A new study on cardiac health, whose results were published this week in the Journal of the American College of Cardiology, makes it all seem so simple: Five changes in lifestyle can reduce your chance of heart attacks by 80%.
Sign us up! But with most things in life, the devil is in the details.
The landmark study is considered a serious contribution to understanding how lifestyle affects health because of its size and scope.
More than 20,000 Swedish men who were 45 to 79 years old in 1997 were tracked until 2009 to see how life treated them, given their choices about diet, exercise and smoking. At the time, they had no history of cancer, heart disease, diabetes, high blood pressure or high cholesterol.
The good news is that those who were considered “ultra healthy” by not smoking, drinking moderately, eating a whole food diet, maintaining a proper weight, and exercising daily had a whopping 86% reduced risk of heart attacks. The bad news is only 1% of men qualified as living this ultra-healthy lifestyle.
Why the disconnect between knowing what’s good for you and actually doing it?
We decided to take the question out of the rarefied world of medical research and into the real world of patients by asking Dr. Doug Pitman, M.D., a seasoned family practice doctor, to interpret the findings for us.
Monsters and Critics: From your perspective as primary care physician, what are the most important “take-aways” from this study?
Dr. Doug Pitman, M.D.: Lifestyle choices are just as important as genetics in determining those at risk for heart disease. Identical twin studies confirm the fact that those twins who make preventative lifestyle changes have less heart disease then their identical twins who do not make those changes. These studies apply to both men and women. As the study stated these changes include attaining healthy BMIs with respect to weight, having an active lifestyle exercising 5 days per week, moderate alcohol consumption, no smoking, and a proper diet that lowers saturated fat intakes and avoid simple sugars.
Monsters and Critics: Of the “Big Three” problems identified with middle-aged men in the study — bad diet, lack of exercise and smoking — which is the most serious?
Dr. Doug Pitman, M.D.:I would say that smoking creates the greatest risk for heart disease. I suspect this is especially true in women who have a natural hormonal protection against heart disease based on cholesterol profiles.
Monsters and Critics: As a medical doctor, are you at all surprised that in 2014, medical researchers are telling American middle-aged men that drinking a cocktail each night is good for their health? (Will they next find that buying a fast car is good for your health?!?)
Dr. Doug Pitman, M.D.: It is been known for a long time that red wine with all of its antioxidants has a protective effect on blood vessels. In addition alcohol itself raises the good cholesterol HDL and in moderation — which is the key to consuming alcohol beverages — can play a small role in preventing heart disease along with the other behaviors mentioned in the study. Excessive alcohol plays havoc with virtually every system in the body creating fluctuations in insulin levels, which can lead to elevated triglycerides well known as significant risk for heart disease. In addition, the pure caloric intake from alcohol can lead to weight gain especially if drinking alcohol leads to uncontrolled eating.
Monsters and Critics: What is the challenge of the typical family practice doctor in encouraging their male (and female) patients to adopt a healthier lifestyle?
Dr. Doug Pitman, M.D.: The challenge for doctors is pursuing a healthy lifestyle themselves so patients can learn by example. One study that I can recall indicated that the most important factor in a primary care physician’s influence on patients’ risk for heart disease is not what he says but how he looks. If the physician is fit and practices cardiac prevention himself, patients or more likely to emulate his lifestyle. Overweight physicians who smoke cigarettes – which, by the way, wasn’t uncommon when my father was a physician in the 1950s and 1960s – can preach cardiac wellness until he or she is blue in the face, and they will not inspire their patients or promote compliance to their good advice..
Monsters and Critics: The study suggests 5 lifestyle changes to dramatically improve men’s cardiac health. If you had to add a 6th, what would it be/?
Dr. Doug Pitman, M.D.: My 6th recommendation is one that I have lived by my entire life. Simply put, it’s stress reduction. Find time during the day to relax your mind away from your work and allow your body to exercise in a comfortable way. Get into a relaxed zone of exercise and your brain will rest. I have always stretched my lunch hours into 90 minute exercise sessions involving jogging, cross-country skiing, biking and more recently walking. What better way to prepare yourself for an afternoon of work? Also, try to take a half-day off per during the work week for some quality relax time. And don’t forget to spend quality time with family and friends.
Doug Pitman, M.D. is a concierge medicine doctor with SignatureMD and the founder ofWhitefish Primary Care in Montana, specializing in premier sports and family medical care.
