Adopting
a Healthy Lifestyle in Middle Age Reduces Later Mortality and Cardiovascular
Disease
July
10, 2007 ? Middle-aged
patients who switch to a healthy lifestyle that includes a diet
with a daily intake of at least 5 fruits and vegetables,
exercise, and other factors have reduced mortality and
cardiovascular disease (CVD) during the next 4 years,
according to the results of a study published in the July issue
of The American Journal of Medicine.
"Despite
the well known benefits of having a lifestyle that includes
exercise, eating a diet high in fruits and vegetables,
maintaining a healthy weight, and not smoking, only a small
proportion of adults follow this healthy lifestyle pattern," write
Dana E. King, MD, MS, from the Medical University of South
Carolina in
Charleston
, and colleagues. "Further
characterization of individuals who adopt a healthy lifestyle in
middle-age, and determining the extent of the health benefit
would be extremely helpful in formulating appropriate lifestyle
advice for such individuals." (This is why having a
lifestyle coach, like Dr. Stern, to keep you on track, is vital)
The
objectives of this study were to determine the proportion of
individuals who adopt a 4-element healthy lifestyle (? 5 fruits
and vegetables daily, regular exercise, body mass index [BMI] of
18.5 - 29.9 kg/m2, no current smoking) in a
middle-aged cohort and to determine the subsequent rates of CVD
and mortality among those who adopt a healthy lifestyle.
The
study cohort was a diverse sample of adults aged 45 to 64 years
in the Atherosclerosis Risk in Communities (ARIC) survey. Outcome
measures were all-cause mortality and fatal or nonfatal CVD.
Of
15,708 participants, 1344 (8.5%) had 4 healthy lifestyle habits
at the first visit and 970 (8.4%) of the other participants had
newly adopted a healthy lifestyle 6 years later. Factors
associated with lower likelihood of adopting a healthy lifestyle
were male sex, African-American race, lower socioeconomic status,
and a history of hypertension or diabetes (all P <
.05).
Compared
with individuals who did not adopt a healthy lifestyle, those who
did had lower total mortality and CVD events during the next 4
years (2.5%
vs 4.2%; ?2 P < .01 and 11.7% vs 16.5%; ?2
P < .01, respectively). After adjustment, new adopters
had lower all-cause mortality (odds ratio [OR], 0.60; 95%
confidence interval [CI], 0.39 - 0.92) and fewer CVD
events (OR, 0.65; 95% CI, 0.39 - 0.92) in the subsequent 4
years.
"People
who newly adopt a healthy lifestyle in middle-age experience a
prompt benefit of lower rates of cardiovascular disease and
mortality," the authors write. "Strategies to encourage adopting
healthy lifestyles should be implemented, especially among people
with hypertension, diabetes, or low socioeconomic status."Note: this is important
for people of all ages from infancy on!
Study
limitations include possible misclassification; lack of dietary
information regarding fiber, fat, sodium, magnesium, and several
other nutrients; food or exercise habits possibly changing
between the visits and the outcome assessment; possibly
conservative estimates of reduced CVD and mortality; and
categorization being limited to black/nonblack in the ARIC study
database.
"The
potential public health benefit from adopting a healthier
lifestyle in middle age is substantial," the authors conclude.
"The current study demonstrated that adopting 4 modest healthy
habits considerably lowers the risk of cardiovascular disease and
mortality in relatively short-term 4-year follow up period. The
findings emphasize that making the necessary changes to adhere to
a healthy lifestyle is extremely worthwhile, and that middle-age
is not too late to act."
The
National Heart, Lung, and Blood Institute in collaboration with
the ARIC Study Investigators supported this study.
Am J Med. 2007;120:598-603.