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Do lifestyle changes improve health?

9 January 2009 -- Can lifestyle changes really improve people's health? In this episode we look at the evidence from new research.

Transcript of the podcast

Veronica Riemer: You’re listening to the WHO podcast. My name is Veronica Riemer and this is the first podcast of 2009, episode number 56.

The evidence for the importance of healthy lifestyles is now overwhelming. New research conducted in Iran shows that lifestyle changes in diet and levels of physical activity improve the health of entire communities. Results of the research have appeared in the January issue of the Bulletin of the World Health Organization.

In the research project -- called "A Healthy Heart" -- mass media was used to educate people about healthy nutrition, food labels, the introduction of half portions in fast food restaurants and healthy snacks in schools. To encourage people to undertake physical activity, the government announced automobile-free days and built bicycle lanes in cities. Smoking was banned in the workplace.

Diet, physical activity and smoking behaviour were assessed annually for four years in the intervention areas and for three years in the control area. Changes were most notable in the diet of the research participants. In one area, 14% of participants had a healthy diet at the beginning of the study. This increased to 30% after four years. Time spent on leisurely physical activity increased from 81 minutes to 181 minutes per week. Smoking declined but not significantly.

Dr Tim Armstrong from the WHO Department of Chronic Diseases and Health Promotion tells us how a healthy lifestyle makes a difference.

Dr Tim Armstrong: Noncommunicable diseases such as cancer, cardiovascular disease and diabetes account for 35 million deaths each year. This is 60% of all deaths. And these diseases have common risk factors: tobacco use, inappropriate diet and physical inactivity. By avoiding these risk factors in the first place, by preventing the risk factors, we can prevent the majority of deaths due to those diseases.

Veronica Riemer: We know that lifestyle-related chronic diseases are placing an increasing burden on health systems around the world. Can a small change in behaviour such as diet, or physical exercise, really make a difference to an individual's health?

Dr Tim Armstrong: Certainly we believe that prevention is the best answer to the problem. We can prevent these diseases by small changes in people's behaviour. For example, 30 minutes of moderate physical activity each day, that is the equivalent of a brisk walk, can reduce your risk of a heart attack by up to 50%. Increasing your fruit and vegetable consumption can reduce your risk of colon cancer by up to 50%. So these changes are real, they are achievable. What we as WHO, and of course governments are encouraged to, do is to create the policies and the environment for people to be able to make these small choices. The health benefits are there, they are real, they are measured and they are cost effective.

Veronica Riemer: Can you tell me a little bit about the most effective interventions in changing people's behaviour and what kind of behaviour are we hoping to change?

Dr Tim Armstrong: The sorts of interventions vary for the sorts of risk factors. What we do know in general is that we have to target our population. We have to give key messages in terms of education. We have to create the environment for these interventions to be effective. For example, to increase physical activity, the population has to be educated to the importance of physical activity, but if we don't have the environment, i.e. a safe place to be physically active, the education programme will not work. We have to ensure that the whole environment is one where people can make the healthy choices.

Veronica Riemer: Do you feel that government restrictions are the only way to effect real behaviour change, such as heavily taxing tobacco and alcohol or subsidizing the use of public transport or building bicycle lanes?

Dr Tim Armstrong: Government restrictions can be very effective. The example with tobacco is one where we know that increasing the taxation on cigarettes has a real effect on the consumption of tobacco. But it is not the only thing we can do. Of course, education campaigns, banning of advertising of cigarettes, and of course restricting the sale and access to cigarettes are also very important.

Veronica Riemer: The programme was obviously a success in Iran. Are there plans to introduce similar programmes in other developing countries? And would these programmes have to be tailored to meet specific country needs?

Dr Tim Armstrong: The programme in Iran is an excellent example of a multi-component series of interventions to increase physical activity and improve diets. The principles of the programme in Iran are the principles that can be applied to other developing countries. Of course, one thing we do know is that all interventions must be tailored to the appropriate situation: we look at the cultural aspects, the country's needs, the country's capacities.

Veronica Riemer: You can find more information on this at www.who.int/topics/chronic_diseases.

The WHO Bulletin is available free online at http://www.who.int/bulletin.

That's all for this episode of the WHO podcast. Thanks for listening. If you have any comments on our podcast or have any suggestions for future health topics drop us a line. Our email address is Podcast@who.int.

For the World Health Organization, this is Veronica Riemer in Geneva.

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