Dr. Jean Marmoreo is a general physician in Toronto.
If you fear 2015 could be the year you have a cardiac event, take heart: Four out of five heart attacks are entirely preventable. That's what a recent study of 20,000 Swedish men showed. What makes this study remarkable is that none of this prevention involved the use of drugs.
Instead, the researchers looked at five very basic lifestyle measurements: smoking; diet; alcohol; exercise; and waist measurement.
That's not much to go on to arrive at such a confident conclusion. It made me look twice at those parameters: Some of them are precise; others, not so much.
Smoking is easy. You either smoke now or you don't smoke now. The same with waist measurement: it should be less than 93 cm (36.6 inches). In other words, you have no to low belly fat.
Alcohol consumption means you either don't drink alcohol or that each day you drink fewer than two glasses of wine or beer or two 1.5 ounce shots of spirits.
As for exercise, you should walk at least 45 minutes each day and have a vigorous cardiovascular workout at least an hour a week.
In fact, the only non-specific requirement was around diet. What you eat should be "healthy." We all know this diet – less of everything, more fruits and vegetables, fewer carbs and saturated fats, less salt and processed foods of all kinds.
The researchers rightly concluded that 79 per cent of the Swedish men enrolled in the study would reduce their incidence of a heart attack.
But here's the problem. We aren't Swedes.
Back in the 1970s, Canadians were shamed to learn that the average 60-year-old Swede is fitter than the average 30-year-old Canadian. Not much has changed in those 40-plus years.
Last year, Heart and Stroke Canada reported that 60 per cent of adult Canadians are overweight, while 25 per cent of our children are overweight. This isn't as bad as in the United States, where 69 per cent of the population is overweight and 30 per cent of kids are overweight.
But when it comes to obesity (i.e. our Body Mass Index (BMI) is more than 30) we're among the fattest people on earth. One in four adult Canadians is obese, as are the same proportion of Canadian children. This means that one in four Canadians, no matter how old or young they are, are so overweight that you'd think, "Wow, are they fat," if you passed them on the street.
As for physical activity, well, we may be getting on it: 55 per cent of adults now report 30 minutes a day. But the kids? Just one in four get the recommended hour a day of exercise.
Our diet is even harder to swallow. The American Heart Association's report that less than 1 per cent of Americans follow a "Healthy" diet, in spite of massive public education, should alarm us as well.
In their 30s and 40s, my patients laid blame for their weight creep on their stubbornly slow metabolism; in their 50s, it was their roller-coaster hormones. By their 60s, we all conceded that fat shifts to the area between breasts and hips-contributing to a waist circumference that never did and never would approach Scarlett O'Hara's 18 inches.
But those Swedes! No belly fat and they exercise. And apparently they eat the best of healthy diets.
True, their obesity rate is rising. By 2011 it was all the way up to 11 per cent, less than half of Canadians'. At least, we're almost their equal in smoking rates and alcohol consumption.
What isn't close is our physical activity. Their average of 34 minutes of daily activity in 18-to-39 year olds, outshines the 19 minutes on average of the obese section of our population. Sad too is that 85 per cent of our population doesn't come close to the recommended 150 minutes of exercise each week. Nor do our kids. Only 6 per cent get one hour or more of physical activity per day.
I'm not parroting these statistics to put you off.
In my office, I know there is nothing I say to my patients they haven't already chewed on before they come to weigh in. So rattling off these comparisons simply discourages them.
One thing may make a difference. Not ad campaigns, not required labelling, not educational programs. They're marginal at best. What I've noticed in my clinic is that the patients who do lose weight and get in shape enlist the help of their physician and a dietician.
In other words, a one-on–one strategy.
Going it alone is too tough, too lonely, too fraught with missteps.
Years of training mid-life women to run marathons taught me that you will run hundreds of miles to encourage your buddy before you will ever do it for yourself.
The same applies to walking. Meeting someone at 6 a.m. at –20C will prompt you to get moving way more than dreading the cold.
All these measures can be started slow and low, and built on incrementally. When I am talking to my 60-year- old patients, I assure them that I'm in it for their long haul. The changes to their fitness level and how they eat will need to last 30 years.
But if you want to feel and look – and last – more like a Swede than a Canadian, you're your worthiest project.