In 1903, Thomas Edison predicted that the doctor of the future will give no medicine, but instead “instruct his patient in the care of the human frame in diet and in the cause and prevention of disease.” A hundred and one years later, the American College of Lifestyle Medicine was born. Lifestyle docs like myself still prescribe meds when necessary, but, based on the understanding that the leading causes of disability and death in the United States are caused mostly by lifestyle, our emphasis is particularly on what we put in our mouths: food and cigarettes. An “impressive number of studies have shown that lifestyle is the root cause of what ails us.” The good news is that by changing our lifestyle we can dramatically improve our health. We have the power.
We’ve known for a long time that for most of the leading causes of death our genes account for at most 10 to 20% of risk, given that rates of killers like heart disease and major cancers differ up to a 100-fold among various populations, and that when people migrate from low- to high-risk countries, their disease rates almost always change to those of the new environment. For example, at least 70% of strokes and colon cancer are avoidable, as are over 80% of coronary heart disease and over 90% of type 2 diabetes. So maybe it’s “time we stop blaming our genes and focus on the 70% that is under our control.” That may be the real solution to the health care crisis.
It doesn’t take much. Adhering to just four simple healthy lifestyle factors can have a strong impact on the prevention of chronic diseases: not smoking, not being obese, exercising half an hour a day, and eating healthier (more fruits, veggies, whole grains, less processed foods and meat). Four simple things cut our risk of developing a chronic disease by 78%. 95% of diabetes risk out the window, 80% of heart attack risk, gone. Half of stroke risk, a third of cancer risk, simply gone. Think of what that means in terms of the numbers. As it stands now, each year a million Americans experience their first heart attack or stroke, a million get diabetes, a million get cancer.
Do we actually get to live longer, too? The CDC followed about 8,000 Americans 20 years or older for about six years. They found that three cardinal lifestyle behaviors exerted an enormous impact on mortality. People who do not smoke, consume a healthy diet, and engage in sufficient physical activity can substantially reduce their risk for early death. By “not smoking” they just meant not currently smoking; by “healthy diet” they just meant in the top 40% in terms of complying with the rather wimpy federal dietary guidelines; and by being “physically active” they just meant averaging about 21 minutes a day or more of at least moderate exercise. Those that managed at least one of the three had a 40% lower risk of dying. Those that hit two out of three cut their chances of dying by more than half. Those that scored all three threw 82% of their chances of dying in those six years out the window.
What does that mean in terms of how much longer we get to live? A similar study on health behaviors and survival didn’t just take people’s word for how healthfully they were eating, they measured the level of vitamin C in people’s blood, a biomarker for how many plants they were eating, and the drop in mortality risk in those nailing all healthy behaviors was equivalent to being 14 years younger.