The Elements of

Good HealthMonte Ladner, M.D.

www.fitnessrocks.org

Healthy Lifestyle HabitsArch Intern Med. 2005;165:854-857

Healthy Lifestyle Habits

Don’t Smoke BMI 18.5 - 24.9 Five/day 30 minutes/day

“Magic Formula”

A Fifth Healthy Habit?AmJMed March 2008

Chronic Diseases

• Leading cause of death and disability

• 45 percent of the U.S. population (125 million Americans)

• 78 percent of all health care spending

http://www.ahrq.gov/news/ulp/chronic/ulpchron1.htm

Causes of Death

• Tobacco 435,000/year

• Poor diet/inactivity 365,000/year

• Excessive alcohol 85,000/year

JAMA. 2004;291:1238-1245

Heart

Cancer

All Other

Stroke

Lung

Alzheimer’sDiabetesInfluenza

Injury

http://www.cdc.gov/nccdphp/publications/aag/aging.htm

World Health OrganizationEstimates of Possible Prevention

http://www.who.int/dietphysicalactivity/publications/facts/chronic/en/

Diabetes Prevention ProgramNEJM February 7, 2002

Type 2 Diabetes in Pima IndiansDiabetes Care August 2006

Compression of Morbidity

DASH Diet

Fruits, vegetables, low-fat dairy, and reduced total fat

BP lowered 11.4/5.5 mm Hg in people with hypertension

Lowering sodium to 1500 mg/day further reduced BP

Mediterranean Diet (Mostly Plants)

High Consumption of:FruitsVegetablesBeansNutsWhole grainsOlive oilFish - moderateAlcohol - moderate

Low Consumption of:Saturated fatDairy products Red meat and poultry

NEJM June 26, 2003

Mediterranean Diet and Risk of Type 2 Diabetes BMJ 2008;336:1348-1351

83% reduced risk

Exercise Capacity and All-

Cause Mortality NEJM March 14, 2002

Stronger Predictor Than:

•Diabetes•High Cholesterol•High Blood Pressure•Smoking

Myers J et al. N Engl J Med 2002;346:793-801

Relative Risks of Death from Any Cause among Subjects with Various Risk Factors Who Achievedan Exercise Capacity of Less Than 5 MET or 5 to 8 MET, as Compared with Subjects Whose Exercise

Capacity Was More Than 8 MET

Exercise Capacity and Cancer Risk

Cancer MortalityHazard Ratios

Maximum Treadmill Duration

Obesity December 2007

Diet, Lifestyle, and Mortality in Elderly Men and WomenJAMA September 22/29, 2004

23% 22% 37% 35% 63%

Reduction in 10-Year All-Cause Mortality in People Aged 70 - 90

Still “Magic” After Age 45AMJMED July 2007

5 fruits and vegetables/day

BMI between 18.5 - 29.9

150 minutes/week of exercise

Not smoking

All-cause mortality down 40%

Cardiovascular disease down 35%

Genomic Medicine?

Obese Kids•One third

overweight/obese

• Increased risk for adult heart disease

• Kids developing:

•High blood pressure

•High Cholesterol

• Type 2 Diabetes

• Fatty infiltration of the Liver

• Ref: Fitness Rocks Podcast 137

Fitness & Academics

•Decline in school physical education participation

• Fit kids score higher on standardized testing - 38% for math and 24% for english

• Ref: Fitness Rocks Podcast 131