The truth is out: Fewer than 3 percent of Americans have the four lifestyle characteristics of healthy living

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There are four easily achievable characteristics that are most strongly associated with good health — and less than 3 percent of the U.S. public has all four, according to a study conducted by researchers from Oregon State University, the University of Tennessee at Chattanooga and the University of Mississippi, and published in the journal Mayo Clinic Proceedings.

The findings have troubling public health implications, said senior author Ellen Smit, PhD.

“The behavior standards we were measuring for were pretty reasonable,” Smit said in a media statement. “We weren’t looking for marathon runners. This is pretty low, to have so few people maintaining what we would consider a healthy lifestyle. This is sort of mind boggling.”

People struggle with diet and exercise

Researchers evaluated 4,745 adults who were enrolled in the National Health and Nutrition Examination Survey for four traits strongly associated with a lower risk of cardiovascular disease, cancer, type 2 diabetes and other chronic health conditions. The four traits are moderate exercise, good diet, not smoking and maintaining an appropriate body fat percentage.

In contrast to prior studies, which have relied on participant reports, the current study used objective measurements to evaluate the four traits. Participants wore accelerometers that tracked their movements, allowing researchers to measure whether they got at least 150 minutes of moderate-to-vigorous activity each week. Smoking status was determined via blood samples, and body fat via X-ray; about 21 percent of the body fat data was reported to be missing and subsequently filled in by researchers using “sequential regression multivariate imputation.” Strangely, a “good diet” was not defined as meeting certain nutritional goals but merely as being among the top 40 percent of the nation in terms of consuming foods recommended by the U.S. Department of Agriculture.

The researchers also measured various cardiovascular health markers, such as blood pressure and blood glucose, and confirmed that the four traits were indeed associated with better heart health.

Only 2.7 percent of participants had all four healthy traits. Approximately 16 percent had three traits, 37 percent had two, 34 percent had one and 11 percent had none of the healthy traits. More specifically, 71 percent of study participants were non-smokers, 46 percent got enough exercise and only 10 percent had a normal body fat percentage. Predictably, only about 40 percent of participants were among the top 40 percent of the U.S. population considered to have a “good diet,” as defined by the study.

The more traits a person had, the better their cardiovascular health markers. Certainhealthy traits were more strongly associated with certain markers. For example, body fat percentage had the greatest impact on HDL (“good”) and total cholesterol levels.

Prevalence of traits also varied by demographic factors. Women were more likely to be non-smokers and to have a good diet, but men were more likely to get enough exercise. Mexican Americans were about 1 percent more likely than non-Hispanic white persons to eat be considered having a “healthy diet,” while only 24 percent of non-Hispanic black participants were grouped in that category.

Adults over age 60 had, on average, fewer of the traits than adults 20–39. Yet, when individual traits were looked at, older adults were more likely to be non-smokers and have a healthy diet, but less likely to get enough exercise.

Adopt healthier habits today

The good news is that, even if you fall short, you can make simple changes to dramatically improve your health.

In a study conducted by researchers from Northwestern University and published in the journal Circulation in 2014, adults in their 30s and 40s who made heart-healthy lifestyle changes were able to halt or even reverse the progression of coronary artery disease.

“It’s not too late,” lead researcher Bonnie Spring said. “You’re not doomed if you’ve hit young adulthood and acquired some bad habits. You can still make a change and it will have a benefit for your heart.”

On the other hand, the researchers also found that people who abandoned healthy habits for bad ones suffered the ill effects just as quickly.

“If you don’t keep up a healthy lifestyle, you’ll see the evidence in terms of your risk of heart disease,” Spring said.

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