1. Not Smoking
2. Regular Physical Activity – 150 mins per week of moderate endurance activity/exercise
3. Healthy Weight – at or near body mass index of 25
4. Healthy Sleep Patterns – 7-9 hours per night
5. Blood Pressure in healthy range – under 130/80
6. Blood Glucose in a healthy range – close to 90 mg/dl (5 mmol/l)
7. HbA1c around 5.1 (to prevent sugar-coating blood proteins linked to heart disease and stroke)
8. Non-HDL cholesterol in a healthy range (especially LDL-cholesterol) – LDL-cholesterol no higher than 2 mmol/l or (76 mg/dl) or preferably below 1.5 mmol/l (57 mg/dl)

Based on these recommendations the UK Biobank Study published results of their findings in the February 2023 issue of JAMA Internal Medicine journal. The UK Biobank Study followed 135,199 adults, average age 55, who were free of chronic diseases such as cardiovascular disease, cancer, diabetes, and dementia at the outset of the study. The participants were divided into three groups based on their AHA 8 Life Essentials Score – low, moderate, and high scores. High scores being the most desirable. They also gave each participant a cardiovascular health score of low, moderate, and high, with a high cardiovascular health score being the most desirable. After following these patients for many years the results showed that a high cardiovascular health score was associated with substantially longer life expectancy and remaining free of 4 major chronic diseases (cardiovascular disease, diabetes, cancer, and dementia) in both men and women.  This was true for people of all sociodemographic backgrounds, meaning that higher education and income did not change the results. Individuals who had healthier diets and lifestyles, who naturally scored higher on measurements of cardiovascular health (blood pressure, blood sugar, LDL-cholesterol, regular exercise) had exceptionally better health overall, as the years went by, compared to those with lower cardiovascular health scores. As one of the researchers commented, “Men with high cardiovascular health scores tended to have an additional 7 years of life expectancy, free of chronic disease, compared with those who had lower scores. In women, the difference was about 9.5 years between high scores and lower scores. Also, the number of years lived with chronic disease was compressed in those with high cardiovascular health scores. They tended to have fewer years living with those chronic diseases but more years living free of chronic diseases. This is called quality of life or health span or healthy life expectancy. It all means the same thing. It translates into putting in the effort, through diet, exercise, and other lifestyle practices, to maintain a highly functioning body and mind for as long as possible.

The UK Biobank Study tells us that healthy diet matters (avoiding saturated fats, trans-fats, fried foods, super sugary foods, alcohol etc.) and that 150-minutes of moderate endurance exercise makes a difference. As does keeping your blood pressure and LDL-cholesterol in the ideal range through healthy diet, healthy weight, and regular exercise habits (and medication if necessary). In the words of Dr. Joann Manson MD Ph.D, a lead researcher and professor at Harvard Medical School and Brigham and Women’s Hospital, “Overall, the findings make a compelling case for the importance of lifestyle factors in extending health span and years free of chronic disease. It can be motivating to tell our patients that a healthy lifestyle not only extends life expectancy but also extends years of health, free of chronic disease.

What’s interesting is that a few months later (July 2023) JAMA published the results of another large study showing that in patients at high risk for cardiovascular disease, the meta-analysis shows that switching to a healthy, more vegetarian diet for just 6-months reduced the bad cholesterol (LDL-cholesterol), HbA1c (another important risk factor for heart disease) and body weight to a significant degree.  The healthy dietary change also reduced the need for medication. The researchers remind patients that not all vegetarian diets are healthy. For instance, deep-fried foods like French fries and potato chips are vegetarian, but they are not healthy choices. The same is true for foods with palm and coconut oil (like the Beyond Meat products). Some of the healthier, more vegetarian diets that produced good results included diets allowing egg whites, and non-fat dairy products, as well as seafood and some fish, along of course with more vegetables, legumes (beans and peas), including soy products, some nuts and fruit and whole grain products. There is now convincing evidence that switching to a healthier, more vegetarian diet can appreciably improve your cardiovascular health score, as it lowers LDL-cholesterol, blood pressure and body fat. According to the UK Biobank Study these improved health markers bode well for more years of disease-free living, a longer life span and healthy life expectancy.

Once again lifestyle medicine is good medicine. So, I would encourage you to keep the 8 Life Essentials outlined by the AHA top of mind in your quest for optimal health and longevity. I have included the references for this information in the text below.

References:

Wang X et al. Association of cardiovascular health with life expectancy free of cardiovascular disease, diabetes, cancer, and dementia in UK adults. JAMA Internal Medicine. Feb 27, 2023 https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2801750

Life’s Essential 8: Higher Scores Extend Health Span. Medscape, March 27. 2023. Dr JoAnn E. Manson MD DrPH. https://www.medscape.com/viewarticle/989752?ecd=mkm_ret_230801_mscpmrk-OUS_InFocus_etid5692664&uac=342474MN&impID=5692664

Life’s Essential 8 – American Heart Association https://www.heart.org/en/healthy-living/healthy-lifestyle/lifes-essential-8

Wang T et al. Vegetarian dietary patterns and cardiometabolic risk in people with or at high risk of cardiovascular disease. JAMA (July 23, 2023) https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2807597

Vegetarian Diets Can Improve High-Risk Cardiovascular Disease. Nancy A. Melville. Medscape, July 23, 2023 Vegetarian Diets Can Improve High-Risk Cardiovascular Disease (medscape.com)

Eat Smart, Live Well, Look Great,
Dr. Meschino