Lifestyle Choices Drive Your Risk
for Heart Attack, Stroke and
There was some encouraging news last week about the benefits of healthful lifestyle changes on your risk for stroke, heart disease and death from all causes.
The first of these was a study published in the medical journal Stroke that found that those who scored highly in seven lifestyle behaviors had almost 50% less risk of stroke. Even those scoring only moderately in these behaviors had a 27% reduced stroke risk.
Considering that someone dies of stroke every four minutes in America, this is worth your attention. The lifestyle factors considered for this study – which included many patients in the southeastern United States (dubbed the “stroke belt” for its much higher rates of stroke) – included the following:
Being physically active
Having a healthy weight
Controlling blood pressure, cholesterol and blood sugar
The study found that “Small differences in health status were associated with large reductions in stroke risk”, according to lead researcher D. Mary Cushman of the University of Vermont. Having an ideal blood pressure – generally considered under 120/80, although under 115/75 might be better considered “ideal” – was most important, reducing stroke risk in this study by 60%.
“Patients Can Control Their Own Wellness”
A second study reported at theheart.org examined the effect of four lifestyle behaviors on the rate of developing atherosclerosis as measured by the rate of calcium buildup in the study participants’ arteries. The behaviors measured here included…
Healthy (Mediterranean) diet
Physical activity of at least 150 minutes a week
Only 2% of participants met all four criteria of healthy living – and they had an 80% reduced risk of dying during the study’s 7-year follow-up period. That means that those following none of these healthy behaviors were five times more likely to die during this time frame.
It’s noteworthy that smoking outweighed the other three criteria combined. Those who followed the other three healthy behaviors but smoked were still more likely to die during the study period than those who didn’t smoke but did follow the other three healthy behaviors – a powerful testament to the damage that smoking causes.
Overestimating What’s Needed
Of course, it’s hard to imagine that those who eat healthy, maintain a healthy weight and get adequate physical activity – the health-conscious among us – would also smoke. Then again, President Obama seems to be one such exception – although he’s apparently trying to kick the habit (nicotine is highly addictive).
It’s fair to say, however, that those in most need of lifestyle reform are least likely to try it.
Part of this has to do with unrealistically high expectations of what’s required for any health benefit. Doctors and patients alike have responded to surveys in ways that suggest their idea of what’s needed for effective lifestyle change is much greater than it actually is.
Doctors surveyed thought patients needed to lose 10-14% of weight to benefit medically, while patients surveyed thought it took 25%. The truth is even 5-7% weight loss has been proven to dramatically reduce disease risk for the overweight and obese. 5-7% is a lot less intimidating – and a lot more doable – than 14-25%.
In fact, not only has a mere 5% weight loss been shown to produce significant health benefit, even a 2.2 pound weight loss has been found to reduce the 10-year risk for type 2 diabetes risk by 33%. This may represent 1% or less of weight loss for many people.
The same is true across the gamut of lifestyle behaviors. Small, incremental improvements compound over time to exert tremendous benefit in terms of staying healthy or recapturing lost health. Consumers need to understand that small, incremental measures in diet and lifestyle can have huge cumulative payoffs in terms of reduced disease risk and future need for medical care.
An Inconvenient Truth About Convenience
It’s the path of least resistance, however, that dictates much of non-emergent medical practice in America – as it does for too many lifestyle choices by American consumers.
In both arenas, we have met the enemy and its name is “convenience”. Convenience isn’t inherently unhealthy, but it is in its current extreme that abandons any sense of the healthful balance that nature favors and requires:
Prescription drugs for symptom control dominate medical practice because they’re more convenient than the more time-consuming process of addressing the underlying problems causing our symptoms;
Convenience also dictates our food choices by way of fast foods, convenience marts, and packaged foods we can unwrap and pop in our mouths; and
We drive everywhere, flip TV channels without leaving our seats, even “walk” through airports on conveyor belts without moving our feet. Our idea of a brilliant invention includes a device allowing us to move from place to place without – again – having to move our feet. This is considered “progress”.
