Modifiable Risk Factors

As mentioned in my previous post, we should all be focusing our attention on the actual risk factors that cause chronic diseases in order to prevent from developing them in the first place. I presented the seminal study Actual Causes of Death in the United States, 2000 that highlights the true root causes of these “killer diseases”. A newer 2009 study entitled The Preventable Causes of Death in the United States: Comparative Risk Assessment of Dietary, Lifestyle, and Metabolic Risk Factors (Danaei G, Ding EL, Mozaffarian D, Taylor B, Rehm J, et al. (2009) The Preventable Causes of Death in the United States: Comparative Risk Assessment of Dietary, Lifestyle, and Metabolic Risk Factors. PLoS Med 6(4)) presents similar findings but includes a greater variety of risk factors.

The aim of this study was to estimate the mortality (another term for death) effects of the following 12 modifiable dietary, lifestyle, and metabolic risk factors in the United States (US) using consistent and comparable methods: high blood glucose, low-density lipoprotein (LDL) cholesterol, and blood pressure; overweight-obesity; high dietary trans fatty acids and salt; low dietary polyunsaturated fatty acids, omega-3 fatty acids (seafood), and fruits and vegetables; physical inactivity; alcohol use; and tobacco smoking.

The results showed that in 2005, tobacco smoking and high blood pressure were responsible for an estimated 467,000 and 395,000 deaths, accounting for about one in five or six deaths in US adults. Overweight-obesity (216,000) and physical inactivity (191,000) were each responsible for nearly 1 in 10 deaths.

High dietary salt (102,000), low dietary omega-3 fatty acids (84,000), and high dietary trans fatty acids (82,000) were the dietary risks with the largest mortality effects. Alcohol use caused an additional 90,000 deaths.

Take home message: Smoking and high blood pressure, which both have effective interventions, are responsible for the largest number of deaths in the US. Other dietary, lifestyle, and metabolic risk factors for chronic diseases also cause a substantial number of deaths in the US.

I also want to stress that these modifiable risk factors are not only important in the development of chronic diseases but also in the development and progression of more acute diseases such as the common cold. For example, exercise has been show to reduce the chances of developing and the symptoms associated with the common cold.

I hope that I have made a strong case for addressing our own modifiable risk factors (tobacco smoking, diet, exercise and alcohol use) and that we ask these questions to our own doctors so that we focus on what really matters: preventing the development of diseases rather than focusing on managing the symptoms of diseases once they have developed.