The age of good health? Healthy lifestyles on decline in U.S.

Heather Woolwine

May 27, 2009

The age of good health? Healthy lifestyles on decline in U.S.

MUSC researchers urge people, especially the middle-aged, to adopt healthier lifestyles

CHARLESTON -- Despite the well-known benefits of physical activity, eating a diet high in fruits and vegetables, maintaining a healthy weight, moderate alcohol use and not smoking, only a small proportion of adults follow this healthy lifestyle pattern, and in fact, the numbers are declining, according to a study by Dana King, M.D., and colleagues at the Medical University of South Carolina (MUSC). The article discussing this research is available in the June 2009 issue of The American Journal of Medicine. Lifestyle choices are associated with the risk of cardiovascular disease as well as diabetes.

King and additional researchers from the MUSC Department of Family Medicine compared the results of two large-scale studies of the US population in 1988-1994 and in 2001-2006. In the intervening 18 years, the number of people adhering to all five healthy habits has decreased from 15 percent to 8 percent. In addition:

• the percentage of adults aged 40-74 years with a body mass index greater than 30 has increased from 28% to 36%;

• physical activity 12 times a month or more has decreased from 53% to 43%;

• eating 5 or more fruits and vegetables a day has decreased from 42% to 26%;

• moderate alcohol use has increased from 40% to 51%.

• smoking rates have not changed (26.9% to 26.1%);

"The potential public health benefits from promoting a healthier lifestyle at all ages, and especially ages 40-74 years, are substantial," King said. "Regular physical activity and a prudent diet can reduce the risk of premature death and disability from a variety of conditions including coronary heart disease, and are strongly related to the incidence of obesity. In the US, medical costs due to physical inactivity and its consequences are estimated at $76 billion in 2000 dollars. Research indicates that individuals are capable of adopting healthy habits in middle age, and making an impact on cardiovascular risk."

Since people with diagnosed health conditions such as cardiovascular disease, diabetes, hypertension, or high cholesterol were part of the samples, the researchers sought to determine whether such individuals were adhering to the healthy habits to a greater or lesser degree than people without those conditions, and whether adherence had changed over time. The study also concluded that people with cardiovascular disease, diabetes, high blood pressure or high cholesterol, or risk factors for those conditions, were no more likely to adhere to a healthy lifestyle pattern than people without such risk factors.

The National Health and Nutrition Examination Survey (NHANES) is a national survey of non-institutionalized persons in the US conducted regularly by the National Center for Health Statistics. The researchers used data from a sub-sample of the NHANES surveys of 1988-1994 and 2001-2006, adults aged 40-74 years, because this age span is the primary time for initial diagnosis of cardiovascular risk factors and disease. In the NHANES 1988-1994, the number of respondents 40-74 years old was 7340, representing a weighted sample size of 78,794,217. For NHANES 2001-2006, the number of respondents was 7811, for a weighted sample size of 65,476,573.

The article is "Adherence to Healthy Lifestyle Habits in US Adults, 1988-2006" by Dana E. King, MD, Arch G. Mainous III, PhD, Mark Carnemolla, and Charles J. Everett, PhD. It appears in The American Journal of Medicine, Volume 122, Issue 6 (June 2009) published by Elsevier.

About MUSC

Founded in 1824 in Charleston, The Medical University of South Carolina is the oldest medical school in the South. Today, MUSC continues the tradition of excellence in education, research, and patient care. MUSC educates and trains more than 3,000 students and residents, and has nearly 11,000 employees, including 1,500 faculty members. As the largest non-federal employer in Charleston, the university and its affiliates have collective annual budgets in excess of $1.6 billion. MUSC operates a 750-bed medical center, which includes a nationally recognized Children's Hospital and a leading Institute of Psychiatry. For more information on academic information or clinical services, visit or