TUCSON, ARIZ. — The benefits of adopting healthy lifestyle habits later in life are significant, Dr. Dana King and colleagues reported at the annual meeting of the North American Primary Care Research Group.
He presented a secondary analysis of the Atherosclerosis Risk in Communities (ARIC) cohort study of 15,792 adults who were aged 45–64 years at the outset. Participants were reexamined every 3 years, with the first baseline screening occurring in 1987–1989, and the fourth and final screening in 1996–1998. Telephone visits were conducted annually.
At baseline, only 1,344 (8.5%) had all of the following four healthy lifestyle habits: They ate at least five fruits and vegetables a day, walked 150 minutes a week or more, were not obese, and did not smoke, “That [low rate was] tremendously disappointing,” said Dr. King, of the department of family medicine at the Medical University of South Carolina, Charleston.
Those less likely to have all four healthy habits tended to be male, black, and aged 45–54 years, and to have hypertension or diabetes mellitus, less than a college education, and an annual family income of less than $35,000.
After 6 years, an additional 970 participants switched to a healthier lifestyle. Women were more likely to switch than men (9.1% vs. 7.4%), he said. The most common changes were improved diet, increased exercise, and smoking cessation. Almost no one changed his or her body mass index category significantly, he said.
For those who adopted all four habits, the benefits were substantial. With an adjusted logistic regression analysis, the relative risk of cardiovascular disease was reduced by 35% and all-cause mortality by 40% in only 4 years, he said. Adopting only three habits was not as beneficial, resulting in a 25% reduction in all-cause mortality and a nonsignificant reduction in cardiovascular disease compared with those who have fewer healthy habits.
Dr. King called the results surprising and powerful because of the substantial benefit in cardiovascular disease and mortality seen after a relatively short period of 4 years. Other studies, such as the Women's Health Study and the Health Professionals Follow-up Study, have shown similar results. But these studies investigated individual habits and didn't focus on people who adopted new, healthy lifestyles in middle age, he said.
“The present study adds new information that adopting a healthy lifestyle later in life is not futile,” Dr. King said. “Doing all the habits is the way to go.”
Dr. King acknowledged that the study was limited by self-report data for diet and exercise; a short mortality and cardiovascular follow-up period; lack of data on the exact timing and consistency of the participants' health habits; and data from only four communities rather than from a nationwide database.