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April 25, 2005

Study finds very few adults leading healthy lifestyles

EAST LANSING, Mich.  A study by a Michigan State University epidemiologist finds that very few Americans are doing all they can to maintain a healthy life, a situation he said could have dire consequences if it doesn’t change.

The research of Mathew Reeves, which used nationally representative data from 153,000 adults and was published in the April 25 issue of the journal Archives of Internal Medicine, found that only 3 percent undertook four basic steps that define a healthy lifestyle – not smoking, holding weight down, eating right and exercising.

“I was really quite surprised at how low that number was,” said Reeves, an assistant professor of epidemiology. “These results illustrate the extraordinarily low prevalence of healthy lifestyles in the U.S. adult population.”

Reeves and Ann Rafferty, an epidemiologist with the Michigan Department of Community Health, analyzed data obtained from the Behavioral Risk Factor Surveillance System (BRFSS), a national survey conducted in 2000 that looked at Americans’ health habits.

Of the 153,000 respondents, only 3 percent participated in all four of what are termed healthy lifestyle characteristics, or HLCs.

Looking at these HLCs individually, about 75 percent reported they didn’t smoke; 23 percent included at least five fruits and vegetables in their daily diets; 22 percent took part in regular physical activity, which is defined as at least 30 minutes of activity a day, five or more times a week; and about 40 percent maintained a healthy weight, which is defined as a body mass index (BMI) of 25 or less.

Reeves said that women tended to follow more of the HLCs than men, as did whites compared with minority populations. But no one group, he said, came even close to what is necessary to lead a healthy life.

“It’s important to note that the effect of following these lifestyles is greater than anything else medicine has to offer,” Reeves said. “I don’t know anything a doctor’s office can do that would reduce your risk of diabetes or cardiovascular disease by 80 to 90 percent, which is what other studies have now shown.

“Before it was just common sense. But now we know from epidemiologic studies that if you do this there are huge benefits in terms of increased life expectancy, reduced disease risk, reduced medical costs and improved quality of life.”

The consequences of continuing down this path are evident in many ways, far beyond the issues of quality of life and life expectancy. One example, said Reeves, is the challenge to the nation’s health-care system.

“We have millions of people now going through adult life leading unhealthy lifestyles and a medical system that can treat illnesses and keep you alive longer than ever before,” he said. “If we don’t turn this around, the costs to society are going to be crippling.”

According to Reeves, all of the HLCs defined in the study are controllable, so the million-dollar question is, why are only a tiny minority of adults able to follow a healthy lifestyle?

He said that in order to get a large segment of the population to change its ways of living, it will be up to society as a whole to shift the cultural norms in terms of how it views healthy lifestyles.

“It’s going to take a real paradigm shift,” he said. “There need to be radical changes in the environment to help people incorporate more physical activity into their daily lives – bike paths, sidewalks and so on, and to eat a healthier diet.

“We are not proactive enough in challenging people to incorporate physical activity and other aspects of healthy lifestyles into their everyday lives. We need a societal change so that leading a healthy lifestyle is seen as a necessary expectation, and not something that is only followed by some tiny minority – everyone needs to understand what we are giving up by not doing this.”

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