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Adopting a healthy lifestyle can control or reverse heart disease

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Unhealthy lifestyle changes linked to increased risk for atherosclerosis

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The benefits of healthy habits are well established. These benefits include boosting mood, weight control and combating diseases. However, it is uncertain whether making health behavior changes as an adult can still alter coronary artery disease risk.

To fin d out if making health behavior changes will change the risk of coronary artery disease, Dr. Bonnie Spring, PhD, professor in preventive medicine, Director, Center for Behavior and Health - Institute for Public Health and Medicine at Northwestern University Feinberg School of Medicine and lead investigator of this study along with colleges examined healthy lifestyle behaviors and coronary artery calcification and thickening among 3,538 young adults, aged 18 to 30 years and who had participated in the Coronary Artery Risk Development in Young Adults (CARDIA) study.

Researchers evaluated five healthy lifestyle factors (not overweight/obese, low alcohol intake, healthy diet, physically active, nonsmoker) at baseline and 20 years later. The team tested whether change from year 0 to 20 in a continuous composite healthy lifestyle factors score is associated with atherosclerosis at 20 years.

After adjusting for demographics, medications, and baseline healthy lifestyle factors the results showed by 20 years 25.3% of the study participants had added at least one healthy lifestyle behavior.

Each increase in healthy lifestyle factors was associated with reduced odds of detectable coronary artery calcification and lower intima-media thickness – two major markers of cardiovascular disease that can predict future cardiovascular events.

Among participants 34.4% stayed the same.

In their conclusion the researchers write “Healthy lifestyle changes during young adulthood are associated with decreased risk and unhealthy lifestyle changes are associated with increased risk for subclinical atherosclerosis in middle age.”

According to Dr. Spring, “This finding is important because it helps to debunk two myths held by some health care professionals.” The first is that it’s nearly impossible to change patients’ behaviors. Yet, we found that 25 percent of adults made healthy lifestyle changes on their own. The second myth is that the damage has already been done – adulthood is too late for healthy lifestyle changes to reduce the risk of developing coronary artery disease. Clearly, that’s incorrect. Adulthood is not too late for healthy behavior changes to help the heart.”

The study also found that 40.4 % of participants had fewer healthy lifestyle factors and gained more bad habits as they aged. Each decrease in healthy lifestyle factor had greater odds of coronary artery calcification (odds ratio=1.17; 95% confidence interval, 1.02–1.33) and greater intima-media thickness (β=+0.020, P<0.01).

"It's not too late," comments Dr. Spring. "You're not doomed if you've hit young adulthood and acquired some bad habits. You can still make a change and it will have a benefit for your heart.”

"If you don't keep up a healthy lifestyle, you'll see the evidence in terms of your risk of heart disease," said Dr. Spring.

According to Dr. Spring the healthy changes people in the study made are attainable and sustainable. She offers some tips for those who want to embrace a healthy lifestyle at any age:

Keep a healthy body-weight

Don’t smoke

Engage in at least 30 minutes of moderate to vigorous activity five times a week

No more than one alcoholic drink a day for women, no more than two for men

Eat a healthy diet, high in fiber, low in sodium with lots of fruit and vegetables

This study is published in the journal Circulation.

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