Lifestyle: General benefits

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LifestyleGeneral benefits
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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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Why is a healthy lifestyle important?DH.
Choosing Health Summaries. 2004 Obesity. NICE
clinical guideline 43. 2006 CDC. The Health
Consequences of Smoking what it means to you.
2004

• Smoking causes cancer, respiratory diseases and
  CVD
• Poor diet has been linked to around 1 in 3 deaths
  from cancer and CHD
• Obesity is associated with cancer, CVD and type 2
  diabetes
• Excessive drinking has been linked to an
  increased risk of CVD, pancreatitis and liver
  disease
• Physical inactivity contributes to CVD, cancer
  and type 2 diabetes
• Following a healthy lifestyle may prevent people
  becoming patients and needing medication

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Whats more important to reduce mortality from
CHD reducing risk factors using lifestyle
interventions or increasing medical
interventions?Kelly MP, et al. HDA Briefing. Nov
2004

• 68,230 fewer deaths from coronary heart disease
  (CHD) In England Wales in 2000 compared with
  1981
• 42 of the decrease was attributable to medical
  and surgical treatments
• 58 was due to change in risk factors,
  particularly reduction in the prevalence of
  smoking
• Most treatment benefits were in secondary
  prevention medications and heart failure
  treatments
• Decline partially offset by increases in obesity,
  diabetes and lack of physical activity

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Reducing cholesterol, blood pressure and smoking
prevalence could halve current CHD mortality
Kelly MP, et al. HDA Briefing. Nov 2004

• If prescribing were increased so that 80 of
  eligible patients received medications, this
  would equate to 20,000 fewer deaths each year
• But..
• Reducing average cholesterol from 5.8 to
  5.2mmol/L (already achieved in Finland, Sweden,
  USA, Australia) prevents 25,000 deaths
• Simply reducing smoking prevalence to USA levels
  17,000 fewer deaths
• These plus a modest reduction in population BP
  50,000 fewer deaths
• This would halve the current CHD mortality

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But does improving lifestyle have health
benefits?NICE think so..
A healthier lifestyle by lowering blood
pressure and cardiovascular risk, may reduce,
delay or remove the need for long-term drug
therapy in some patients
Hypertension. NICE clinical guideline 34. 2006
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Whats the effect size of lifestyle interventions
on BP?Hypertension. NICE full guideline 18. 2004
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How does that compare with drug interventions?
Lowering BP to prevent MI stroke. HTA 2003731
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Even a small change in lifestyle can make a
significant difference to mortality Faculty of
Public Health. Easing the pressure tackling
hypertension. 2005
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Summary

• We have good observational 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