For those interested in reducing their risk of death from cardiovascular disease, heart experts have some good news: regular exercise, a healthy diet and five other simple measures can cut one's near-term risk of death by more than half.
And here's the bad news: In a nationwide study of more than 17,820 adults, only two people met all of the criteria for top-notch cardiovascular health.
The message of the study, presented Monday at the American Heart Association's Scientific Sessions conference in Chicago, is clear, said Dr. Mark Urman, medical director of Cedars-Sinai Heart Institute's Preventive and Consultative Heart Center.
"Boy, most Americans aren't very healthy," said Urman, who wasn't involved in the research. However, he added, "on a more positive note, the study confirms that individuals can take control of their health. Incremental changes can make a huge difference."
The changes, dubbed Life's Simple 7, were laid out in January as part of an AHA campaign to guide Americans toward "ideal cardiovascular health." They are:
-At least 150 minutes of moderate exercise, or 75 minutes of intense exercise, per week.
-Having a body mass index of less than 25.
-Being a non-smoker for at least one year.
-Meeting four out of five of the AHA's key components for a healthy diet.
-Keeping total cholesterol below 200 milligrams per deciliter of blood.
-Maintaining blood pressure below 120/80 millimeters of mercury.
-Having a fasting blood sugar level below 100 mg/dL of blood.
"These are the sorts of things your grandmother told you," said Dr. Mary Cushman, the cardiovascular disease researcher at the University of Vermont who conducted the study.
Cushman used a database of people between the ages of 45 and 84 who were already enrolled in a nationwide study on the prevalence of stroke. All of the participants had been evaluated for the factors that make up Life's Simple 7.
In addition to the two individuals who met all seven criteria, another 213 people were compliant with six.
Death rates for those who met at least five of the criteria were 55 percent lower over the five-year study period than for those who met none, Cushman reported.
The analysis showed how much each health factor mattered - for every additional one met, a person reduced his or her chance of dying in the next four years by 15 percent.
"That tells how powerful these things relate to heart-disease risk," Cushman said. "Being as good as you can be on all of these factors is what your goal should be."
On the whole, Americans are most compliant when it comes to maintaining a healthy blood pressure and abstaining from smoking. More than 80 percent of those in the survey were nonsmokers, and almost 67 percent were in the ideal range for blood pressure, Cushman said.
On the flip side, eating a healthy diet was the criterion with the fewest adherents - only 0.43 percent managed to do so, the study found.
The ideal diet requires meeting four of five of these key components based on a 2,000-calories-per-day meal plan: four-and-a-half cups of fruits and vegetables per day, two or more 3.5 ounce servings of fish (preferably oily fish) per day, fewer than 450 calories a week of sugar-sweetened beverages, three or more one-ounce servings per day of whole grains and less than 1,500 mg of sodium per day.
Cushman could not identify the two people who scored perfect on the assessment. "It would be interesting to go back and talk to them," to see just how they live so healthfully, she said.
But the large portion of Americans who are far from the ideal range suggests that societal, not just individual, changes are needed, she said. Public projects like more parks, sidewalks and farmers' markets; soda taxes; smoking restrictions and physical activity requirements in preschools and schools could move large numbers of people toward better health.