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Healthy Habits Cut Women's Heart Disease Up to 82%

Prevention: Findings show cumulative effect is far higher than expected, researchers report.

November 09, 1999|TERENCE MONMANEY | TIMES MEDICAL WRITER

People have an unexpectedly high ability to prevent the nation's No. 1 killer, according to a preliminary study showing that women with the most healthful habits cut their chances of developing heart disease by up to 82%.

The new study of about 84,000 women by researchers at the Harvard School of Public Health suggests that several of the known steps to reduce heart disease can combine to produce an overall benefit that is larger than mainstream authorities have estimated. Previously, experts estimated that about 50% of heart disease cases could be averted by following the familiar advice of prudent eating, weight-watching, not smoking and being active.

Presented Monday at an American Heart Assn. meeting in Atlanta, the findings also highlight the paradox that relatively few people in this supposedly health-crazed land are indeed doing everything they can to avert the disease that is most likely to kill them.

Though the women in the study were nurses or other health professionals, no more than 2% followed all the heart-health guidelines that they are in the business of recommending to patients. The others yielded to one or more indulgences such as smoking, being overweight or not exercising regularly.

That low compliance rate surprised the Harvard researchers, who were led by medical epidemiologist Dr. Meir Stampfer.

Dr. Nieca Goldberg, national spokeswoman for the American Heart Assn., said the study offered overwhelming evidence that heart disease was largely preventable. Moreover, it provides needed data on women. "It's important that this study focused on women, because past studies have focused on men," she said.

That is especially significant, she said, because other studies show that women are less physically active than men, more likely to be obese, and more likely to take up smoking in adolescence.

On a broader level, the findings--which health experts suggest also apply to men--represent the triumph of standard advice over more exotic health regimens such as extreme low-fat diets, meditation, herbal supplements, heavy exercise and prescription drugs that have been promoted to reduce heart disease. For preventing run-of-the mill heart disease, none of those approaches appears to be as powerful as the combined effect of following the humdrum government health guidelines, according to the study.

As one of the Harvard co-authors put it, "You don't have to run marathons" to prevent heart disease.

The research is a preliminary analysis of recent data from the ongoing Nurses' Health Study, which has involved tracking the health and habits of 84,129 women health professionals from 1980. The researchers surveyed the women every two years and tracked their medical records until 1994. Overall, 296 heart disease deaths and 833 heart attacks were documented.

The Harvard researchers have published numerous previous studies analyzing the role of a single factor--such as body weight or vitamin intake--on the health of this same group of women.

This study is the first to look at all the previously identified major health factors in combination.

To do so, the researchers narrowed the field to the relatively small group of women who had all the healthful habits. They did not smoke, drank an average of less than one alcoholic beverage daily, got at least 30 minutes of physical activity daily, and ate a diet rich in fruits and vegetables and low in saturated fat and so-called trans fatty acids.

The researchers found that the women in this group had a heart-disease risk rate that was 82% less than women who complied with some or none of the guidelines. Smoking was the most potent single risk factor, accounting for about half the documented heart disease, the researchers found.

Still, dietary factors and exercise also were effective: Among women who did not smoke at all, those who ate most carefully and were most consistently active had 74% less heart disease than did other nonsmoking women.

Eating a beneficial diet amounted to more than simply minimizing the intake of saturated fat (found in butter and meat) and so-called trans fats (found in margarine, junk food and baked goods). Other ingredients of the lowest-risk diet were ample fiber, folate (B) vitamins and fish oil. Generally, the researchers' findings supported the standard advice to consume five helpings daily of fruits, vegetables or grains.

Though the researchers summarized the findings at the Atlanta heart meeting, details remained sketchy because they have submitted the study to a medical journal for publication.

"This study suggests that the majority of premature coronary heart disease can be prevented by following current recommendations for a healthy lifestyle and diet," one of the study coauthors, Dr. Frank Hu, told a news conference in Atlanta. "These are simple and straightforward changes."

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Reuters contributed to this story.

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