New Year’s Resolutions: Which One Gives the Most ‘Bang-for the Buck’?


Healthy Living – January 2, 2018
William Sturrock, MD – Eastern Maine Medical Center
Here we are at another temporal milepost on the road of life where many of us are tempted to face our bad habits and make a ‘resolution’ to change and become a better person. If  you looked at the medical research underpinning the forswearance of a variety of foibles – indulging in alcohol, not exercising, over-eating, smoking, to name a few – you may be able to increase your motivation by focusing on the how to get the most ‘mileage’ on one successful change.
Research on the many ways that smoking tobacco affects us harmfully will probably convince all but the most-hardened skeptics on the value of stopping this habit. Of course there is the widely known connection to cancers of the lung, oropharynx and GI system. However, there is also the lesser known but no less deadly cancers of the bladder and cervix. Not to forgotten in this litany are the effects on heart disease, stroke and other diseases of the circulation. So it’s pretty clear that if you could only change one risk and this your bad habit, you will get a lot of benefit for quitting tobacco.  Actuarial statistics exist where a person can calculate in years what quitting can bring. 
Now let’s look at some of the next candidates in line for getting ‘kicked off the island’.  Losing weight is probably the next best thing you could do for yourself, especially if you make the life-style changes to make it long-lasting. We know how being obese increases risk of diabetes, and from there all the circulatory diseases mentioned above can be affected.   But there are other lines of research supporting less obvious connections such as atrial fibrillation. This chronic rhythm disorder of the heart affects up to 5% of older adults and carries its own risks of stroke, heart failure, and other ‘bad outcomes’. 
Perhaps the most convincing study was a large meta-analysis, done by Dr. Frank Hu and others that was reported in July of 1016 in the Lancet. The research looked at data from 239 studies involving 10.6 million participants from 1978-2015 in 32 countries. They determined that the risk of dying went up in stepwise fashion for every percentile increase in body mass index.  Body mass index (BMI) is calculated by taking your weight in kilograms and dividing this by the square of your height in centimeters. Specifically, they found that the people with a BMI range of 22-25% had the best longevity. Those with a BMI of 25-27.5 had a 7% higher mortality.  Those with a BMI between 27.5- 30 had a 20% higher mortality all the way up to a 600% increase in mortality if it was over 60. The data also showed that those who were under the ideal range also had higher rates of death. 
So what’s the bottom line? Each of us probably needs to look in the mirror as honestly as we can and determine our individual health risk, as well as how we can realistically make some positive changes. If you are among the 16% of the population that includes tobacco-smokers, focus on cessation of smoking first. For many of us -- the research shows 70% of Americans are either over-weight or obese – our marching orders should be clear. Now, what if you are in the group of non-smokers at an ideal BMI – don’t get too smug, there’s always something you could improve upon.  How about working on World Peace?