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Studies Affirm Value of Healthy Lifestyle

Those who ate right, exercised lowered chances of cardiovascular trouble

TUESDAY, July 21 (HealthDay News) -- All that heart-healthy advice about eating the right foods, exercising and losing weight pay off in real life for both men and women, two new studies show.

The reports, both originating at Brigham and Women's Hospital in Boston and published in the July 22/29 issue of the Journal of the American Medical Association, focused on different aspects of cardiovascular risk in two large groups: the 83,882 women in the second Nurses' Health Study, and the 20,900 men in the Physicians' Health Study I. Both arrived at the same conclusion: Do the right things, and you get measurable benefits.

Simultaneous appearance of the two reports was more or less a coincidence, said Dr. Luc Djousse, an associate epidemiologist at Brigham and Women's at Harvard Medical School, who led the men's study.

The study in men looked at the relationship between the lifetime risk of heart failure and six lifestyle factors: obesity, exercise, smoking, alcohol intake, consumption of breakfast cereals, and consumption of fruits and vegetables.

"Previous studies have shown benefit from individual lifestyle factors," Djousse said. "We looked at all of these factors together."

That look found a straight-line relationship between adherence to healthy lifestyle factors and the risk of heart failure, the progressive loss of ability to pump blood that is often a prelude to death. The lifetime risk of heart failure in the 22-year study was about one in five in men who ignored the advice about all beneficial lifestyle factors and one in 10 for those who adhered to four or more of the factors.

"The one with a huge difference was adiposity," Djousse said. "The risk of heart failure was 17 percent in men who were overweight or obese, and about 11 percent in those of normal weight."

Exercise was the next most important. Heart failure occurred in 11 percent of the men who exercised five or more times a week and in 14 percent of those who did not exercise, Djousse said.

Smoking played a surprisingly small role, probably because its incidence was not high among the participants. "These were all physicians, so you would expect a smaller amount of smoking," Djousse said.

The women's study looked at the association between high blood pressure -- a significant risk factor for heart disease, stroke and other cardiovascular problems -- and six lifestyle factors: obesity, exercise, alcohol intake, use of non-narcotic painkillers, adherence to a diet designed to prevent high blood pressure and intake of supplemental folic acid. All six were found to be associated with the risk of developing high blood pressure in the 14-year study, and the association was cumulative.

Women who followed advice on all six factors -- just 0.3 percent of those in the group -- had an 80 percent lower incidence of high blood pressure than those who followed none of the rules. The incidence was 72 percent lower for the 0.8 percent of the women who followed five lifestyle rules, 58 percent lower for the 1.6 percent of the women following four rules and 53 percent lower for the 3.1 percent of the women who followed three rules. As in the male group, obesity was the most important risk factor.

While the clear message of both studies is that "a healthy lifestyle prevents a number of illnesses," what is often overlooked is that the choice of a healthy lifestyle is not a purely individual decision, said Dr. Veronique L. Roger, a professor of medicine and epidemiology at the Mayo Clinic, who wrote an accompanying editorial.

"There is a shared responsibility between the individual and the community," said Roger, who read off a dictionary definition of lifestyle as "a typical way of life of an individual, group or culture."

"The reality is that society has engineered physical activity out of our lives," Roger said. "And it is difficult for me to tell someone in Nebraska to follow the Mediterranean diet, which is anchored in the culture of that society."

Government interventions, such as the decision of New York and other communities, to bar smoking in restaurants and bars, can help more people achieve the healthy lifestyles described in the two reports, she said.

More information

The full list of cardiovascular risk factors is given by the American Heart Association.

SOURCES: Luc Djousse, M.D., Sc.D, associate epidemiologist, Brigham and Women's Hospital, and associate professor, medicine, Harvard Medical School, Boston; Veronique L. Roger, M.D., professor, medicine, Mayo Clinic, Rochester, Minn.; July 22/29, 2009, Journal of the American Medical Association

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