Sound advice not always easy to come by

Shahar Madjar, MD

We are all looking for advice, a different perspective that could help us make the right decision.

We feel that professional advice doesn’t come cheap, nor is it easy to understand. To get proper advice, it seems, one would have to sit down, listen, learn complicated terms, then pay a hefty bill. Wouldn’t it be nice if, for example, we could get clear, straightforward, inexpensive advice that would fit on a 3-by-5 index card?

Helaine Olen, a personal finance writer and professor Harold Pollack from the University of Chicago tried to come up with such advice about financial life. They wrote down almost all you need to know to secure your financial future–advice such as: maximize your 401(k), buy well-diversified mutual funds, and save 20 percent of your money.

They wrote their advice in a clear, brief manner on a 3-by-5 index card. Their book “The Index Card; Why Personal Finance Doesn’t Have To Be Complicated” became a hit.

I asked myself, can medical advice be written as clearly and as briefly as the financial advice Olen and Pollack’s wrote on their index card?

A study recently published in the journal Circulation made me think that giving medical advice in this manner is possible. Dr. Yanping Li from Harvard T.H. Chan School of Public Health and colleagues analyzed data from the Nurses’ Health Study (78,865 participants) and the Health Professional Follow-up Study (44,354 participants). These two large studies were conducted in the U.S. and followed large groups of nurses and other health professionals for many years. The researchers collected information by using questionnaires about the participants medical history and lifestyle.

Yanping looked at 5 lifestyle factors: smoking, body mass index, level of physical activity, alcohol consumption, and the quality of the diet. He wanted to know whether there is a correlation between these factors and the risk of death.

The 5 low-risk habits included: never smoke; keep body mass index at18.5 to 24.9 kg/m2; participate in moderate to vigorous physical activity for at least 30 minutes a day; drink moderate amounts of alcohol (5-15 grams per day for women and 5-30 gram per day for men); and consume a high-quality diet.

Yanping found that participants who adhered to these 5 low-risk lifestyle habits had much prolonged life expectancy. At age 50, women who adhered to all of the 5 low-risk lifestyle habits were expected to live 14 years longer than those who didn’t adhere to any of the 5 habits. For men, the benefit was a bit less pronounced but still significant: At age 50, men who adhered to all of the 5 low-risk lifestyle habits were expected to live 12.2 years longer than those who did not adhere to any of the 5 habits.

The benefit in life expectancy was higher with increasing adherence to the low-risk habits. The larger the number of low-risk habits one adhered to, the longer the potential gain in life expectancy. Those who adhered to three low-risk habits, for example, did better than those who adhered to only one or two low-risk habits.

The benefit of adhering to each of the low-risks habits was seen in both men and women. Also, adherence to each of the low-risk factors was not only associated with the lower risks of total mortality, but, more specifically, to reduced risks of death from cancer and from cardiovascular disease (heart attacks and strokes).

Take a 3 by 5 index card and write the following advice (it is clear and I will charge you nothing at all):

Don’t ever smoke (and if you smoke, quit smoking).

Keep normal body weight (a 5’10” men, for example, should weigh 173 pounds or less)

Exercise moderately or vigorously for at least 30 minutes a day.

Avoid excessive alcohol consumption.

Eat right.

There is nothing new about the advice above–it is old news. The study confirms what scientists and doctors knew. The scope of the study (multiple participants followed for many years) and the very significant effect on life expectancy should be a driving force in making life-style changes.

As with any good advice, be it financial, medical, or other, the real difficulty isn’t the complex language experts use, or the cost involved. We usually recognize good advice when we hear it. Yet, no matter how simple or inexpensive the advice is, we often find it difficult to follow any advice, even sound advice. For some reason, or no reason at all, we are just stuck in our old habits.