Showing posts with label Lifestyle. Show all posts
Showing posts with label Lifestyle. Show all posts

Thursday, November 14, 2013

Treating Heart Disease: Part 2 Lifestyle

Yesterday, I briefly discussed the American Heart Association & American College of Cardiology's new guidelines on treating high cholesterol.  Today, I thought I'd review their recommendations regarding the effect of lifestyle on heart disease risk.  However, as the authors pointed out, they did not have the time & resources to actually consider outcome benefit but rather only at the effect of lifestyle on blood pressure & lipids.

What I found intriguing is that the recommendations to lower blood pressure are very similar to those to lower cholesterol.  In other words, the authors found strong evidence to support consuming mostly vegetables, fruits & whole grains while limiting sweets, sugar-sweetened beverages, and red meat.  Low-fat dairy products, poultry, fish, legumes & non-tropical vegetable oils & nuts help serve as an alternative.

While strong, the evidence regarding physical activity was not nearly as impressive as that of diet, whether attempting to improve cholesterol or blood pressure.  Still the authors concluded that adults should be encouraged to reduce LDL cholesterol & blood pressure via 3-4 40 minute sessions a week of moderate-to-high intensity physical activity.

So there you have it.  But before arranging for more meds, see if you can improve your risk factors via lifestyle modification.



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Tuesday, August 6, 2013

Lifestyle Affects Cancer Risk

Did you ever get an itch that you just couldn't scratch?  Well, some how I got it in my head that some study was published recently linking lifestyle to cancer.  Problem was, I couldn't find it!  So I did my best imitation of the proverbial blind squirrel looking for a nut and finally found the prospective multicenter study published earlier this spring in March in Circulation in which the authors concluded that greater adherence to just seven habits of a healthy lifestyle was associated w/lower risk of cancer.  If this sounds familiar, it's because these same Life's Simple 7 habits were linked to a lower risk of stroke barely 2 months ago.

Of note, the 13,253 participants were in the Atherosclerosis Risk In Communities (ARIC) trial rather than June's Reasons for Geographic And Racial Differences in Stroke (REGARDS) trial.  Let's recall that these 7 ideal metrics are part of the American Heart Association's Strategic Impact Goal Through 2020 and Beyond.  Specifically, they were never having smoked (or having quit more than 12mo); having body mass index less than 25kg/m2; daily consumption of 4-5 components of a healthy diet score; engaging in more than 75min/wk of vigorous physical activity or 150min/wk of (at least) moderate physical activity.  They also looked for an untreated total cholesterol less than 200mg/dL, untreated blood pressure less than 120/80mm Hg; and untreated fasting glucose less than 100mg/dL.  

Those who met at least 6 of the 7 lifestyle goals had half the cancer risk of those who had met none of the goals.  After excluding the effect of tobacco use, those who met at least 5 of 6 lifestyle goals still had 25% lower risk of cancer compared to those who had met none of the goals.  Bottom line: what's good for your heart is good for your brain and also lowers your risk for cancer.  You have to admit that's a pretty impressive 3 for the price of 1 deal!




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Monday, June 10, 2013

Lifestyle Affects Stroke Risk Part 2

Nearly two years ago, I wrote about a study published in the Archives of Internal Medicine in which lifestyle was linked to stroke risk. Just two months ago, a study published in the European Heart Journal noted that while cardiac risk factors were good in predicting heart disease risk, they weren't nearly as impressive in predicting stroke risk.  So who are we to believe?

As a tie-breaker, let me point your direction to a population-based cohort study of 30,239 older than 45yo who were followed from 2003-2007 that was published early online last week in Stroke.  The authors were able to link blood pressure, cholesterol, glucose, body mass index, smoking, physical activity & diet to stroke risk, based upon a simple 2 point scale (0=poor, 1=intermediate & 2=ideal) such that inadequate cardiovascular health was 0-4 points while average CV health was 5-9 points and optimum CV health was 10-14 points, thus comprising the 

Regardless of gender & ethnicity, an improvement in health category from inadequate to average health or from average to optimum was linked to a 25% lower risk of stroke.  More importantly, each point was associated w/8% lower risk of stroke.

This, to me, makes more sense.  After all, a blood vessel is a blood vessel is a blood vessel is a blood vessel, regardless of the organ for which it supplies.  Bottom line, take care of your heart & brain at the same time.




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Wednesday, April 10, 2013

TV Might Not Be So Good For Our Kids Either Part 2

Washing hands to minimize puerperal fever.  H pylori as causative agent of peptic ulcers.  Estrogen replacement therapy as not so convincingly safe.  It's these studies & more that revolutionize our thinking and keep us on our toes.  However, medicine is more often full of "Duh!" moments.  After all, whenever studies support conventional wisdom, we slap our foreheads like the old V8 commercial and question why we had to spend time & money on something so obvious.  We've known for a while that watching television & spending time in front of a computer isn't healthy for adults.  But does all this data also apply to adolescents?

Well, in a small study published online in Pediatrics earlier this week, the authors concluded that screen time is indeed linked to body mass index in adolescents.  Cue the sound of foreheads being slapped.  The authors found 91 young teenagers 13-15yo and obtained self-reported diaries of time spent watching TV, playing video games and in front of a computer.  They also calculated BMI based upon weight & height in a typical fashion.  Interestingly, while time spent watching TV was not related to BMI, greater time spent in front of the television relative to playing video games or in front of computer was indeed linked to higher BMI.  In fact, those in the highest quartile vs lowest had 2+kg/m2 greater BMI.

So while all screen time is of concern, it would appear that we need to be even more on alert to the various (food) advertisements that are more prevalent during TV viewing as opposed to playing video games and/or sitting in front of a computer.  In other words, our teens are easily swayed by Madison Avenue ads.  Cue more forehead slapping.



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