Adopting healthy habits: It's not just about losing weight

Motivation to lose weight varies immensely but health seems to be an important driver. "I want to get healthy" or "I want to live to see my grandchildren" or "I want to get of these medications/fear getting sicker." or "I want to be able to do things!".

For many, the simple act of losing weight improves health significantly - I've been known to state that the single most important risk factor for metabolic-related diseases is weight loss. Study after study shows this to be true.

However, I also see certain types of questions posed over and over on MFP - do I need to exercise? Or I don't like fruits/vegetables, must I eat them? In other words, should I follow what are generally considered healthy lifestyles choices?

In a words: Yes. If you are doing this for health, look at your overall lifestyle and exercise, don't just lose the weight.

Or more exactly, probably. (I'll get to that)

A quick review of a research article* looks at lifestyle habits and the risk of dying for people at various weights. This was done with a sample of 11700 people followed over a period of 170 months.

In short, whether you were obese or not, people with healthy lifestyles (as measured by no smoking, regular exercise, 5 fruits/veg or more per day, moderate alcohol) had a MUCH lower risk of death in this period.

Take a look a this graph:



On the left, being obese and having no healthy habits results in very high risk. And on the right, people with the 4 measured healthy habits, independent of weight, had much lower risks of death.

Wait, can I stay fat and eat all the food and just work out? This research makes no statement on the impact of obesity on long term healthy - just that people with healthier lifestyle habits had better outcomes. This is about health risk - want to reduce it? Losing just weight might not be enough but overall lifestyle factors may improve overall health.

Are the risk changes seen in the study significant?

Yes the risk change was very large, the authors note "the adoption [presence, really] of each additional healthy habit decreased all-cause mortality between 29% and 85%" and compare it to statin use as a risk reducer of 12% for cardiovascular disease.

Two other points.

First, I am not suggesting that one should forget about losing weight. There are a lot of reasons to do so, however, if health is a concern - an effective strategy should also include significant focus on an overall healthy lifestyle (whatever you see that to be). In the study the health indicators used were, as self-reported:

'healthy eating' was at least 5 servings of fruit/veg per day
'exercise' was leisure time physical activity of 12 times per month
'moderate alcohol consumption' was defined as more than 0 but no more than 1 drink a day for women and up to 2 drinks a day for men
'smoking' - self reported whether the person smoked.

Second, the causation/correlation issues - as the researchers note "healthy habits were associated with decreased mortality, association does not prove causation" It most likely isn't just adopting the measured parameters that will improve health but perhaps overall living style or other undetermined factors. caveat emptor That's the probably. It's probably a good idea. It doesn't necessarily mean you need exactly match the parameters measured and, for example, eat exactly 5 fruits/veg every day. Perhaps an overall increase is an improvement - focus in general in eating variety, etc...

*Healthy Lifestyle Habits and Mortality in Overweight and Obese Individuals.
Eric M. Matheson, MS, MD, Dana E. King, MS, MD and Charles J. Everett, PhD, J Am Board Fam Med January-February 2012 vol. 25 no. 1 9-15 (here: http://jabfm.org/content/25/1/9.full )


TL;DR - If you are doing this for health, look at your overall lifestyle and exercise, don't just lose the weight.