It’s frustrating, at times, to have a conversation with my friends and others about what they’ve decided to do to improve their health.
They tell me excitedly about some supplement or diet or other health fad they’ve just heard about. Surely, this is just the thing that will help them live a healthier and longer life.
Then comes the moment I silently dread. They turn to me and ask, “What do you think?”
Save your money, I tell them. The best thing you can do for your long-term health is change the way you’re living. Now. Exercise daily — with vigor. And be sure to throw in twice-weekly (at least) weight-lifting and stretching sessions. Also, eat a mostly vegetarian diet (lots and lots of fruits and vegetables, only a smidgeon of red meat, and switch to whole-grain carbohydrates — real whole grains, not, for example, brown “wheat” bread that’s dyed to look like whole-wheat bread). Watch your calories — and thus your weight. Make sure your waistline stays flat. And stop staying up so late watching TV. Get more sleep.
Well, I’m probably a little more diplomatic than that.
Everybody is looking for a quick fix for staying healthy. This or that vitamin. Probiotics. “Natural” hormones. Detox diets. Mesotherapy. Oxygen bars. Even eating placenta. But there isn’t a quick fix. To stay healthy into your old age — to avoid diabetes, heart disease, stroke and cancer, the chronic diseases that cause the greatest number of premature deaths in the United States — you need, of course a bit of luck (“good” genes and a good job with health insurance). But you also need healthful habits. It’s that simple. And that difficult.
Most people, I find, are bored by that message. Whenever I start talking about exercise and diet and keeping the pounds off, my friends’ eyes seem to glaze over and the conversation soon drifts on to something else.
The fabulous four factors
Perhaps a study published Tuesday in the Archives of Internal Medicine will give me stronger talking points. Called “Healthy Living Is the Best Revenge,” the study analyzed almost eight years of data from more than 23,000 Germans between the ages of 35 and 65. From that data, it found that adherence to just four lifestyle factors (never smoking, exercising regularly, following a healthful diet and maintaining a healthy weight) was associated with an 80 percent reduction in the risk of developing those four potentially deadly chronic diseases I mentioned above.
During the course of the study, people who had all four healthy lifestyle factors were 93 percent less likely to develop diabetes, 81 percent less likely to have a heart attack, 50 percent less likely to have a stroke, and 36 percent less likely to be diagnosed with cancer.
Even adhering to just one of these healthy behaviors sliced the risk of chronic disease in half.
What supplement is going to give you that kind of return?
The greatest drop in risk was associated with having a BMI of under 30, followed by not smoking, exercising at least three-and-a-half hours weekly, and eating healthy (defined in this study as a high consumption of fruits and vegetables and a limited consumption of meat).
Yes, the study had some limitations. Most notably, participants self-reported how much they exercised and what they ate. And who knows if German data reflects what happens in the United States?
A tough sell
The study’s findings aren’t all that surprising. Plenty of other research has come up with similar results. In fact, as an editorial accompanying the study notes, the same modifiable behaviors have persisted as the leading causes of both premature death and chronic disease for more than a decade, yet we seem unable to persuade “those not already choosing health on their own to join with those who are.”
In a phone interview earlier this week, I asked Earl Ford, M.D., the lead author of the study and a public health official with the Centers for Disease Control and Prevention in Atlanta, Ga., why the healthy-lifestyle message is so difficult to sell to people.
He acknowledged that, except for improvements in the number of people not smoking, “we really are not making a whole lot of progress.” The growing number of people who are overweight and obese is probably inhibiting much of that progress, he added, particularly given the strong association between obesity and diabetes.
“All we can do is hopefully hammer away at [the healthy lifestyle message], and hope that people will maybe see the light and practice as many of these as they can,” Ford said.
We’re going to be pounding at that message for a long, long time, though, as David Katz, M.D., director of the Yale Prevention Research Center, noted (a bit poetically) in the editorial that ran with Ford’s study:
Ford and colleagues have offered us yet another glimpse of a public health promised land. For all concerned with the human condition, the arduous traverse from here to there, from knowledge of what most matters to health to the power of its application, beckons. Across an expanse of policies, practices, programs, personal responsibility, and political will yet to be mustered and in some cases yet to be devised — we have miles to go before we sleep.