Healthy Behaviors Trim Dementia, Chronic Diseases

Five healthy behaviors-regular exercise; no smoking; and maintaining a low body weight, a healthy diet, and low alcohol intake-appear to reduce the risk of dementia and several chronic diseases significantly, according to a 35-year study that monitored men’s health habits.

The men who consistently engaged in 4 or 5 of these behaviors experienced a 60% reduction in dementia and cognitive decline-with exercise being the strongest mitigating factor-as well as 70% fewer instances of diabetes mellitus, heart disease, and stroke, compared with persons who engaged in none of them.

“Undoubtedly, these protective behaviors affect a host of biological mechanisms. Separating out relationships between the 5 behaviors and the 4 disease outcomes we examined would be an enormous, and probably a rather fruitless, task. It would not be helpful to the overall aim of promoting healthy lifestyles to dissect out and promote individual behaviors. People should be urged to adopt a healthy lifestyle as a complete package,” lead author Peter Elwood, DSc, MD, of the Cochrane Institute of Primary Care and Public Health at Cardiff University told ConsultantLive.

Researchers have known for some time that what is good for the heart is good for the head, Dr Elwood pointed out, noting that the study provides more evidence that healthy living could significantly reduce the chances of developing dementia.

The Caerphilly Cohort Study recorded the healthy behaviors of 2235 men aged 45 to 59 years in Caerphilly, South Wales. An important aim of the study was to examine the relationships among healthy lifestyles, chronic disease, and cognitive decline over a 35-year period. The researchers also monitored changes in the take-up of healthy behaviors.

“The size of reduction in the instance of disease owing to these simple healthy steps is of enormous importance in an aging population,” said Dr Elwood. “What the research shows is that following a healthy lifestyle confers surprisingly large benefits to health. Healthy behaviors have a far more beneficial effect than any medical treatment or preventative procedure.”

However, Dr Elwood pointed out, “Our study showed that over 30 years health promotion had no detectable effect on the prevalence of healthy living.”

Despite increasing knowledge of the relevance of lifestyle to health and to survival, the proportion of the adult Welsh population following all 5 healthy behaviors was, and remains, under 1%. The prevalence of all 5 healthy behaviors is estimated to be only 3% in large, primary prevention studies in the United States.

“Clearly there is an urgent need for new strategies in health promotion to be developed and evaluated,” Dr Elwood said.

He suggested that rather than talk to their patients about the benefits of a healthy lifestyle in rather vague terms, physicians should speak in precise, quantitative terms, saying something like: “People who live a truly active lifestyle experience 60% fewer heart attacks, 70% less diabetes, and a 60% reduction in dementia. Furthermore, those who follow a healthy lifestyle and still get a disease or dementia get it when they are about 12 years older.”

Dr Elwood also urged health care practitioners and primary care physicians in particular to be role models themselves for their families, friends, and their patients.

The researchers presented their results in the December 9, 2013, issue of PLoS One.