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How to Prevent Stroke (and lots of other stuff)
We know that maintaining a healthy weight, eating right, getting some exercise and not smoking is a good way to help reduce your risk of heart disease and diabetes. What about stroke - the third leading cause of death in the United States?
Mediterranean Diet, lifestyle factors, and the elderly
Researchers in the Department of Dietetics at Harokopio University, in Athens, Greece, evaluated the combined effects of a Mediterranean Diet, alcohol consumption, physical activity, and other factors on the cholesterol levels of persons 65 and over (Lipids in Hlth and Dis 2005;4:17).
What I (Un)Learned in Medical School
It was about 15 years ago, but as amazing as it may seem, I actually had a professor say, "I don't care about my diet, I'll just take Zocor or another cholesterol lowering medication and keep eating my thick, juicy steaks." This was in response to a Grand Rounds lecturer speaking about the importance of diet in preventing heart disease.
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We know that those who have a certain combination of what we doctors call Healthy Lifestyle Factors (HLF) in middle age tend to have a better quality of life (and incur fewer Medicare charges) as they get older. These Healthy Lifestyle Factors are known risks for heart disease and include normal weight, good cholesterol scores, normal blood pressures, never smoking, and no history of diabetes or heart attack. Studies have suggested that if all Americans had these five Healthy Lifestyle Factors in the year 2010, we would have had 95% fewer deaths from heart disease in that year. That's huge!
The problem, of course, is that only about 7.5% of people between the ages of 25 and 74 actually meet those criteria. And that percentage gets lower as people age.
You probably know from your own experience how hard it can be as an adult to achieve those Healthy Lifestyle Factors like good cholesterol scores, normal weight and normal blood pressure if you've had problems with them. A recent study published in the journal of the American Heart Association (Circulation 2012;125(8): 996-1004) looks at whether having those Healthy Lifestyle Factors as a young adult can help them have the resulting low risk of heart disease in middle age.
The study lasted over 20 years and followed over 3,000 men and women who were young adults (between 18 and 30) at the start of the study. At the start of the study and at regular intervals afterward the participants had their height, weight and blood pressures measured and provided blood samples to be tested for cholesterol scores and glucose levels. They also responded to detailed questionnaires regarding their diet, health status, exercise levels, whether they smoked or drank (and how much or how often), among other information.
At the end of the study the researchers were able to identify those with the specific Healthy Lifestyle Factors and at what point in the study they had them. Were those with a higher HLF score at the start of the study more likely to have higher HLF scores at the end of the study? Yes!
At the start of the study over 40% of the participants had a low risk profile, which is 4 or more of the Healthy Lifestyle Factors. Those who started with 5 HLF were about 75% more likely than those with only 0 or 1 HLF to still have a low risk profile 20 years later. On the other hand, when compared to those with 0 or 1 Healthy Lifestyle Factors, those who started with 2 HLF were only 8% more likely to have a low risk profile later in life.
The take-home message here is that it's easier to maintain a healthy lifestyle throughout your life than to correct health problems later. Help your kids be healthy adults, from young adulthood through old age, by modeling a healthy lifestyle for them and encouraging them to eat healthy, stay active, and not smoke.
First posted: March 7, 2012