Generally, adherence to healthy lifestyle patterns has decreased during the last 18 years. Obesity is up, exercise is down, and the number of people eating just five servings of fruits and veggies a day dropped like a rock. And we didn’t start out that great to begin with.
Only 3% of Americans at the turn of the 21st century had the following four healthy lifestyle characteristics: not smoking, not overweight, five daily servings of fruits and vegetables, and exercising a half hour a day at least five days a week. Whether people were wealthy or college-educated didn’t matter; no sub-group even remotely met clinical or public health recommendations.
Where are people falling down the most? You can see in my video What Percent of Americans Lead Healthy Lifestyles?. If you look at heart disease risk factors, for example, most people don’t smoke and about half are exercising. But if we look at the healthy diet score–which is based on things like drinking less than four cups of soda a week–a scale of zero to five, only about 1% of Americans score a four or five. The American Heart Association’s aggressive 2020 target to improve that by 20% would bring us up to 1.2%.
Since we’ve known for decades that advanced coronary artery disease may be present by age 20—with atherosclerosis often even present in young children—it is particularly disturbing that healthy lifestyle choices are declining rather than improving in the U.S.
In terms of life expectancy, the U.S. is down around 27 or 28 out of the 34 OECD free-market democracies. The people of Slovenia live a year longer than citizens of the United States. Why? According to the most rigorous analysis of risk factors ever published, the number one cause of death and disability in the United States is our diet.
It’s the food.
According to the Global Burden of Disease study, the worst five things about our diet are: we don’t eat enough fruit, we don’t eat enough nuts and seeds, we eat too much salt, too much processed meat, and not enough vegetables.
Studies that have looked at diet quality and chronic disease mortality risk found that those scoring higher (e.g. more whole plant foods), reduced the risk of dying prematurely from heart disease, cancer, and all causes of death combined. There is now an overwhelming body of clinical and epidemiological evidence illustrating the dramatic impact of a healthy lifestyle on reducing all-cause mortality and preventing chronic diseases such as coronary heart disease, stroke, diabetes, and cancer.
Why do we eat so poorly? Aren’t we scared of dying from these horrible chronic diseases? It’s almost as if we’re eating as though our future didn’t matter. And there’s actually data to back that up, from a study entitled Death Row Nutrition.
The growing macabre fascination with speculating about one’s ‘‘last meal’’ offers a window into one’s true consumption desires when one’s value of the future is discounted close to zero. In contrast to pop culture anecdotes, a group of Cornell researchers created a catalog of actual last meals–the final food requests of 247 individuals executed in the United States during a recent five-year period. Meat was the most common request. The researchers go out of their way to note that tofu never made the list, and no one asked for a vegetarian meal. In fact, if you compare the last meals to what Americans normally eat, there’s not much difference.
If we continue to eat as though they were our last meals, eventually, they will be.
A few years ago I did a video called Nation’s Diet in Crisis. It’s sad that it doesn’t seem like much has changed. How Many Meet the Simple Seven? is another video in which you can see how your own habits stack up.
For more on fruits and veggies and living longer, see Fruits and Longevity: How Many Minutes per Mouthful? Surprised that nuts made the longevity list? See Nuts May Help Prevent Death. What about legumes? See Increased Lifespan from Beans.
The reason public health professionals are so keen on measuring lifestyle characteristics is because modest improvements may have extraordinary effects. See, for example:
- Lifestyle Medicine: Treating the Causes of Disease
- Eliminating 90% of Heart Disease Risk
- Fully Consensual Heart Disease Treatment
- How Not to Die: An Animated Summary
Didn’t know the beginnings of heart disease may already be present in children? See my video Heart Disease Starts in Childhood. Think that’s tragic? Check out Heart Disease May Start in the Womb. Is it too late if we’ve been eating poorly most of our lives? It’s Never Too Late to Start Eating Healthier.
Michael Greger, M.D.
PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:
- 2012: Uprooting the Leading Causes of Death
- 2013: More Than an Apple a Day
- 2014: From Table to Able: Combating Disabling Diseases with Food
- 2015: Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet
- 2016: How Not To Die: The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers