Once these people achieved 4 healthy behaviors, eating at least 5 fruits and vegetables daily, exercising at least 2.5 hours per week, maintaining their Body Mass Index (BMI) between 18.5 and 30 kg/m, and not smoking, investigators saw a 35% reduction in CVD incidence and a 40% reduction in mortality compared to people with less healthy lifestyles.

Writing in the study, Dana E. King, MD, MS, states, The potential public health benefit from adopting a healthier lifestyle in middle age is substantial. The current study demonstrated that adopting four modest healthy habits considerably lowers the risk of cardiovascular disease and mortality in relatively short-term 4-year follow up period. The findings emphasize that making the necessary changes to adhere to a healthy lifestyle is extremely worthwhile, and that middle-age is not too late to act.

Starting in 1987 to 1989, 15,792 men and women ages 45 to 64 years participated in the Atherosclerosis Risk in Communities Study (ARIC) in four communities across the United States. This was designed to investigate the origin and progression of various atherosclerotic diseases. Follow up visits every three years through the end of 1998 included an interval medical history, weight, height, diet questionnaire, updated smoking history and current participation in sports and leisure exercise.

There were three key findings from the study first, the benefit of switching to a healthy lifestyle past age 45 became evident even in the 4-year, short-term follow up; second, the beneficial impact of the changes occurred despite the relatively modest changes in health habits; and third, the healthy lifestyle was beneficial when compared to all persons with three or fewer healthy habits, not just in comparison to people with none or one habit. People adopting only three healthy habits experienced lower mortality but not fewer CVD events over the same period.

The authors found that only 8.5% of middle-aged adults practice these four behaviors and only 8.4% newly adopt such a lifestyle past age 45. Further, men, African-Americans, and individuals with less than college education, lower income, or a history of hypertension or diabetes are less likely to adopt a healthy lifestyle past age 45, and are therefore at greater risk of mortality and cardiovascular disease.

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