What Percent of Americans Lead Healthy Lifestyles?

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Death row nutrition offers some insight into the standard American diet.

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Generally, adherence to a healthy lifestyle pattern has decreased during the last 18 years. Obesity is up, exercise is down, and eating just five servings of fruits and vegetables a day dropped like a rock. And we didn’t start out that great to begin with. Guess what percentage of Americans at the turn of the century had the following four healthy lifestyle characteristics: not smoking, not overweight, five servings of fruits and vegetables a day, and exercising half an hour a day at least five days a week? 3%. And whether people were wealthy, college-educated, no sub-group even remotely met clinical or public health recommendations.

Where are people falling down the most? If you look at heart disease risk factors, most people don’t smoke, shown here in green. About half are exercising. But check out the healthy diet score, which gives folks points for drinking less than four cups of soda a week. On a scale of zero to five, only about 1% score a four or a five. So the American Heart Association’s aggressive 2020 target to improve that by 20% would bring us up to 1.2% of men and women.

Given that we’ve known for decades that advanced coronary artery disease may be present by age 20, and that coronary atherosclerosis is often even present in young children, it is particularly disturbing that healthy lifestyle choices are declining rather than improving in the U.S. And it shows.

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? Well, according to the most rigorous analysis of risk factors ever published, the #1 cause of death and disability in the United States is our diet. What about our diet is so bad? The worst five things about our diet is that we don’t eat enough fruit, we don’t eat enough nuts and seeds, we eat too much salt, too much bacon, hot dogs, lunch meat, etc., and not enough vegetables.

That’s based on data like this, on diet quality and chronic disease mortality risk, which found that those scoring higher using a variety of different systems that all agreed on more whole plant foods, reduced the risk of dying 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.

So why do we eat so bad? Aren’t we scared of dying from some of 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. 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. If that future didn’t matter, what would we eat?  Well, in contrast to pop culture anecdotes, this 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 commonly made request. The researchers go out of their way to note tofu never made the list. And no one asked for vegetarian. 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.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Generally, adherence to a healthy lifestyle pattern has decreased during the last 18 years. Obesity is up, exercise is down, and eating just five servings of fruits and vegetables a day dropped like a rock. And we didn’t start out that great to begin with. Guess what percentage of Americans at the turn of the century had the following four healthy lifestyle characteristics: not smoking, not overweight, five servings of fruits and vegetables a day, and exercising half an hour a day at least five days a week? 3%. And whether people were wealthy, college-educated, no sub-group even remotely met clinical or public health recommendations.

Where are people falling down the most? If you look at heart disease risk factors, most people don’t smoke, shown here in green. About half are exercising. But check out the healthy diet score, which gives folks points for drinking less than four cups of soda a week. On a scale of zero to five, only about 1% score a four or a five. So the American Heart Association’s aggressive 2020 target to improve that by 20% would bring us up to 1.2% of men and women.

Given that we’ve known for decades that advanced coronary artery disease may be present by age 20, and that coronary atherosclerosis is often even present in young children, it is particularly disturbing that healthy lifestyle choices are declining rather than improving in the U.S. And it shows.

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? Well, according to the most rigorous analysis of risk factors ever published, the #1 cause of death and disability in the United States is our diet. What about our diet is so bad? The worst five things about our diet is that we don’t eat enough fruit, we don’t eat enough nuts and seeds, we eat too much salt, too much bacon, hot dogs, lunch meat, etc., and not enough vegetables.

That’s based on data like this, on diet quality and chronic disease mortality risk, which found that those scoring higher using a variety of different systems that all agreed on more whole plant foods, reduced the risk of dying 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.

So why do we eat so bad? Aren’t we scared of dying from some of 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. 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. If that future didn’t matter, what would we eat?  Well, in contrast to pop culture anecdotes, this 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 commonly made request. The researchers go out of their way to note tofu never made the list. And no one asked for vegetarian. 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.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Doctor's Note

A few years ago I did a similar video, 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? Unfortunately not something considered in the study, but one indeed may get an 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:

Didn’t know the beginnings of heart disease may already be present in children? See my video Heart Disease Starts in Childhood. Is it too late if we’ve been eating poorly most of our lives? It’s Never Too Late to Start Eating Healthier.

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