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

Why making just two lifestyle changes can have positive and far reaching affects on health

A recent study, at the Northwestern University Feinberg School of Medicine, found that changing one bad habit can have a positive knock on effect on other behaviours.  A simple step such as watching less television, can simultaneously reduce the amount of time one spends snacking on unhealthy foods – as these two behaviours are closely related.   As such, the notion that you must radically transform your life in order to be healthier is not necessarily true and often hard to maintain.  Making just a couple of small changes, as the study demonstrates, can have a real and long lasting impact on people’s health.

The study was conducted by Bonnie Spring, professor of preventive medicine at Northwestern University Feinberg School of Medicine, in an attempt to find out the most effective way to spur people to change common bad health habits.  204 adult patients with unhealthy habits, were given the following treatments; an increase in vegetables/fruit and physical activity and decrease in fat and sedentary leisure.  Over the course of the three weeks, the patients had to record their daily data into a personal digital assistant in order to establish if they met their goals. 

After the three weeks, patients no longer had to maintain their “healthier” lifestyles, but were still required to send data three days a month for six months.

After the completion of the six months, the study found that the patients kept to their new healthier lifestyle changes rather than reverting back to their old habits.  Around 86% of the participants said that once they had made the initial change, they tried to maintain it.  By incorporating fruits and vegetables in their diet empowered them to believe that they were in fact capable of change. 

The results indicated that the most effective way to improve health required two key behaviour changes, namely cutting the amount of time spent watching TV or on the computer and eating more fruits and vegetables.  It is believed that these two simple changes could have long lasting results.   

Spring said, "Just making two lifestyle changes has a big overall effect and people don't get overwhelmed."

The majority of the population, where obesity is most prevalent, often lead unhealthy and sedentary lifestyles, putting them at high risk for heart disease, diabetes and cancer.  Spring argues that it is often hard for doctors to know where to initiate change in unhealthy habits, without discouraging or offending patients.   Thus this “two way” simple approach enables others to make realistic and manageable changes by giving them confidence to carry it out.

“With this simplified strategy, people are capable of making big lifestyle changes in a short period of time and maintaining them”  


Photo by Sina Bahrami http://5127.co.uk/

Sporting Advice

Today the Department of Health launched new advice on how to maintain fitness levels and stay or get healthy, for people of all ages.  The UK-wide physical activity guidelines by the four nations’ Chief Medical Officers, is intended to help people understand the benefits of physical activity and also promote the simple steps that people can take to incorporate activity into their everyday lives.

Although the guidelines build on previous advice about the positive outcomes of physical activity, they also highlight that being more active can dramatically reduce the risk of serious diseases such as heart disease, stroke and diabetes.

Key New Elements of the Guidelines Include:

How to incorporate physical activity into busy lives.  Adults can get their 150 minutes of activity a week in sessions of ten minutes or more and should aim to be active every day. 30 minutes five times a week is just one way this can be achieved.

·         Greater emphasis on vigorous activity and muscle strengthening through, heavy gardening, group sports, such as volleyball and basketball or swimming. There is good evidence this stimulates bone formation and maintains muscle mass;

·         Advice tailored to every age group including - for the first time - guidance for parents for under-fives;

·         Reducing and minimising periods of sedentary behaviour.

·         The guidance has a renewed focus on being active everyday and spells out the recommended minimum levels of activity for each age group:

The Recommendations:

Under Fives

180 minutes - three hours - each day, once a child is able to walk

Children and young people (5-18 year olds)
60 minutes and up to several hours every day of moderate to vigorous intensity physical activity. Three days a week should include vigorous intensity activities that strengthen muscle and bone. Adults (19-64 years old) and older people (65+) 150mins - two and half hours - each week of moderate to vigorous intensity physical activity (and adults should aim to do some physical activity every day). Muscle strengthening activity should also be included twice a week.

