Americans Need Help with Heart Healthy Habits

While there are many factors that impact a person’s weight and risk for heart disease, it’s no surprise that a nutritious diet and exercise remain the leading strategies to manage both.

A recent study published in the Journal of the American Heart Association. on more than 20,000 adults in the US finds that eating a healthier diet and doing regular exercise leads to weight loss and a reduced risk of heart disease. Despite the hype, diet pills and skipping meals appear less effective.

Unfortunately, dropping 5% of body weight did not erase risk factors for heart disease as would be expected. A score of eight risk factors was evaluated and weight changes (up or down) did not alter it.

The study done at The Ohio State University was the first to investigate weight loss methods and results considering the American Heart Association’s “Life’s Essential 8”- a checklist of 8 areas of cardiovascular risk reduction.

The checklist includes managing weight, blood pressure, blood sugar, cholesterol, smoking, physical activity, diet, and sleep. This updated version was released in June 2022. The first published list included seven metrics in 2010.

Researchers at OSU discovered that US adults scored an average of 60 out of 100 on the eight measures, meaning there’s lots of room to improve even in those that had healthy diets and exercise habits that improved some of the metrics.

Senior study author Colleen Spees, associate professor of medical dietetics in the School of Health and Rehabilitation Sciences at Ohio State, notes, "The Life's Essential 8 is a valuable tool that provides the core components for cardiovascular health, many of which are modifiable through behavior change,". She notes that her findings show that Americans have more work to do in practicing the Life Essential 8 behaviors directly linked with cardiovascular health.

The study data included 20,305 adults aged 19 and older who were part of the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2016. Participants. Subjects offered information on smoking, exercise, average hours of sleep each night, weight history and weight loss methods, and diet history of the past 24 hours. Other health parameters included lab tests, BMI, blood pressure, LDL cholesterol, and blood sugar.

This information was used to determine individual scores for Life’s Essential 8 measures and evaluate diet quality according to the Healthy Eating Index, which measures how well the US Dietary Guidelines for Americans are followed.

Within participants, 17,465 people lost 5% of their body weight, gained weight, or maintained weight over the previous year. The remaining 2,840 reported an intentional weight loss of a minimum of 5% of the body weight during the same time.

Spees notes, "Clinically significant weight loss results in improvements in some health indices," "People should feel hopeful in knowing that losing just 5% of their body weight is meaningful in terms of clinical improvements. This is not a huge weight loss. It's achievable for most, and I would hope that incentives people instead of being paralyzed with a fear of failure."

A higher-quality diet was reported in those with clinically significant weight loss, especially from protein, whole grains, and reduction of added sugar. Moderate and vigorous physical activity and lower LDL cholesterol were also seen in those with clinically significant weight loss.

However, the weight-loss group also had higher BMI, fewer hours of sleep, and higher HbA1c blood sugar numbers. These measures decreased their Life Essential 8 scores.

In those that didn’t lose at least 5% of their weight, meal skipping and using prescription diet pills as a weight loss method were more common. Other ways of losing weight reported in the group included low-carb and liquid diets, laxative use, vomiting, and smoking.

"We saw that people are still gravitating to non-evidence-based approaches for weight loss, which are not sustainable. What is sustainable is changing behaviors and eating patterns," Spees said.

As recent data shows over 85% of the US population will be overweight or obese by 2030, prevention is much needed to ward off heart disease as well as other chronic conditions.

"We absolutely need to be moving toward prevention of disease versus waiting until people are diagnosed with a disease. This becomes quite overwhelming, and individuals may feel it's too late at that point," she said.

One idea to consider, she offers, would be prescriptions for regular visits with registered dietitians trained in behavior change, complete with insurance reimbursement -- similar to physical therapy.

"We have fantastic research; we have incredible educators," she said. "What we don't have is a policy that promotes optimal health across the lifespan, from pregnancy through older adulthood."

How can you encourage healthier habits in your clients? Here are 8 Tips to Help Your Clients Improve Their Lifestyle Essential 8 Scores:

·         Encourage clients to get regular metabolic measures done, including blood pressure, blood sugar, and fasting lipids.

·         Make small changes- reduce added sugar, cook with less fat, or eat out less often to start.

·         Pay attention to sleep. Set boundaries around screen use, caffeine intake, and alcohol consumption, impacting sleep hygiene.

·         Find fitness that’s fun and fits your schedule. Try a water aerobics or a dance class. Join a walking group or pickleball team.

·         Offer cooking classes or grocery tours to teach healthier options for heart health.

·         Advocate for Registered Dietitians. They are the “Real Deal” when it comes to Medical Nutrition Therapy.

·         Refer clients for smoking cessation if they’re using it as a means to control their stress or weight.

·         Advise them against fad diets and extreme methods of weight loss such as vomiting or meal skipping. These aren’t sustainable and could do more harm than good.

Lisa Andrews, MEd, RD, LD