Adherence to Healthy Lifestyle Habits in US Adults, 1988-2006

Lifestyle choices are associated with cardiovascular disease and mortality. Comparing healthy lifestyle habits in adults between 1988 and 2006, the authors found adherence to 5 healthy habits decreased from 15% to 8% in the US, as obesity increased.

Abstract
Background
Lifestyle choices are associated with cardiovascular disease and mortality. The purpose of this study was to compare adherence to healthy lifestyle habits in adults between 1988 and 2006.

Methods
Analysis of adherence to 5 healthy lifestyle trends (≥5 fruits and vegetables/day, regular exercise >12 times/month, maintaining healthy weight [body mass index 18.5-29.9 kg/m2], moderate alcohol consumption [up to 1 drink/day for women, 2/day for men] and not smoking) in the National Health and Nutrition Examination Survey 1988-1994 were compared with results from the National Health and Nutrition Examination Survey 2001-2006 among adults aged 40-74 years.

Results
Over the last 18 years, the percent of adults aged 40-74 years with a body mass index ≥30 kg/m2 has increased from 28% to 36% (P <.05); physical activity 12 times a month or more has decreased from 53% to 43% (P <.05); smoking rates have not changed (26.9% to 26.1%); eating 5 or more fruits and vegetables a day has decreased from 42% to 26% (P <.05), and moderate alcohol use has increased from 40% to 51% (P <.05). Adherence to all 5 healthy habits has gone from 15% to 8% (P <.05). Although adherence to a healthy lifestyle was lower among minorities, adherence decreased more among non-Hispanic Whites over the period. Individuals with a history of hypertension/diabetes/cardiovascular disease were no more likely to be adherent to a healthy lifestyle than people without these conditions.

Conclusions
Generally, adherence to a healthy lifestyle pattern has decreased during the last 18 years, with decreases documented in 3 of 5 healthy lifestyle habits. These findings have broad implications for the future risk of cardiovascular disease in adults.

-- Dana E. King, MD, MS, Arch G. Mainous III, PhD, Mark Carnemolla, BS, Charles J. Everett, PhD

This article was originally published in the June 2009 issue of The American Journal of Medicine.

.A Quick Overview of Carbohydrates

With the recent popularity of hundreds of “low-carb” diets, more and more people are choosing to omit carbohydrates from their diet. While this may provide a quick (though usually temporary) way of losing weight, completely cutting carbohydrates from your diet is generally not a wise decision. This is because there are different types of carbohydrates, some of which can have huge health benefits. It’s important to understand exactly what a carbohydrate is, and how to distinguish between “healthy” and “unhealthy” carbohydrates.

What is a Carbohydrate?

On a biochemical level, a Carbohydrate is a simple fusion of carbon, hydrogen and oxygen molecules. Different types of carbohydrates have a different chemical makeup, and can have significantly different effects on your body when ingested. Though it is possible to group carbohydrates into two different categories (simple carbohydrates and complex carbohydrates), this is a slight oversimplification of how carbohydrates affect the body. Carbohydrates are in many foods, such as bread, milk, beans, potatoes, pasta, corn and sweets.

To digest a carbohydrate, your body needs to break each carbohydrate down into single sugar molecules, since this is the required size for sugar to be transported into the bloodstream. All digestible carbohydrates are usually converted to glucose, which provides the “fuel” needed by cells for proper functions. Carbohydrates in the form of fiber are an exception, since fiber is not directly digested by your body. Instead, fiber provides “bulk” to the waste that passes through your intestines, helping to properly dispose of all waste products from the intestines. Soluable fiber (the type of fiber that dissolves in water) helps your body by bonding to fatty substances in the intestines, which disposes of these fatty substances, also helping to lower levels of “bad” cholesterol (low-density lipoprotein).

Carbohydrates and Diabetes

When your body digests a carbohydrate (subsequently breaking down that carbohydrate into single sugar molecules), the sugar molecules from that carbohydrate enter the blood. This promotes a rise in blood sugar levels. With higher blood sugar levels, the pancreas begins to produce more insulin, which is required for the proper absorbtion of sugar molecules by the blood cells. When blood sugar levels begin to fall, the pancreas instead begins producing glucagon, which is a hormone that stimulates the liver to start releasing stored sugar. This process runs on a balance, and ensures that all cells in the body will recieve a proper level of blood sugar (especially the brain).

People with diabetes are not able to naturally maintain this balance of blood sugar. In Type 1 diabetes, the pancreas doesn’t produce enough insulin to promote absorbtion of sugar molecules into the bloodstream. Type 2 diabetes is characterized by a condition in which the blood cells do not respond to the insulin levels, and are not receptive to absorb sugar molecules. This is also called “insulin resistance”. This condition can be brought about by being genetically succepbtible to this condition, over-eating, or consuming a large amount of highly processed carbohydrates. The best way to prevent becoming insulin resistance is to limit processed carbohydrates (such as sweets, white flour pastries, and white flour pasta) and replace them instead with whole-grain carbohydrates

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