Like medical practice in America, convenience – when taken to its current extremes – also has a dark underbelly of discouraging the physical activity we need to survive. Others discourage selecting and preparing whole foods that promote health in favor of denuded foods that add back isolated nutrients as “fortification” – as if that restores their original nutritional value.
Taking The Road Less Traveled
Informed medical consumers realize it pays dividends, both financially and health-wise, to control our conveniences rather than be controlled by them – taking the “road less traveled” when it comes to our and our families’ needs.
Medicine’s main roads are littered with human debris, after all, including the misuse of expensive technologies and interventions, unsafe hospitals, and the overmedication of vulnerable patients (see Our Healthcare Sucks).
Much of this “medical mayhem” is well-intentioned – and we know where that other road paved with good intentions leads – but up to half of it is unnecessary. These unnecessary medical interventions put high-risk patients at heightened risk of common medical errors or treatment complications that are often fatal.
And with personal bankruptcies due to medical bills setting new highs in the U.S., let’s not forget that much of this medical misuse is for big-ticket tests and procedures that mean money-out-of-pocket for millions who can no longer afford such wasteful expenditures in an unforgiving economy.
In some very real ways, going along with the medical status quo is a sucker’s bet.
Lifestyle Upgrades Can Reduce
Your Family’s Medical Needs
Smart consumers look instead for new and better ways to implement lifestyle upgrades most likely to reduce their need to rely on a bloated and overpriced medical system incentivized to “pad the bill” to maximize incomes.
Notice the word “reduce” rather than “eliminate”. Foregoing medical care when it’s truly needed would be foolhardy, not smart. Nevertheless, it pays to learn to be highly skeptical when it comes to what’s prescribed or recommended by your physicians.
This is especially true for lifestyle-related conditions like “pre-hypertension”, high cholesterol, pre-diabetes, and other conditions where prudent lifestyle changes – or “upgrades” – are safer, cheaper, and more effective.
And it will also pay to resist panicking when handed a diagnosis that may very well prove to be wrong (see “Medical Errors Start With Misdiagnoses“). Carefully adopting lifestyle measures can only help regardless of what the ultimate diagnosis turns out to be.
Are many people unwilling or unable to make these needed changes and stick with them as a permanently healthier lifestyle? Of course, they’re the majority of people.
But that doesn’t mean the rest of us must accept being “tarred with the same brush” of medical indifference and neglect of lifestyle solutions to medical problems – especially those caused by lifestyle abuses that are the norm for the majority of Americans.
Better Than Drugs
Many more of us might be willing to at least attempt an upgraded lifestyle if we were aware of how effective these measures have proven – easily besting prescription drugs in several head-to-head clinical trials at substantially less risk of complications and/or side effects.
Upgrading your lifestyle requires personal and family time, effort, and expense – prudent “maintenance costs” to keep aging cars (bodies) out of expensive garages (hospitals).
The essence of healthy living is replacing self-destructive behaviors with health-promoting behaviors to reduce dependence on our dysfunctional medical system as much as possible.
Get started by checking your health status at mylifecheck.org, a free service of the American Heart Association and the American Stroke Association.
And use what you learn about your own health status – and that of your loved ones – to guide your need for positive lifestyle changes for a healthier, safer and more prosperous future with minimal reliance on our poorly performing healthcare system.
That’s the smartest answer to today’s runaway medical costs – and you don’t need to rely on the government, your insurer, employer or anyone else to make it happen.
You just need to do it.
 Primary Care Physicians’ Attitudes about Obesity and its Treatment. Obesity Research.11(10):1168-77.10/ 03.
 Relation of weight gain and weight loss on subsequent diabetes risk in overweight adults. J Epidemiol Community Health. 2000 August;54(8):596-602.