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Dr. Monte Ladner presentation at the 2009 IASA Spring Conference.
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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