The Dirty Dozen: Top 12 Lifestyle Risk Factors

An important new study* has found that the biggest premature killer of Americans is not big bad things like acts of Mother Nature, jumbo jet crashes, or flu epidemics. The biggest premature killer in the U.S. is, essentially, ourselves.

The lifestyle choices we make, like smoking, eating too much salt, and eating too many calories, do more damage to us than anything else.

Wrote journalist Daniel Akst in The Wall Street Journal (May 15, 2009) in a commentary on this new study: “Too many of us appear to be bent on slow-motion suicide.”

The study’s authors, from several institutions including the Harvard School of Public Health, the University of Washington, and the University of Toronto, analyzed nationally representative data and concluded that more than one million Americans die annually from 12 lifestyle-related risk factors.

What it all boils down to is this: Of the 2.5 million deaths that occur every year in the United States, roughly half could be prevented if we simply followed healthier lifestyles, summed up lead author Dr. Goodarz Danaei and colleagues.

The Dirty Dozen

The 12 risk factors and the estimated number of U.S. deaths annually related to them were:

  • 467,000 for smoking
  • 395,000 for high blood pressure
  • 216,000 for overweight and obesity
  • 191,000 for inadequate physical activity and inactivity
  • 190,000 for high blood glucose
  • 113,000 for high LDL cholesterol
  • 102,000 for high dietary salt
  • 84,000 for low dietary omega-3 fatty acids from seafood
  • 82,000 for high dietary trans fat
  • 64,000 for alcohol use (26,000 averted from benefits for heart disease, stroke, and diabetes versus 90,000 alcohol-related deaths from injuries, violence, cancers, and other diseases)
  • 58,000 for low fruit and vegetable intake
  • 15,000 for low dietary polyunsaturated fatty acids (less than 1% of all deaths)

Alerting Congress

The purpose of their new study, concluded the authors, was to bring the importance of lifestyle changes to the forefront of the health care discussions currently going on in Washington, D.C., and nationwide.

Getting Everyone On Board

Yes, change begins with each individual making lifestyle choices, but “population-wide interventions” are also important, noted Dr. Danaei and co-authors. “It should be possible to reduce preventable deaths by changing modifiable risk factors through introducing public health policies, programs, and regulations that reduce exposures to these risk factors.”

Certainly, the exposures in America are relentless. We have a food industry, for example, that spends millions promoting things (let’s not even call them “foods”) like Twinkies and precious little on fruits and vegetables. A restaurant industry that sells kids’ meals that are 1000+ calories (about 75% of what most kids should eat in an entire day.) Is it any wonder that one in five 4-year-olds in the U.S. is now obese? Not just overweight…obese.

We can do better.

What is needed is the whole country getting on board in the same way that other countries have successfully accomplished. In Finland, in particular, aggressive promotion of healthy choices from several facets of society – health centers, worksites, the media, grocery stores, schools, women’s clubs, private industry, legislation and more – cut the number of deaths of Finnish men from heart disease by 75%.

We have the tools.

Lifestyle interventions like the Pritikin Program, already in place in the United States, address all 12 lifestyle risk factors, and have been documented to reap significant dividends, including lower blood pressure, lower body weight, and lower cholesterol levels.  So recognized is Pritikin’s success that in the early 1980s the Finnish physician credited with overhauling Finland’s health habits, Dr. Pekka Puska, came to the Pritikin Longevity Center to learn Pritikin’s strategies and implement them back home.

So let’s get going. 

Very quickly, The Dirty Dozen can become The Disappearing Dozen.

* Danaei G, Ding EL, Mozaffarian D, Taylor B, Rehm J, et al. (2009) The Preventable Causes of Death in the United States: Comparative Risk Assessment of Dietary, Lifestyle, and Metabolic Risk Factors. PLoS Med 6(4): e1000058. doi:10.1371/journal.pmed.1000058

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