Lifestyle Really Does Matter!

Lifestyle Really Does Matter!

Many people know that the leading causes of death in the United States are heart disease, cancer, and stroke.When it comes to prevention, however, it is more important to know why people suffer from these conditions. In other words, what are the actual causes of disease or reasons people die? A landmark study titled "Actual causes of death in the United States," published in 2004, shed a lot of light on this subject [1].

Tobacco has been the biggest actual cause of death in the United States for decades. In the new study, however, poor diet and physical inactivity ranked a very close second to tobacco (see table 1). Excess alcohol consumption ranked a distant third. Infections, toxins, motor vehicles, and firearms combined killed only half as many Americans as poor diet and physical inactivity.

In recent years, dietary excess and lack of exercise have contributed to an absolute epidemic of overweight and obesity in this country. During the past 20 years, rates of obesity in adults have doubled, and rates in teens have tripled. Fully two out of three American adults are now overweight or obese. Sadly, increased weight contributes to increased death rates from heart disease, cancer, diabetes, and strokes.

Table 1: Actual causes of death in the United States, 2000 [1]

1. Tobacco (435,000)

2. Poor diet & physical inactivity (400,000)

3. Alcohol consumption (85,000)

4. Infectious agents (75,000)

5. Toxic agents (55,000)

6. Motor vehicles (43,000)

7. Firearms (29,000)

8. Sexual behavior (20,000)

9. Illicit drug use (17,000)

Though poor diet and physical inactivity are wreaking havoc on Americans’ health, a new study from Europe provides convincing scientific evidence that healthy lifestyles can reverse this trend and save lives. The HALE (Healthy Aging: a Longitudinal study in Europe) project followed 2,339 European’s aged 70 to 90 for 10 years [2]. The participants who avoided smoking, were physically active, drank in moderation, and ate a Mediterranean diet had drastically lower death rates during the study compared with those who did not. People with all four healthy habits had death rates one-third as high as people who had none or only one of the healthy lifestyle factors.

To protect health, physical activity did not require extreme exertion. Thirty minutes of walking, gardening, or cycling per day was enough. The Mediterranean style diet was rich in monounsaturated fats (such as olive oil), legumes, nuts, fish, whole grains, and fruits and vegetables. Non-smokers and those who quit tobacco more than 15 years ago both lived much longer than smokers. The strongest protective factors were regular physical activity (37 percent lower death rate) and not smoking (35 percent lower death rate). The message was clear: simple, healthy lifestyle habits increase longevity.

I recently wrote a wellness and prevention book. In researching the medical literature, I was constantly reminded of the vital impact of lifestyle on health. With virtually every major condition I looked at—heart disease, diabetes, cholesterol, blood pressure, cancer prevention, osteoporosis, memory loss, and more—the four keys to preventing problems and maintaining good health were physical activity, healthy eating, avoidance of tobacco, and moderation with alcohol. Modern medicine can work miracles, but the key to a long, healthy life may well lie in in the lifestyle choices you make every day.


1. Mokdad A, Marks J, Stroup D, Gerberding J. Actual causes of death in the United States, 2000. JAMA. 2004;291:1238-45.

2. Knoops K, deGroot L, Kromhout D, et al. Mediterranean diet, lifestyle factors, and 10-year mortality in elderly European men and women, The HALE project. JAMA 2004;292:1433-9.

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