing Our Health Efforts

EHE Newsletter, Volume 10, Number 27
July 6, 2010

In making decisions, one must to be able to recognize degrees of importance; that is, an individual must be able to prioritize effectively. The most important tasks, or the tasks with highest priority, are those that help an individual achieve his or her long-term goals or those that have other meaningful and significant long–term consequences.

Good health is the foundation of a long and healthy life. Despite this, many individuals spend a significant portion of their time worrying about issues that will have little or no impact on their health and do not direct enough time, attention and energy to those things that will produce long–term positive health outcomes. A lack of good health can make it difficult for individuals to gain and keep the things that they want in life such as a family, a fulfilling work life or financial security. Even when these things are achieved, they are much more difficult to enjoy without good health. That is why it is important for individuals to prioritize their efforts in a way that promotes a healthy life.

What are the behaviors that have been proven to be the most important in contributing to a long and healthy life? With new research studies on health making news headlines almost every day, it can be difficult to make sense of the constantly emerging — and often conflicting — information. Individual efforts can have a dramatic impact on health, yet these efforts will have little impact if they are not directed toward the right areas. It is, therefore, vital that individuals identify areas in which the impact will be most significant.

The Good: Setting Our Priorities

Some important studies have narrowed down the behaviors that are the most important in contributing to a long and healthy life.

The European Prospective Investigation into Cancer and Nutrition (EPIC) is a large study of diet and health that recruited over half a million people in ten European countries as participants. EPIC was designed to investigate the relationships between diet, nutritional status, lifestyle factors, environmental factors and the incidence of cancer and other chronic diseases. The findings of two smaller studies within the larger scope of EPIC are especially significant:

After following 25,663 adults aged 45 to 79 from 1993 to 2006, it was found that:

  • Eating five servings of fruits and vegetables a day gives an individual the life expectancy of someone three years younger.
  • Not smoking gives an individual the life expectancy of someone four to five years younger.
  • Increasing exercise by a moderate amount increases an individual’s life expectancy by up to three years.

By following these three simple changes, an individual can add ten more healthy years to his or her life expectancy.

In a separate study, alcohol intake was added as a factor and it was found that individuals who followed the three behaviors above and limited alcohol intake added the equivalent of up to 14 more healthy years to their life expectancies.

A June 2005 report by the World Health Organization (WHO), Preventing Chronic Diseases: A Vital Investment, found that, of the 35 million deaths from chronic diseases worldwide each year, the three most important modifiable risk factors are:

  • Unhealthy diet and excessive energy intake
  • Physical inactivity
  • Tobacco use

According to the researchers, these three simple lifestyle behaviors account for 9.5 million (or over 40 percent) of premature lifestyle–related deaths. Additionally, the researchers found that these three modifiable risk factors cause and/or lead to the intermediate risk factors of raised blood pressure, raised glucose levels, abnormal blood lipids (particularly low–density lipoprotein cholesterol [LDL], or "bad" cholesterol) and overweight and obesity, which all combine to account for over 14.1 million premature deaths per year. All of these modifiable risk factors, therefore, add up to almost 24 million deaths per year worldwide. This means that 65 percent of the 35 million deaths from chronic diseases could have easily been prevented if individuals had followed a few simple lifestyle behaviors. In addition, the WHO Report stated that eliminating these risk factors would prevent at least 80 percent of heart disease, stoke and diabetes occurrences as well as 40 percent of cancers.

The good news: a few simple lifestyle behaviors can have a dramatic impact on our health

The Bad: How Well Are We Doing?

Several studies have looked at the number of Americans who actually engage in these healthy lifestyle practices that are known to prevent most chronic diseases. A 2005 study that was published in the Archives of Internal Medicine surveyed over 153,000 adults aged 18 to 74 to find out if they adhered to the following 4 Healthy Lifestyle Characteristics (HLC):

  • Healthy weight (defined as a BMI of 18.5 to 25) — approximately 40 percent of the participants were at a healthy weight.
  • Consumption of a minimum of five fruits & vegetables per day — about 22 percent of respondents consumed the minimum recommended amount.
  • Regular physical activity (defined as 30 minutes, five times per week) — 23 percent of respondents reported engaging in adequate exercise.
  • Not smoking — approximately 76 percent of the respondents did not smoke.

When all 4 factors are combined, however, only 2.8 percent of U.S. adults followed all 4 HLCs.

Two other large–scale studies looked at the percentage of Americans who follow these four Healthy Lifestyle Characteristics with the addition of alcohol consumption — defined as one drink or less per day — as a fifth characteristic.

  • From 1980 to 1994, the Nurses’ Health Study followed 84,129 women aged 30 to 55 and found that:
    • Only 12.7 percent practiced any 3 of the 5 Healthy Lifestyle Characteristics,
    • Only 7.2 percent practiced any 4 of the 5 Healthy Lifestyle Characteristics, and
    • Only 3.1 percent practiced all 5 Healthy Lifestyle Characteristics
  • The Health Professionals Follow-Up Study looked at these same five Healthy Lifestyle Characteristics among 42,847 men aged 40 to 75 and found that only 4 percent of participants followed all 5 Healthy Lifestyle Characteristics.

Complicating matters further is the fact that these findings were self–reported; the actual reality may be even worse than these studies show.

The bad news: Very few Americans are following the four or five healthy lifestyle behaviors that could dramatically change their health.

The Ugly: Are We Getting Better?

Adherence to simple lifestyle guidelines can have a dramatic affect on one’s health. Yet, as we have seen from several studies, most Americans are not following them.

In light of all of this information, the question now is, "are we (or have we) getting any better at following these known healthy lifestyle behaviors?" According to an article published in the June 2009 issue of The American Journal of Medicine, despite the well–known benefits of having a lifestyle that includes physical activity, eating a diet high in fruits and vegetables, maintaining a healthy weight, moderate alcohol use and not smoking, the proportion of adults who follow this healthy lifestyle pattern is, in fact, declining.

According to the article, the results of two large–scale studies of the U.S. population — one from 1988 to 1994 and one from 2001 to 2006 — were compared and resulted in the following findings:

  • The percentage of adults aged 40 to 74 years with a body mass index greater than 30 increased from 28 to 36 percent.
  • The percentage of adults who perform physical activity 12 times a month or more had decreased from 53 to 43 percent.
  • Smoking rates remained about the same (26.9 to 26.1 percent).
  • The percentage of adults who eat five or more fruits and vegetables a day decreased from 42 to 26 percent.
  • Moderate alcohol use increased from 40 to 51 percent.

Overall, the number of people adhering to all five healthy habits decreased 47 percent.

The ugly news: Not only is the amount of Americans who adhere to these healthy behaviors low, the number has dropped significantly over the last 20 years.

Conclusion

The results of these studies should provide much food for thought. Do not be confused by the misleading and conflicting information in the news; focus your time and attention on achieving the few simple lifestyle behaviors that are known to have the biggest impact.

Achieving a healthy weight, maintaining an active lifestyle, consuming a healthy diet with adequate fruits and vegetables, avoiding or minimizing alcohol intake and not smoking are extremely important to overall health and are the behaviors that have been proven to be the most important in contributing to a long and healthy life. These are the areas, therefore, where individuals should prioritize their efforts to improve their health because they will help individuals to achieve their long–term goals and will have meaningful and significant long–term consequences.

MEDICAL DISCLAIMER: The information is not intended to constitute medical advice and is not a substitute for consultation with a physician or other healthcare provider. Individuals with specific complaints should seek immediate consultation from their personal physicians.