Less than 3 percent of American adults have the four most basic characteristics of a healthy lifestyle, according to a study recently published in the journal Mayo Clinic Proceedings.
That’s a dismal statistic, for the healthy characteristics examined in this study play a key role in reducing the risk of heart disease, type 2 diabetes and some cancers — leading causes of premature death and disability in the United States
Those four characteristics are 1) 150 minutes a week of moderate or vigorous exercise, 2) a diet that scores in the top 40 percent of the Healthy Eating Index, 3) a body fat percentage under 20 percent (for men) and 30 percent (for women), and 4) not smoking.
Not exactly onerous.
Or, as Ellen Smit, the study’s senior author and a nutritional epidemiologist at Oregon State University, said in a released statement, “We weren’t looking for marathon runners.”
“This is pretty low, to have so few people maintaining what we would consider a healthy lifestyle,” she added. “This is sort of mind boggling. There’s clearly a lot of room for improvement.”
How the number was reached
For the study, Smit and her colleagues used data collected from a nationally representative sample of 4,745 adults, aged 20 to 85, who participated in the National Health and Nutrition Examination Survey between 2003 and 2006.
All four healthy characteristics were objectively measured. Participants wore an accelerometer for a week to measure their physical activity. They filled out two 24-hour food diaries to determine their dietary score. Their body fat was measured with X-ray absorptiometry, which is considered a more accurate measurement tool than body mass index (BMI). And their smoking status was determined not by the participants’ say-so, but by the levels of cotinine — a marker for exposure to tobacco smoke — in their blood.
That data revealed that 71.5 percent of the participants were nonsmokers, 46.5 percent received enough exercise and 37.9 percent followed a healthy diet, and 9.6 percent had a “normal” body fat percentage.
It also revealed that only 2.7 percent of the survey’s participants had all four healthy lifestyle characteristics, and 11 percent had none. As for the rest, 16 percent had three characteristics, 37 percent had two, and 34 percent had one.
Different demographic groups were more likely to have particular characteristics. Women, for example, were more likely to not smoke and to eat a healthy diet than men, but were less likely to be sufficiently active. People aged 60 and older were more likely to not smoke and eat a healthy diet than younger individuals, but they were less likely to not be overweight and to get enough exercise.
The study also broke the data down by three ethnic/racial groups: non-Hispanic whites, non-Hispanic blacks and Mexican Americans. Mexican Americas were found to be more likely than whites or blacks to consume a healthy diet. The study also found that blacks, particularly black men, tended to have the fewest number of healthy lifestyle habits.
Impact on markers for heart disease
The researchers also compared the healthy characteristics to 13 biomarkers for cardiovascular disease, such as blood pressure and levels of cholesterol, glucose and homocysteine. (The presence of a biomarker for a disease doesn’t mean that someone has the disease; it simply suggests that they person may be at an increased risk of developing the disease.)
The data revealed, perhaps not surprisingly, that the greater the number of healthy characteristics people had, the more they were likely to have biomarkers with favorable measurements.
But they also found that some healthy characteristics appear to be more important for specific risk factors. The strongest characteristic linked to favorable high-density lipoprotein (HDL) cholesterol levels was body fat percentage, for example, while for homocysteine levels, it was a healthful diet and not smoking.
‘A million dollar question’
So, why do so many of us — despite all the public health campaigns — fail to adopt all four of these basic characteristics of a healthy lifestyle?
“That is the million dollar question,” Smit told Huffington Post Erin Schumaker.
Smit cited a long list of possible contributing factors, including not having enough time to exercise or to cook healthful meals, not having a safe environment for exercising, needing a car to commute, and the marketing of unhealthful food.
Interestingly, that list suggests that if we truly want to help people get healthier, we need to not only encourage individuals to adopt healthier behaviors, but also to instigate major changes in how our society and communities are organized and run.
FMI: The study can be read in full at the Mayo Clinic Proceedings website.