Almost four out of every five myocardial infarctions (MI) in men may be preventable with combined low-risk behavior, according to a study published Sept. 22 in the Journal of the American College of Cardiology. 

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Examining the benefit of combined low-risk diet and healthy lifestyle practices on the incidence of MI in men, Agneta Akesson, PhD, associate professor at the Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden, and colleagues performed a population-based, prospective cohort comprised of 20,721 45- to 79-year-old men with no history of cancer, cardiovascular disease, diabetes, hypertension, high cholesterol levels. Measuring five low-risk behavior factors including a healthy diet (top quintile of Recommended Food Score), moderate alcohol consumption (10 to 30 g/day), no smoking, being physically active (walking/bicycling 40 min per day and exercising one hour per week), and having no abdominal adiposity (waist circumference <95 cm), the authors conducted follow-ups across an 11 year period.

Recording 1,361 incidences of MI, the study found that low-risk dietary choice together with moderate alcohol consumption was associated with a relative risk of 0.65 (95 percent confidence interval [CI]: 0.48 to 0.87) compared with men having zero of the five low-risk factors. Men who maintained all five low-risk factors compared with those with zero low-risk factors had a relative risk of 0.14 (95 percent CI: 0.04 to 0.43). Based on the study population, men that achieve all five low-risk factors could prevent 79 percent (95 percent CI: 34 percent to 93 percent) of the potential MI events.

“It is not surprising that healthy lifestyle choices would lead to a reduction in heart attacks,” said Akesson. “What is surprising is how drastically the risk dropped due to these factors … It is important to note that these lifestyle behaviors are modifiable, and changing from high-risk to low-risk behaviors can have great impact on cardiovascular health,” she adds. “However, the best thing one can do is to adopt healthy lifestyle choices early in life.”

In a commenting editorial Dariush Mozaffarian, MD, FACC, writes, “These findings highlight the primacy of healthy lifestyle. For both individual patients and populations, lifestyle goals should not be formulated solely for control of weight or blood pressure, cholesterol and glucose levels. Although lifestyle has major benefits on these physiological factors, a healthier diet, greater activity and nonsmoking influence numerous other pathways of risk and produce substantial additional benefits for cardiovascular and non-cardiovascular health.”

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