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Does healthy lifestyle really make much difference?

In an earlier post (January 3, 08), I looked at how common sense isn’t common, at least for healthy behaviours. Only about 3% of the population are ticking all the right boxes for non-smoking, alcohol use, exercise, weight and diet. This is interesting and maybe surprising, but does it really matter much?

Well, if we want to stay alive and healthy, it matters a hell of a lot! The US study of over 84,000 nurses showed that, during 14 years of follow-up, the 3% with the healthiest behaviours had less than a sixth the rate of major coronary events when compared with the 97% with less healthy behaviours (Stampfer, Hu et al. 2000). Somewhat similarly, a study looking at over 82,000 adults under 40 and well over 284,000 adults between the ages of 40 and 59 found that the approximately 7% who were low risk for smoking (none), cholesterol (less than 5.17 mmol/l), and blood pressure (less than or equal to 120/80 mm Hg) suffered deaths from cardiovascular problems at only about a fifth the rate of the 93% or so with less favourable risk profiles when they were followed up for a couple of decades (Stamler, Stamler et al. 1999). Again the findings are similar with the elderly. Over 2,300 European men and women aged 70 to 90 were monitored for 10 years (Knoops, de Groot et al. 2004). More than 18% qualified as low risk on all four factors that were assessed – non-smoking, moderate alcohol, regular exercise and good diet. This low risk group had about a third of the all-cause death rate when compared with the approximately 82% with less healthy lifestyles. It was noteworthy that this improved risk was almost as strong for reduction in cancer as for cardiovascular disease. Another research group, focusing just on 11 preventable cancers (mouth, oesophagus, stomach, colorectal, pancreas, laryngeal, lung, female breast, endometrium, kidney and bladder) estimated that about 50% could be avoided if people followed healthy lifestyle advice (Soerjomataram, de Vries et al. 2006).

At this point, some people query whether the additional years of life achievable through a healthy lifestyle are just a burden of decrepit old age. Typically this isn’t the case. Healthy lifestyle both dramatically increases life expectancy and also life quality. When nearly 6,000 men were followed from their mid-50’s for nearly 40 years, those with the healthiest lifestyles had a 55% chance of reaching age 85 with no significant physical or cognitive impairment. Those with the poorest lifestyles reduced their chances to just 9% (Willcox, He et al. 2006). There’s a great web resource on evidence-based healthy living at Oxford-based Bandolier. Visit the site. Be good to yourself!

Bandolier. Healthy Living. www.jr2.ox.ac.uk/bandolier/booth/booths/hliving.html Accessed January 8, 2008.
Knoops, K. T., L. C. de Groot, et al. (2004). "Mediterranean diet, lifestyle factors, and 10-year mortality in elderly European men and women: the HALE project." Jama 292(12): 1433-9. [Free Full Text]
Soerjomataram, I., E. de Vries, et al. (2006). "Excess of cancers in Europe: A study of eleven major cancers amenable to lifestyle change." International Journal of Cancer 120(6): 1336-43. [PubMed]
Stampfer, M. J., F. B. Hu, et al. (2000). "Primary prevention of coronary heart disease in women through diet and lifestyle." N Engl J Med 343(1): 16-22. [Free Full Text]
Stamler, J., R. Stamler, et al. (1999). "Low risk-factor profile and long-term cardiovascular and noncardiovascular mortality and life expectancy: findings for 5 large cohorts of young adult and middle-aged men and women." JAMA 282(21): 2012-8. [Free Full Text]
Willcox, B. J., Q. He, et al. (2006). "Midlife risk factors and healthy survival in men." Jama 296(19): 2343-50. [Free Full Text]

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