Diet and Fitness: A Proven Path to Heart Health
Lifestyle changes can slash your risk for cardiovascular disease as well as diabetes
It may not be a magic wand for better health, but it sure seems to come close.
Eating healthfully and exercising regularly can sharply lower your risk of death from cardiovascular disease -- the leading cause of death in the United States -- and type 2 diabetes, a major risk factor for heart disease.
That's the uplifting word from Dr. Walter Willett, chairman of the Harvard School of Public Health's department of nutrition. Willett is also the principal architect of the Nurses' Health Study (NHS) II, one of the largest prospective studies of risk factors for chronic disease in women.
His eye-opening report, "Diet and Optimal Health: A Progress Report," suggests that better lifestyles habits could prevent 80 percent of heart disease and 90 percent of type 2 diabetes. These estimates are based on the NHS II study, begun in 1989, the original NHS study, launched in 1979, and dozens of other studies focusing on the effects of lifestyle on heart disease and diabetes.
An estimated 71 million Americans suffer from heart disease, and 2.4 million die from it each year, making it the nation's top killer, according to the American Heart Association. And, as many as 20 million adults and children have type 2 diabetes, says the National Institutes of Health.
Willett maintains that staggering reductions in disease risk are achievable -- and with fairly modest changes. For instance, he suggests that switching from highly refined to whole grain breads and cereals is one way to improve your odds against these diseases.
"This is pretty easy, as it can mostly be done by substitution," Willett said. "For example, replace a low fiber cereal with a 100 percent whole grain cereal; replace white bread with whole grain bread; replace white rice and potatoes with brown rice and other whole grains."
He also recommends eating fish twice a week and choosing from a variety of fish, including tuna, cod and salmon; keeping red meat consumption to a minimum; and eliminating trans fats. Smokers must give up cigarettes to cut their risk for heart disease, too.
And even moderate amounts of exercise can make a difference in a person's body mass index, a ratio of weight to height that is useful in assessing whether a person is at a healthy weight.
"Building physical activity into our daily lives is essential for good health, and there are thousands of ways to do this," Willett noted.
Yet, while a healthy diet-and-exercise regimen may be a potent antidote in the war against heart disease, many Americans just can't get their nutritional and physical fitness acts together.
"Many factors have been barriers," Willett conceded. "Lack of information or incorrect information has been part of the problem," he said. "Unfortunately, many people have been told the most important change was to reduce total fat in the diet, which will be ineffective or even harmful for some people."
Old habits also can impede change.
How people eat and exercise become mostly ingrained by adulthood, explained Karen Chapman-Novakofski, an associate professor of nutrition at the University of Illinois at Urbana-Champaign. "So, the first part of it is to really raise awareness of what people are eating, how they're living, how they're exercising, because if they don't recognize that, then you can't hope that they're going to change," she explained.
The second part, she added, is planning ahead.
"One of the things that I tell audiences when I'm talking about obesity and diabetes is you have to have a plan. I don't like to use the word 'diet' because that sounds restrictive," Chapman-Novakofski said. "But having a plan for what you're going to eat, when you're going to exercise, that's reasonable, that you can really do, and means you're much more likely to accomplish that then if you unconsciously complete your dietary habits and exercise habits and hope it was right."
For health professionals like Chapman-Novakofski, the challenge is helping ordinary Americans make sense of the latest dietary and exercise advice and showing them how to apply it in their daily lives.
This gaping need was underscored after a recent talk Chapman-Novakofski gave on diabetes. "A man came up to me and said, 'I've bought five books on diabetes, and I've sent them all back. Tell me what I should eat for lunch.' "
The Executive Office of the President and the U.S. Department of Health and Human Services can tell you more about nutrition and physical activity.
SOURCES: Walter Willett, M.D., Fredrick John Stare Professor of Epidemiology and Nutrition, Harvard School of Public Health, and professor of medicine, Harvard Medical School, Boston; Karen Chapman-Novakofski, R.D., L.D., Ph.D., associate professor, nutrition, College of Agricultural, Consumer & Environmental Sciences & College of Medicine, extension specialist, University of Illinois, Urbana-Champaign, Urbana; American Heart Association, Dallas; type 2 diabetes fact sheet, National Institutes of Health, Bethesda, Md.