Last month, I started a series on healthism. In it, I discuss making health a priority as a means to live a happier, more vibrant life. Unfortunately, taken to an extreme, a focus on health can result in an unnatural preoccupation with body perfectionism and/or disordered eating patterns. I have witnessed, and have even dipped my toe in with, those immersed in “healthism.”
I have inched my way in and out of the hot water very quickly. I have seen how it can rob one’s zest for living outside of their own “healthosphere.” Healthism can also lead to constantly stressing over making the “wrong, unhealthy choices,” long hours of exercise to sculpt one’s physique, and judging and excluding those who don’t share the same “health morals,” or fit into the societal accepted “ideal” body size.
It does not help matters that the very authorities we entrust to assist us with tools to lead our lives feeling well, could be contributing to the disease by focusing on the wrong measurement. In fact, medical and fitness experts may even praise these extreme measures, forgetting the wellness implications of living within a community and enjoyment of an optimistic and harmonious life! (Read more here.)
As luck would have, just before I was finishing my review of the recent health, integrative medicine, and nutritional headlines for my monthly Top Reads, another “diet” study was released. The study was unique in that, rather than measuring weight loss and lab values alone, it assessed a very specific outcome. The authors tracked how a change in food quality, using three different dietary assessment tools over twelve years, would affect one’s risk of death, the ultimate endpoint.
The results indicated that changes in diet quality, adding additional healthy foods and cutting out non-foods, regardless of dietary plan, was associated with reduced risk of both total and specific-cause death. The methods used are summarized below:
We used Cox proportional-hazards models to calculate adjusted hazard ratios for total and cause-specific mortality among 47,994 women in the Nurses’ Health Study and 25,745 men in the Health Professionals Follow-up Study from 1998 through 2010. Changes in diet quality over the preceding 12 years (1986–1998) were assessed with the use of the Alternate Healthy Eating Index–2010 score, the Alternate Mediterranean Diet score, and the Dietary Approaches to Stop Hypertension (DASH) diet score. (N Engl J Med 2017; 377:143-153)
(You can also access further details on the methods and findings here.)
I admit, the associations were impressive:
20-percentile increase in diet scores (indicating an improved quality of diet) was significantly associated with a reduction in total mortality of 8 to 17% with the use of the three diet indexes and a 7 to 15% reduction in the risk of death from cardiovascular disease with the use of the Alternate Healthy Eating Index and Alternate Mediterranean Diet. Among participants who maintained a high-quality diet over a 12-year period, the risk of death from any cause was significantly lower — by 14% (95% CI, 8 to 19) when assessed with the Alternate Healthy Eating Index score, 11% (95% CI, 5 to 18) when assessed with the Alternate Mediterranean Diet score, and 9% (95% CI, 2 to 15) when assessed with the DASH score — than the risk among participants with consistently low diet scores over time.
There were some limitations to the study, however, beyond what were mentioned by the authors. One of them was that many of the participants also changed their lifestyle (smoking, exercise, and alcohol intake) throughout the same span of studying dietary changes. This makes it hard to conclude that diet alone was responsible. Even if the other factors weren’t significant, they could still affect results.
Another issue was the method used for measuring the association of diet quality and death. It included assessing medical records and lifestyle every two years and a FFQ (Food Frequency Questionnaire) every four years. Subjective measurements such as these could introduce bias and inaccuracy based on subjects’ recall. (1,2,3,4)
Other issues with lifestyle interventions include attention to the participants and expectations of “good” and “bad” outcomes based on lifestyle experiences, memes, or researchers’ influence. I go into these aspects more here.
As I mentioned in last week’s blog, I do feel that food quality is one aspect of health, but diet and preoccupation with body weight should not be the sole focus of wellness. Furthermore, living life with a health obsession can take away one’s community, passion, and self-acceptance. These very aspects are what make life worth living.
Click here for Part II. You will also get access to September’s Top Holistic and Integrative Health Reads and learn how essential oils can help support emotional freedom.