Artinian and her co-authors analyzed 74 studies conducted among U.S. adults between January 1997 and May 2007. The studies measured the effects of behavioral change on blood pressure and cholesterol levels; physical activity and aerobic fitness; and diet, including reduced calorie, fat, cholesterol and salt intake, and increased fruit, vegetable and fiber consumption.
Cardiovascular disease (CVD) is the leading cause of death in the United States. According to American Heart Association statistics, about 81.1 million adults, or one out of every three people in America, have at least one type of CVD, such as heart attack, stroke or heart failure. If cardiovascular diseases were completely eradicated, life expectancy could increase by nearly seven years.
“Lifestyle change is never easy and often under-emphasized in clinical encounters with our patients. This statement shows what types of programs work and supports the increased need for counseling and goal setting to improve healthy cardiovascular habits,” said Ralph Sacco, M.D., president of the American Heart Association. “We need to find more effective ways to make lifestyle change programs available, especially to the groups at highest risk for cardiovascular diseases – older Americans, African-Americans and people of Hispanic origin.”
Sacco added that the first step in making a change is to know your health status, “because a lot of people don't realize they're at risk for heart disease and stroke. The American Heart Association's My Life Check can help identify your risk level and offers simple steps to get started on the path to ideal cardiovascular health.”
Although obesity, physical inactivity and poor diet are well recognized as major risk factors for cardiovascular disease, it's often difficult for doctors and nurses to help patients reduce their risk for an extended period. They are faced with numerous obstacles, including time constraints, reimbursement problems and insufficient training in behavioral-change techniques, the statement authors write.
Despite these difficulties, Artinian said policy changes will eventually make critical interventions more readily available.
Federal health reform legislation includes provisions that would improve access to preventive services and help Americans make healthier food choices to control risk factors for heart disease and stroke. For example, the new law requires calorie information on restaurant menus and vending machine products and eliminates co-pays for certain preventive services under Medicare and new private health plans. The legislation also includes funding to support public health interventions at the state and local levels aimed at lowering risk factors for chronic disease.
“I'm looking forward to the future when we will have a healthcare system that gives more weight to the importance of prevention and changing lifestyle behaviors to help people stay healthy and reduce cardiovascular risk,” Artinian said.
Using the results of Project EAT-II: Eating Among Teens, researchers from the College of Saint Benedict and Saint John's University, the University of Minnesota, and the University of Texas, Austin, analyzed the diets, weight status, weight control behaviors, and drug and alcohol use of 2,516 adolescents and young adults between the ages of 15 and 23. These participants had been part of Project EAT-I, an earlier survey of middle school and high school students from 31 Minnesota schools using in-class surveys, food frequency questionnaires, and anthropometric measures taken during the 1998-99 academic year.
Participants were identified as current (4.3%), former (10.8%), and never (84.9%) vegetarians. Subjects were divided into two cohorts, an adolescent (15-18) group and a young adult (19-23) group. They were questioned about binge eating and whether they felt a loss of control of their eating habits. More extreme weight control behaviors including taking diet pills, inducing vomiting, using laxatives, and using diuretics were also measured.
The authors found that among the younger cohort, no statistically significant differences were found with regard to weight status. Among the older cohort, current vegetarians had a lower body mass index and were less likely to be overweight or obese when compared to never vegetarians.
Among the younger cohort, a higher percentage of former vegetarians reported engaging in more extreme unhealthy weight control behaviors when compared to never vegetarians. Among the older cohort, a higher percentage of former vegetarians reported engaging in more extreme unhealthy weight control behaviors when compared to current and never vegetarians.
In the younger cohort, a higher percentage of current and former vegetarians reported engaging in binge eating with loss of control when compared to never vegetarians. In the older cohort, a higher percentage of current vegetarians reported engaging in binge eating with loss of control when compared to former and never vegetarians.
Writing in the article, Ramona Robinson-O'Brien, Assistant Professor, Nutrition Department, College of Saint Benedict and Saint John's University, St. Joseph, MN, states, “Study results indicate that it would be beneficial for clinicians to ask adolescents and young adults about their current and former vegetarian status when assessing risk for disordered eating behaviors. Furthermore, when guiding adolescent and young adult vegetarians in proper nutrition and meal planning, it may also be important to investigate an individual's motives for choosing a vegetarian diet.”
While vegetarians tend to eat healthier diets and are less likely than non-vegetarians to be overweight or obese, they may be at increased risk for binge eating with loss of control, and former vegetarians may be at increased risk for extreme unhealthful weight-control behaviors, according to researchers at University of Minnesota, University of Texas and St. John's University.
The researchers analyzed vegetarianism, weight, dietary intake and weight-control behaviors data from a population-based study in Minnesota of more than 2,500 males and females between 15 and 23. They found vegetarians ate healthier diets than non-vegetarians when it came to fruits, vegetables and fat intake. Among young adults, current vegetarians were less likely to be overweight or obese.
However, adolescent and young adult vegetarians were also more likely to report binge eating with loss of control compared to non-vegetarians. Among adolescents, former vegetarians were more likely to engage in extreme unhealthful weight-control behaviors. And among young adults, former vegetarians were more likely to engage in extreme unhealthful weight-control behaviors than people who either were currently vegetarians or had never followed a vegetarian eating plan.
Examples of extreme unhealthful weight-control behaviors included “took diet pills,” “made myself vomit,” “used laxatives” and “used diuretics.”
The researchers conclude: “Adolescent and young adult vegetarians may experience the health benefits associated with increased fruit and vegetable intake and young adults attain the added benefit of decreased risk for overweight and obesity. However, vegetarians may be at increased risk for disordered eating behaviors, such as binge eating and unhealthful weight-control behaviors.
“Study results indicate that it would be beneficial for clinicians to ask adolescents and young adults about their current and former vegetarian status when assessing risk for disordered eating behaviors. Furthermore, when guiding adolescent and young adult vegetarians in proper nutrition and meal planning it may also be important to investigate an individual's motives for choosing a vegetarian diet.”
Source: Journal of the American Dietetic Association