Lifestyle: Benefits of individual interventions

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LifestyleBenefits of individual interventions
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What is a healthy lifestyle?

• Dont smoke
• Maintain a normal body weight for adults (BMI
  18.5 to 24.9 kg/m2)
• Eat a healthy balanced diet
• Plenty of fruit and vegetables (at least 5
  portions/day), nuts, fish and fibre (approx
  18g/day)
• Limited dairy products and meat
• Avoid saturated fat mono-unsaturated vegetable
  oils are preferable
• At least 2 portions of oily fish per week
• Limited salt intake (max 6 g/day)
• Avoid processed foods
• Engage in regular physical activity of moderate
  intensity for at least 30 minutes per day, most
  days of the week
• Limit daily alcohol consumption

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Benefits of smoking cessation BMJ Group. Putting
evidence into practice smoking cessation. 2007
CDC. The Health Consequences of Smoking what it
means to you. 2004

• There is good evidence that stopping smoking
  reduces the risk of
• all-cause mortality
• CHD and stroke
• lung cancer
• It also reduces the rate of deterioration in COPD
• Stopping smoking at any age is beneficial to the
  health of smokers and those people around them
• The earlier a person stops smoking the better
• but better late than never

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Benefits of losing weight Avenell A, et al. HTA
2004821Lean MEJ, et al. BMJ 2005330133940

• Losing weight is associated with a reduction in
• Mortality (all cause, cancer, CVD and
  diabetes-related)
• The risk of developing type 2 diabetes
• Hypertension
• Cholesterol
• Move a little more, eat a little less
• 90 of obesity in the USA could be abolished by
• walking an extra 2000 steps a day (about a mile)
• and
• reducing dietary intake by 0.418MJ (100kcal)
  per day
• 100 kcal a pat of butter or 2 Jaffa cakes
  or 5 Rolos or 1 small Kit Kat or ½ a Lion bar
• www.americaonthemove.org

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NICE diet recommendations NICE. Clinical
Guideline 43. Dec 2006 Premier Collaborative
Research Group. JAMA 2003289208393 Sacks FM,
et al. N Engl J Med 2001344310

• Total energy intake should be less than
  expenditure
• For sustainable weight loss, recommend diets with
  600kcal/day deficit or those that reduce calories
  by lowering fat content, in combination with
  expert support and intensive follow-up
• Low calorie diets (10001600 kcal/day) may be
  considered but are less likely to be
  nutritionally complete
• In the longer term, people should move towards
  eating a balanced diet, consistent with other
  healthy eating advice
• People should be encouraged to improve their diet
  even if they do not lose weight, because there
  can be other health benefits
• A Mediterranean diet is associated with a reduced
  risk of death (all cause mortality, CHD and
  cancer)
• Oily fish may protect against CHD
• The DASH diet reduces BP
• Lowering salt intake reduces BP

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Benefits of limiting alcohol intake Castelnuovo
AD, et al. Arch Intern Med 2006166243745 DH.
Safe. Sensible. Social. 2007

• Consumption of 24 drinks in men and 12 drinks
  in women is associated with a reduced risk of
  mortality
• Higher levels of drinking are associated with an
  increased risk of mortality
• Men should not regularly drink more than 34
  units of alcohol/day
• Women should not regularly drink more than 23
  units of alcohol/day
• After an episode of heavy drinking refrain from
  drinking for 48 hours

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Benefits of physical activity DH. At least five
a week. 2004

• Strong evidence that physical activity helps
  prevent CHD, stroke, type 2 diabetes,
  osteoporosis, colon cancer and breast cancer
• Strong evidence that it is useful to treat low
  back pain
• Moderate evidence that it is a useful treatment
  for CHD, peripheral vascular disease, obesity,
  osteoarthritis and depression
• Helping inactive people to become moderately
  active will produce the greatest reduction in
  risk to the population
• The health benefits far outweigh any risks

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Summary

• We have good observational data and some RCT
  evidence that improving lifestyle improves health
  or protects against disease
• So following a healthy lifestyle not smoking,
  eating a balanced diet, limiting alcohol intake
  and exercising regularly would seem to be
  sensible
• It may help to
• Reduce the risks of becoming ill
• Modify risk factors
• Control disease
• Reduce mortality
• Avoid the need for drug treatment and the
  associated risks
• On a population basis small changes are likely to
  have the biggest benefits
• Although the evidence for multiple interventions
  is limited small changes in several areas may
  improve health outcomes further
• Its never too late to adopt a healthy lifestyle