England's Chief Medical Officer Sally Davies said:

"Being active has enormous health and well being benefits. It protects against many of the biggest causes of early death like heart disease, and stroke, and can promote good mental health.
"The latest figures show that almost a quarter of adults are obese and on current trends by 2050 it means 9 in 10 adults will be overweight or obese. We know that more than 60 per cent of adults are not active enough which is why today the UK Chief Medical Officers are launching the first UK-wide guidelines that draw on the latest science to inform weekly levels of physical activity - whatever your age. "But it's not just about health. Cycling and walking more can save on transport costs, reduce congestion and pollution."

Robin Gargrave, Director of Innovation and Development at Central YMCA said:
"In terms of health benefits, we know that the duration, intensity and type of physical activity for a young person is very different to that required for an older adult. Most people know they can improve their health by being more active, but face barriers, which prevent them from doing so.

"This advice addresses these barriers by recognising the limitations of a 'one size fits all' approach to physical activity - it speaks directly to people at different stages of their lives and is flexible in its approach. For providers such as Central YMCA, this advice will enable us to develop and target physical activity interventions more effectively."

To access the guidelines, click here and to view the press release, click here

RSPH – Sport for Health: Bringing Sport into People’s Lives.

Sport for Health is a two part programme specifically for people who work in sport, either in a professional or voluntary role. It is designed to help them increase the level of physical activity amongst people who do not normally take part in sport.  It provides an understanding of how an active lifestyle promotes good health, and a practical approach to understanding the barriers people face and ways to overcome them.

Through the Mayor’s Legacy Fund, applicants can attend the courses at a 75% discount on the normal rate (ie the trainee fee is £50 per day as opposed to the normal £200).   In order to qualify for the discount applicants need to commit to 20 hours of voluntary work in the London area – either in sports or in encouraging others to take part in physical activity.
To find out more about this course, available funding and other programmes offered by RSPH, please click here call Nicolette Boustaoui on 020 7265 7325 or email sportforhealth@rsph.org.uk. 

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

Ways of Tackling Obesity - Fat Tax, Better Labelling and Restricting Advertisements

A team of researchers from the Organisation for Economic Co-operation and Development, and from the World Health Organization (WHO), published a paper in The Lancet Series on Chronic Disease and Development.  The paper explores and highlights ways to tackle the rise in obseity in nations of all incomes.

The paper studied obesity rates in seven countries: Brazil, China, India, Mexico, Russia, South Africa, and,  England.  The researchers found that in all seven countries, obesity posed a big health problem.  Statistics reveal that the UK is the fattest country in Europe and this is set to rise by 10% over the next decade.  Seven in ten Mexican adults are now considered obese or overweight.  Similarly China now has the same rates of diabetes as the USA (92 million).    

As such, the paper concluded that in order to tackle rising obesity levels, a combined approach needs to be implemented nationally.  Taxing unhealthy foods, (or reducing tax on healthy foods), restricting advertisements on unhealthy foods and improving labeling, is among the most cost effective ways to promote healthy eating.  It is estimated that these measures would add nearly 7 million life years in good health over the next two decades in seven countries covering almost half of the world population.

Clearly authors of the paper provide some clear actions that need to be seriously considered to help drive down obesity levels.  However, what other ways and initiatives can be introduced to encourage people to make healthier lifestyle choices?
 



World Diabetes Day "Eye Lights" The Global Diabetes Panademic

The 14th November is World Diabetes Day (WDD) which was created to raise awareness and understanding of the global diabetes pandemic.  Currently in the UK the number of people affected by diabetes is over 2.8 million and this figure is expected to rise.  By 2025 it is estimated that over 4 million people will suffer from diabetes due to aging populations, increasing rates of obesity and sedentary lifestyles. 

To mark WDD, Andrew Lansley, Secretary of State for Health, will be the guest speaker at a reception this evening.  The event will bring together members of the diabetes community and will address key issues facing patients, healthcare professionals and policy makers throughout the UK.  To coincide with tonights reception and the 14th November, the Merlin Entertainments London Eye will be illuminating blue to respresent the WDD blue circle logo.