Health-related aspects of lifestyle

Health-related aspects of lifestyle

Diet

Diet is one of the most important behavioral influencing factors in health. However, there is only a manageable number of individual foods and food components whose health effects have been proven. For example, while unsaturated fatty acids and plant-based products are among the health-promoting food components, an excess of saturated fatty acids, salt, sugar, or so-called red meat is detrimental to health. Sweetened drinks such as lemonade or cola also promote obesity and associated diseases.

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However, since diet always comprises a more or less large spectrum of foods, it makes sense to consider the health effects of more comprehensive dietary patterns. Nutrition patterns are also more closely related to a lifestyle than the (non-) consumption of individual food components.

The health-promoting and/or at least health-motivated nutritional patterns in western industrial societies include, in particular, a vegetarian diet, a vegan diet (completely without products of animal origin), a diet with little fat, a diet with little carbohydrates, and the Mediterranean diet. There are many other diet patterns with a more “idiosyncratic focus”, for example, a gluten-free diet. A growing interest in the USA and recently also in Germany is experiencing a diet based on the Stone Age, which in particular dispenses with grain and dairy products (which come from cattle and agriculture that were unknown in the Stone Age) and highly processed foods.

In favor of a low-fat diet, there is evidence that reducing the amount of fat in the diet reduces the frequency of heart attacks and strokes as well as overall mortality. However, the health benefits of a diet focused on low fat are partially counteracted by an increased intake of other calories or even more than compensated for by highly processed foods that are reduced in fat but contain a lot of starch and sugar

The health benefits of the Mediterranean diet have long been discussed and have also been documented in meta-analyses. A Mediterranean diet is associated with a longer life expectancy, a reduction in cardiovascular diseases and cancer, and a better maintenance of cognitive abilities. In terms of cardiovascular risks, the Mediterranean diet even appears to be superior to the low-fat diet. The Mediterranean diet includes a wide range of foods, consisting primarily of plant-based foods, fish and olive oil, and rather limited consumption of meat and dairy products. In the overview article, it is the only ('healthy') eating pattern that also mentions the taste and enjoyment of eating.

It is hardly possible to weigh up the health benefits between the various health-promoting and/or at least health-motivated nutritional patterns - also because of the many overlaps. Generally speaking, however, it can be said that promoting health and avoiding diseases is associated with a diet that consists of low-processing foods (“close to nature”) and is dominated by plants

Sport and exercise

Sports activity and (other) physical activity behavior in everyday life are at least as important for health as diet. This is also reflected in WHO recommendations on physical activity. These recommend moderate physical activity of at least 150 minutes a week of intense physical activity of at least 75 minutes a week for 18 to 64-year-olds.

Physical inactivity is a risk factor for numerous diseases, especially cardiovascular diseases, type 2 diabetes, colon and breast cancer, and even dementia. In Germany, physical inactivity - defined as an activity level that falls short of WHO recommendations - is responsible for 7.5% of premature deaths.

The health benefits are primarily associated with recreational physical activity. With regard to the risk of cardiovascular disease, a high level of activity has the greatest protective effect. Five hours of leisure activity per week is significantly better than 2 ½ hours. However, even very little physical leisure activity is associated with reduced cardiovascular risk. With regard to dementia, the full health effect is largely achieved with “low to moderate” activity.

In contrast to leisure activities, work-related physical activity is not or only at a moderate level of activity beneficial to health.

However, two restrictions need to be mentioned. On the one hand, there is also an inverse causality between physical activity and health: It is not only the case that sport and exercise promote health, but conversely it is also the healthy people who are more likely to be active. The protection effect is therefore overestimated in cross-sectional studies as well as in everyday life. However, the aforementioned results are backed up by prospective longitudinal studies. Another restriction concerns the fact that there are people - so-called sport non-responders - for whom sport does not improve health genetically and in particular does not protect against diabetes.

Bodyweight

In addition to genetic factors above all a function of calorie intake and consumption and thus dependent on diet and exercise. However, many studies only deal with bodyweight - interpreted partly as an indicator for diet and exercise and partly as an independent determinant of health. By far the most common key figure for assessing body weight is the so-called Body Mass Index (BMI): the body weight in kilograms divided by the squared height in meters. A person who measures one meter and seventy centimeters and weighs seventy kilograms has a BMI value of (70 / 1.7 2 =) 24.2 and thus normal weight, which, according to the World Health Organization (WHO), is a BMI Value is between 18.5 and 25.

Obesity and, in particular, being very overweight are risk factors for numerous diseases. The influence on cardiovascular diseases (e.g. heart attack, stroke, high blood pressure) and metabolic disorders such as type 2 diabetes are particularly well known. The diabetes risk is primarily associated with large waist circumference. In addition, obesity is common for many cancers and for dementia jointly responsible.

The importance of body weight for health, however, varies with age. At the age of 65 and over, mortality is only increased if the patient is very overweight (BMI greater than 33), while, conversely, excessively low weight (BMI less than 23) is life-threatening (Winter et al.2014). And middle-aged body weight is important for the risk of dementia in old age, with both being overweight and underweight increasing the risk of dementia.

Similar to sport and exercise, the relationship between weight and health is ultimately also dependent on genetic disposition: there are on the one hand the "healthy fat people" and on the other hand slim ones with cardiovascular parameters, which are often found in overweight people.

Smoking and alcohol consumption

Smoking is also associated with other aspects of lifestyle and can therefore be described as part of a lifestyle - not only in tobacco advertising. With regard to the health-related lifestyle aspects, codependency with alcohol consumption is well documented. Smoking also impairs physical performance and in this way promotes a physically inactive lifestyle. And it is also considered certain that smoking cessation goes hand in hand with weight gain on average - the development of weight after quitting smoking is inconsistent, after all, 16% even lose weight.

The serious health effects of smoking are now undisputed. These particularly concern about cardiovascular diseases and cancer. Even the risk of cancers such as liver and kidney cancer, which are generally less associated with smoking, is on average more than 1½ times as high for smokers than for non-smokers. Not to mention the almost 7-fold risk of throat and larynx cancer and a 9-fold (!) Risk of lung cancer. But many other diseases are also associated with smoking behavior. Even mental health improves after quitting smoking, depression, and anxiety are reduced, and mental health and quality of life improve.

In contrast to smoking, alcohol consumption has both favorable and unfavorable health effects. The decisive factor here is the dosage. Numerous meta-analyses come to the conclusion that moderate alcohol consumption is associated with better health (compared to abstinence), while excessive alcohol consumption is known to be unhealthy. This relationship applies to both the mortality risk and life expectancy and cardiovascular diseases, for type 2 diabetes and even for dementia.

The definition of moderate alcohol consumption varies between the studies and is probably also dependent on the health aspect examined in each case. With regard to heart failure, the risk associated with 21 “drinks/week” is no greater than that of non-drinkers. Nevertheless, the authors of this study advise against recommendations on moderate alcohol consumption, as it is unclear to what extent the observed U-shaped relationship reflects causality or selection. The biographical perspective is also relevant for the health consequences of alcohol consumption: an increased risk of mortality is primarily associated with heavy drinking from adolescence. Also, the acceptable amount of alcohol per day for women is only half that for men. The German Nutrition Society “allows” 10 g of pure alcohol per day for women and 20 g of pure alcohol per day for men, which corresponds to about an eighth or a quarter of a liter of wine.

 

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