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November 8, 2000
LIVING WELL
Prevention and Primary Care - Elizabeth Smoots, M.D.


Young at Heart
Simple lifestyle changes keep you healthier

For years I've pounded the pavement, pumped iron, shunned fat like the plague, and piled on the veggies -- all in the name of good health. But sometimes I wonder, does it really help?

I recently read research in the New England Journal of Medicine that renewed my faith in what I'm doing. For those of you who, like me, need reassurance from time to time that you're making the right health choices, here is the evidence. And it is impressive!

During the 14-year study, Harvard researchers gave questionnaires to 84,129 healthy 30- to 55-year-old women nurses every two years. They answered questions about their diet, exercise, smoking habits, and alcohol consumption. After adjusting for age, family history, high blood pressure, cholesterol level, and use of postmenopausal hormones, researchers found that women with the healthiest overall lifestyles had an 83 percent reduced risk of heart attack and a 75 percent reduced risk of stroke.

The new findings demonstrate the powerful effect of adding multiple healthy habits together. In fact, the researchers predicted that adopting a healthier lifestyle could prevent the majority of coronary disease events in women. Since heart disease is the number one killer in the United States -- resulting in more than 300,000 deaths among women each year -- the potential to save lives is tremendous. And the savings would actually be even greater since men, who weren't included in the study, would likely experience similar improvements.

Every wee bit helps

But I caution you not to rush out making drastic changes. The research findings indicate that you can improve your health simply by accumulating small, positive changes in your lifestyle. In the study each woman was categorized as to how many low-risk factors she had. While women with all five low-risk factors gained the greatest health benefits, risk was also reduced among women who had at least a few healthy lifestyle factors. For example, women who had four out of five low-risk factors had a 66 percent risk reduction in heart disease. And those who had three factors had a 57 percent lower rate. Not too shabby!

So it looks like we can all enjoy the enormous benefits demonstrated in the study when we make healthy lifestyle choices. Here are the five key habits found by researchers to control your risk of cardiovascular disease:

  • Smoking. The single most important risk factor in the study was smoking. People who smoked 15 or more cigarettes a day were over five times as likely to have a heart attack than nonsmokers. Fortunately, when a person quits, his or her risk gradually falls -- reaching the level of someone who has never smoked after 10 to 14 years.
  • Diet. At lowest risk were those who ate a diet high in fish, fiber, and folic acid (found in fruits, vegetables, whole grains, and legumes) and low in saturated fat and sugar.
  • Weight. Women with a body-mass index of less than 25, the standard cutoff point for being overweight, were considered low risk in the study.
  • Alcohol. Results suggest that alcohol in moderation may help protect against heart disease. Most experts define a moderate intake as up to one glass a day for women or up to two for men. If you don't drink, however, I don't advise you start because alcohol can increase your risk of certain kinds of cancer and can cause other health problems.
  • Exercise. Researchers found that people who engaged in an average of one half-hour per day of moderate or vigorous exercise were at the lowest risk for heart disease.

I'm a firm believer that a healthy lifestyle helps keep you young. So keep walking, jogging, or playing sports, and eat heart-healthy foods. Don't smoke and watch the booze. You'll enjoy the benefits now and for years to come.

Elizabeth Smoots, M.D., F.A.A.F.P., is a board-certified family physician in Seattle, Washington. A fellow of the American Academy of Family Physicians, Dr. Smoots specializes in prevention and primary care medicine.