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Diet? Exercise? Sleep? Vanderbilt study identifies best immediate changes for long-term health benefits

Jan. 12, 2017, 10:58 AM

The project began with a question — among a list of 10 lifestyle behaviors, any of which a person can change immediately, which ones have the most impact on health?

Here’s the list, in random order:

  • Strength exercise
  • Low-fat intake
  • Aerobic exercise
  • Adequate sleep
  • Seat belt use
  • Consumption of whole grain breads
  • Regular breakfast
  • Increased intake of fruits/vegetables
  • Avoidance of unhealthy snacks
  • Nonsmoking

All of these are good ideas for better health, but Vanderbilt’s Health & Wellness team identified the ones that have the most impact over the long-term.

Leading the way as most impactful was No. 1, eating a low-fat diet, followed by No. 2, aerobic exercise; No. 3, nonsmoking; No. 4, seat belt use; and No. 5, adequate sleep.

A Vanderbilt study identified the 10 lifestyle changes people can make immediately that most impact health. (photo by Joe Howell)
A Vanderbilt study identified the 10 lifestyle changes people can make immediately that most impact health. (photo by Joe Howell)

“We wanted to identify what we could tell people they could start doing right now,” said Mary Yarbrough, M.D., MPH, associate professor of Clinical Medicine and executive director of Faculty and Staff Health and Wellness, and the senior author of the study, which was published in the American Journal of Preventive Medicine.

“People can get paralyzed by so much information. This can provide focus,” she said.

The study was based on 10 years of de-identified data provided by Vanderbilt employees who voluntarily participated in the annual “Go for the Gold” health risk assessment. The researchers examined the data from more than 10,000 Vanderbilt health risk assessments submitted between 2003 and 2012, and matched risk factors to health outcomes across the studied population.

“This is one of the most important questions that people ask themselves: ‘Of the health behaviors that I can control today, what are the most important to my long term health outcomes?’” said Daniel Byrne, Director of Quality Improvement and Program Evaluation in the Department of Biostatistics, who was the lead author of the study.

He noted that the data show that even small changes can affect health over time.

“If you are sedentary, and begin to exercise one day a week, that benefits significantly the prevention of diabetes,” he said. “You can’t change your age, race or genetic makeup, but you can change what you eat or how much you exercise.”

Yarbrough said that she thought one of the most significant findings of the study was the importance of sleep.

“The thing that I most often hear people say about their health that I think we need to educate them about is, ‘I don’t need much sleep.’ We need to remind people that seven to eight hours of sleep is really a good idea.”

She noted that diet, exercise, nonsmoking and wearing seat belts are better-known healthy lifestyle measures than adequate sleep, but “in terms of healthy-habits education, sleep is our next frontier.”

Both Yarbrough and Byrne pointed out that this is a Vanderbilt study, using data provided by Vanderbilt employees, and acknowledged the institution’s leadership in health promotion to employees as the keystone to the data collection that made the study possible.

“We want to be a learning health system and use what we learn to help employees,” Byrne said. “This is translational, population-based research, using one of the largest, most comprehensive employee data sets ever studied.”

Beyond the information that individuals can use to change unhealthy behaviors, the Vanderbilt study can also serve to guide other employer-based health promotion efforts, and shows that a focus on prevention can pay dividends in better employee health.

“Vanderbilt should really be proud of itself,” Yarbrough said. “There is a rationale to what we were doing. We were preventive when preventive wasn’t cool.”

Other Vanderbilt staff and faculty who worked on the study included Lori A. Rolando, M.D., MPH; Muktar H. Aliyu, M.D., Dr.PH.; Paula W. McGown, R.N., MSN; Lisa R. Connor, R.N.; Bradley M. Awalt, M.S.; Marilyn C. Holmes, M.S., R.D.; and Li Wang, M.S.

The research was supported in part by the National Center for Advancing Translational Sciences grant 2 UL1 TR000445-06.

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