The Seven Golden Rules for a Healthy Life

If we follow these simple steps, can we really reduce our risk of heart disease?

Cardiovascular disease (CVD) still remains the biggest killer in the UK.  In 2010, around 180,000 people died from CVD and 80,000 of these deaths were from coronary heart disease (CHD).  Although over the past decade, there has been a decline in death rates from heart disease in England, there still remains regional and socioeconomic differences in both incidence and case fatality, along with behaviour inequalities.

In 2010, the American Heart Association (AHA) proposed seven factors to help people understand the most effective ways of avoiding CVD and lowering the risk of developing cancer. 

The findings came from a long term study carried out by researchers from Northwestern University (Chicago), the University of Minnesota, and a number of other US research institutions; their findings were published in the peer-reviewed journal Circulation.  The cohort study followed 13,253 white and African American participants for between 17 and 19 years, to establish if maintaining ideal levels of the seven health factors could reduce heart disease and lower the risk of cancer. 

The Seven Simple Steps

• 1      Not smoking (never smoking or quitting more than 12 months ago
• 2      Maintaining a healthy body weight (that is a healthy Body Max Index (BMI)
• 3      Eating Healthily (diets rich in nutrition, fruits and vegetables)
• 4      Physical Activity (at least 75 minutes per week of vigorous physical activity, or 150 minutes per week of moderate or moderate plus vigorous activity
• 5      Having low cholesterol levels
• 6      Healthy blood sugar rates
• 7      Healthy blood pressure

The Findings

From the study, researchers found that the health benefits were higher among people who met the ideal levels for each of the seven factors.  For example, people who achieved ideal levels for six of more factors had a 51% reduced cancer risk and those who met the ideal levels of four factors had a 33% reduced rate of developing cancer.

While the findings have been welcomed, it is worth noting that smoking appeared responsible for the majority of the associations seen between the seven factors and cancer risk. This once again exemplifies how smoking has a direct correlation with your heart, blood pressure, circulation and individual risk of lung cancer.

What more can be done?

As highlighted above, CVD and CHD continues to be a major health concern in the UK, with health issues being more prevalent among low income earners. Those from lower socioeconomic groups are more likely to have poorer diets, lead sedentary lifestyles, suffer from mental health issues and partake in health risk behaviour, including smoking and alcohol abuse. These factors have a major impact on heart disease.

Type 2 diabetes and obesity are also some of the main contributors leading to CVD.  In England alone, a quarter of adults are obese and the prevalence of diabetes in the UK is around 5% for women and 6% for men.  The financial cost to society can also be detrimental.  The statistics reveal that in 2009, CVD cost the UK economy £19 billion – putting further strain on the health care system.

Although the AHA’s seven steps to improving health helps people to understand where to make the changes in their life (healthy eating, exercising), the problem is how to make these changes?  For most people, breaking old habits and changing behaviour can seem like an impossible task, and for some, change is not always welcomed. How do we engage with people and offer advice on sensitive issues that could potentially save their lives?

The RSPH, having recognised the fundamental importance of behaviour change to improve health, has developed a qualification in Understanding Behaviour Change, Level 2 Award, to provide an understanding of communication styles and practical skills to help individuals implement lifestyle changes. The one day programme will also aim to give learners knowledge and confidence to offer brief advice and engage in brief interventions.  Sometimes, having the right conversation with someone can have far reaching positive affects.   For further information on the qualification please click here or contact Gina Mohajer.

For further information on heart disease visit the British Heart Foundation here

Obese Pregnant Women - The Health Risks

In a study carried out by the Centre for Maternal and Child Enquiries (CMACE) "Maternal Obesity in the UK: Findings from a national Project" reveals that one in twenty women are seriously obese when they become pregnant putting their health and that of their baby at risk.

In 2008 the CMACE commenced a three year UK wide Obesity in Pregnancy project.  The project was initiated because of the growing concerns surrounding obesity and the challenge facing maternity services today.  These concerns included i) growing evidence that obesity is associated with increased morbidity and mortality for both mother and baby, ii) that women with obesity were over represented among those who died of direct deaths compared to those who died of indirect deaths, iii) the need for clinical guidance for the care of women with obesity in pregnancy.

The study looked at women who had a body mass index of 35 or more, with 18 to 25 classed as healthy, 25
30 classed as overweight and 30 to 35 obese.  A woman of average 5'5 height would weigh at least 15 stone or 95 kgs to have a BMI of 35 and be classed as severely obese. 

Evidence derived from the report highlighted that women with obesity have an increased risk of pregnancy-related complications and adverse outcomes compared to women with a healthy BMI.  These primarily include higher levels of fetal abnormality, hypertensive disorders, blood pressure problems, diabetes thrombosis, induction of labour, caesarean section and neonatal death.  The report highlighted that stillbirth rate was twice as high for women with a BMI of 35 or more and they were four times as likely to suffer a haemorrhage after birth. 

However, the report also revealed that despite the large number of obese women, maternity units are "under prepared" and do not have the necessary resources to care for obese pregnant women.  It was reported that there is a lack of extra wide wheelchairs, examination couches, trolleys and beds.  With almost one in five obstetric units not having operating tables to bear the extra weight.

Dr Imogen Stephens, CMACE Clinical Director said: “This CMACE report shows that much more needs to be done in the NHS to deal with the growing numbers of obese pregnant women."

"The findings from this new study show that the risks of clinical intervention increase with increasing levels of obesity and that specialist obstetric care is needed. All this requires improved, and better integrated, care for these women”. 

However, the CMACE report also recommended that GP's and primary care health professionals need to do more to encourage women to lose weight and adopt a healthier lifestyle before they conceive. 

Dr Tony Falconer, President of the Royal College if Obstetricians and Gynaecologists (RCOG) said: “Pregnant women who are obese need to know about the associated risks for them and their baby and must be supported to lose weight before they embark on pregnancy. This will involve counselling and advice from a range of healthcare professionals including GPs, midwives, maternity support workers and nutritionists.
"We need to think about being more proactive by encouraging and enabling women to lead healthier lives before they fall pregnant and after giving birth so that they take a more long-term approach to being healthy."

Professor Cathy Warwick, General Secretary of the Royal College of Midwives said “There is wider and long-term public health message here. There is a real need to reduce obesity in the population as a whole, tackling the issue before women become pregnant.”

To read the full CMACE report please click here