What is a healthy lifestyle according to this study?
Non smoker
Eating a healthy diet
Normal body fat percentage
Being active
What is the evidence this is helpful?
Using surrogate markers for cardiovascular disease they showed that certain behaviors made a difference. Clearly smoking was a major issue for lifestyle changes but 71/5% of those studied were non-smokers.
Only 9.6% of people had a healthy body fat, in spite of having others. This, however, had the greatest impact on those markers. People with a healthy body fat ratio had lower blood pressure, better cholesterol and lipoprotein levels, and other markers. Next up was being active.
37.9% consumed a healthy diet and 46.5% were active enough.
From their paper:
Results
Only 2.7% (95% CI, 1.9%-3.4%) of all adults had all 4 healthy lifestyle characteristics. Participants with 3 or 4 compared with 0 healthy lifestyle characteristics had more favorable biomarker levels except for mean arterial blood pressure, fasting glucose, and hemoglobin A1c. Having at least 1 or 2 compared with 0 healthy lifestyle characteristics was favorably associated with C-reactive protein, WBCs, HDL-C, total cholesterol, and homocysteine. For HDL-C and total cholesterol, the strongest correlate was body fat percentage. For homocysteine, a healthy diet and not smoking were strong correlates; for WBCs, diet was not a strong correlate.
What Markers Did They Use?
The authors of the study used surrogate markers that are associated with a decrease in cardiovascular disease. Most were measured by a blood test such as C-reactive protein (CRP), white blood cells (WBCs), total cholesterol, high-density lipoprotein cholesterol (HDL-C), total cholesterol to HDL-C ratio, fasting low-density lipoprotein cholesterol, fasting triglycerides, fasting glucose, fasting insulin, insulin resistance, hemoglobin A1c (HbA1c), and homocysteine. Blood pressure measurements were taken.
The flaw in using surrogate markers can be seen with how smoking had less of an impact, and yet from long-term studies we know that smoking has more of an impact on health than any of the other markers in the study.
What Can You Do?
Eating a healthy diet and being active are two things that lead to improved function. But losing body fat is more important. Weight loss surgery is only performed on 1% of all obese Americans and yet, based on this study it would have the greatest impact on the health of all. That combined with eating better and physical activity is the best thing most Americans can do for themselves.
From the study:
| Biological/health marker | Unstandardized coefficient (SE, P value)c | |||
|---|---|---|---|---|
| Nonsmoker vs smoker | Healthy diet vs unhealthy diet | Sufficiently active vs not | Normal body fat percentage vs not | |
| MAP (mm Hg) | 0.82 (0.5, .11) | −0.85 (0.4, .06) | −1.33 (0.4, .002) | −3.14 (0.5, <.001) |
| C-reactive protein (mg/L) | 0.04 (0.03, .20) | −0.07 (0.03, .01) | −0.16 (0.02, <.001) | −0.16 (0.05, .01) |
| White blood cells (×1000 cells/μL) | −0.85 (0.1, <.001) | −0.24 (0.1, .009) | −0.50 (0.1, <.001) | −0.62 (0.1, <.001) |
| Total cholesterol (mg/dL) | −3.5 (1.8, .05) | −4.1 (1.4, .006) | 0.41 (1.2, .73) | −16.3 (1.9, <.001) |
| HDL-C (mg/dL) | 0.30 (0.5, .55) | −0.39 (0.6, .50) | 3.2 (0.6, <.001) | 11.6 (0.9, <.001) |
| Total cholesterol to HDL-C ratio | −0.13 (0.1, .03) | −0.1 (0.1, .12) | −0.25 (0.1, <.001) | −1.1 (0.04, <.001) |
| Fasting LDL-C (mg/dL) | −1.2 (2.8, .67) | −5.0 (2.1, .02) | 1.8 (1.6, .25) | −15.8 (2.9, <.001) |
| Fasting triglycerides (mg/dL) | −17.0 (9.2, .07) | −0.16 (5.5, .97) | −20.3 (7.2, .008) | −51.8 (6.6, <.001) |
| Fasting glucose (mg/dL) | 0.60 (1.3, .63) | 0.86 (1.4, .55) | −4.8 (1.3, <.001) | −6.0 (1.5, <.001) |
| Insulin (μIU/mL) | 1.8 (0.6, .003) | −1.1 (0.4, .01) | −3.1 (0.6, <.001) | −6.0 (0.4, <.001) |
| HOMA | 0.41 (0.1, .008) | −0.08 (0.1, .53) | −0.80 (0.2, <.001) | −1.5 (0.1, <.001) |
| HbA1c (%) | 0.02 (0.02, .43) | 0.05 (0.02, .05) | −0.14 (0.03, <.001) | −0.08 (0.03, .01) |
| Homocysteine (μmol/L) | −0.65 (0.2, <.001) | −0.51 (0.1, <.001) | −0.30 (0.1, .02) | −0.17 (0.2, .36) |
REFERENCE:
Healthy Lifestyle Characteristics and Their Joint Association With Cardiovascular Disease Biomarkers in US Adults
Loprinzi, Paul D. et al.
Mayo Clinic Proceedings , Volume 0 , Issue 0 ,
http://www.mayoclinicproceedings.org/article/S0025-6196(16)00043-4/fulltext
