Researchers in China have found that adherence to a healthy lifestyle may substantially lower the burden of cardiovascular disease in the country, according to research published Feb. 27 in the Journal of the American College of Cardiology. Adherence to healthy lifestyle factors has been related to a considerable reduction of cardiovascular risk in white populations; however, little is known whether such associations persist in nonwhite populations like the Asian population.

The study, led by Jun Lv, PhD, et al., examined the associations of six lifestyle factors with ischemic heart disease and ischemic stroke in the China Kadoorie Biobank of 461,211 participants 30 to 79 years of age who did not have cardiovascular disease, cancer or diabetes at baseline. Low-risk lifestyle factors were defined as nonsmoking status or having stopped smoking for reasons other than illness, alcohol consumption of <30 g/day, a median or higher level of physical activity, a diet rich in vegetables and fruits and limited in red meat, a body mass index of 18.5 to 23.9 kg/m², and a waist-to-hip ratio <0.90 for men and <0.85 for women.

The results of the study show that current nonsmoking status, light to moderate alcohol consumption, high physical activity, a diet rich in vegetables and fruits and limited in red meat, and low adiposity were independently associated with reduced risks of major coronary events and ischemic stroke. Approximately 67.9 percent of the major coronary events and 39.1 percent of the ischemic stroke cases were attributable to poor adherence to healthy lifestyle.

In an accompanying editorial comment, Thomas A. Gaziano, MD, FACC, notes that “more research is needed to understand both the long-term effects of … interventions and the reproducibility of these interventions in low-income settings. In the end, we must find a simple but clear message regarding diet and exercise that is a little like what our grandmother might say, ‘Everything in moderation but make sure you eat your vegetables.’” 

Keywords: Adiposity, Alcohol Drinking, Biological Specimen Banks, Body Mass Index, Cardiovascular Diseases, China, Diabetes Mellitus, Diet, Exercise, Fruit, Myocardial Ischemia, Neoplasms, Obesity, Reproducibility of Results, Risk Factors, Risk Reduction Behavior, Stroke, Vegetables, Waist-Hip Ratio

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