Why are nutrition and lifestyle so important?
There is a global epidemic of chronic disease termed non-communicable diseases (NCDs). According to the World Health Organisation, 71% of all deaths globally each year (41 million people) are caused by NCDs. Four conditions account for 80% of all premature deaths (less than age 70 years). These are cardiovascular disease, cancers, respiratory disease and diabetes. Approximately 80% of chronic disease and premature death could be prevented by adopting four healthy lifestyle factors; healthy diet, regular physical activity, not smoking tobacco and sensible use of alcohol. Of course, we also have to be aware that there are other important factors that significantly impact health outcomes, including socio-economic, political and cultural. For example, people with a higher level of educational attainment and higher incomes have more favourable health behaviours and better health outcomes.
Returning to lifestyle factors, a study reported in 2018 using data from the Nurses’ Health Study and the Health Professionals Follow-up Study in the United states, involving more than 170,000 men and women, defined 5 healthy lifestyle factors; healthy diet, never smoked, normal body mass index, moderate and not excess alcohol consumption and more than 30 minutes of moderate/vigorous activity per day. During the 34 years of follow-up, with each healthy lifestyle factors there was a significant reduction in the incidence of chronic disease, including cardiovascular disease and cancer, and a reduction in the risk of death. Adhering to all 5 healthy factors resulted in a 74% reduction in the risk of death and a 65% and 82% reduction in the risk of dying from cancer and cardiovascular disease respectively. Adherence to these 5 healthy lifestyle factors prolonged life expectancy at the age of 50 years by 14 years in women and 12 years in men. Figure 1 shows the 5 healthy lifestyle factors and the definition of a healthy diet. A healthy diet was one that was high in whole plant foods and low in processed and red meat and processed food.
Figure 1. Five healthy lifestyle factors and a healthy diet
Data from the UK with smaller numbers of participants showed similar results. The study involving 4886 men and women defined 4 unhealthy behaviours; smoking, low fruit and vegetable consumption, minimal physical activity and high alcohol consumption. With a median follow up of 20 years, each unhealthy lifestyle factor contributed to a significantly increased risk of dying from any cause, cardiovascular disease and cancer and those with all 4 unhealthy behaviours had a 12-year reduction in life expectancy.
What about diet alone? Globally, it is reported that unhealthy diets contribute to more death and disability than tobacco, alcohol and drug abuse combined. The most comprehensive analysis of dietary risk factors and effects on health has determined that globally, 1 in 5 deaths are caused by an unhealthy diet. In 2017, this accounted for 11 million deaths and 255 million DALYs (disability adjusted life years). The top 5 leading dietary risk factors were diets high in sodium (mainly a reflection of eating processed foods), low in whole grains, low in fruit, low in nuts and seeds and low in vegetables. The top three diseases resulting from these dietary risk factors were cardiovascular disease, cancer and type 2 diabetes. From the available data, it is clear that unhealthy diets are responsible for a large proportion of chronic disease and death globally.
Lifestyle as medicine
In recognition of the fact that lifestyle factors and behaviours are responsible for the vast majority of chronic disease and death, a new medical speciality has come to the fore — termed lifestyle medicine. Lifestyle medicine focuses of 6 main factors shown in Figure 2.
Figure 2. The six core components of lifestyle medicine
With regards to nutrition, the founding organisation of the global lifestyle medicine movement — The American College of Lifestyle Medicine — defines the optimal diet as ‘an eating plan based predominantly on a variety of minimally processed vegetables, fruits, whole grains, legumes, nuts and seeds’. This is essentially the definition of a whole food plant-based diet. The practice of lifestyle medicine has the opportunity to impact the root cause of chronic disease and improve the quality of a vast numbers of lives.
If you have found this article useful, please follow my organisation ‘plant-based health professionals UK’ on Instagram @plantbasedhealthprofessionals and facebook. You can support our work by joining as a member or making a donation via the website.