How low should you go?

When it comes to your health, making even small changes can lead to big improvements. Whether you are trying to eat a healthier diet, get in shape, or lose weight, a little effort can go a long way. But doing more can produce even more meaningful changes.

The same is true for risk factors including blood pressure, cholesterol, and glucose. For example, if you have high blood pressure, you can reduce your risk of having a heart attack or stroke by lowering it, even if it doesn’t get into the “normal” range. This is often a goal for patients with high cholesterol or diabetes, too.

According to recent news reports, a major study suggests that treating risk factors—specifically, hypertension—to bring them well below previous targets has even greater benefits. This study, and how it applies to other health indicators, is the topic of my Health & Fitness column in the Aiken Standard this week.

blood pressure


The study, which examined the effect of lowering blood pressure on heart attack and stroke risk, produced such remarkable findings that the results will be published two years ahead of schedule. The researchers found that lowering systolic blood pressure (the top number) to less than 120 mmHg resulted in a risk of heart attack or stroke that was significantly lower than that of treating blood pressure to a typical goal of below 140 mmHg.

This suggests that getting your blood pressure out of the “high” category isn’t enough and that lowering it more is beneficial. Not only is this is good news for people with hypertension, but it also likely applies to other conditions as well. For example, the goal for people with type 2 diabetes is to get blood glucose level, frequently determined by the “A1c” number, as low as possible to prevent complications like blindness, kidney failure, and amputations. And it seems that the risk of heart problems are reduced proportionally to how low LDL cholesterol gets.

This concept can also be applied to health behaviors. For people who are mostly sedentary, something as simple as a 30 minute walk each day can lead to big improvements in fitness. And simply swapping high-calorie drinks like soda or sweet tea for water or other calorie-free beverages can result in noticeable weight loss for many people. And overweight individuals can reduce their risk of diabetes by losing as little as 10% of their excess weight.

But greater changes to activity level or diet almost always have even bigger benefits. Cutting back on calories from drinks is a good start, but losing significant weight almost always requires making other changes in what you eat and how active you are. Walking is an excellent exercise, but greater improvements can be achieved by doing more, either longer duration or a higher intensity. And building muscle will require doing some form of resistance training—walking typically isn’t enough.

It’s true that every pound of weight loss matters, and many people notice changes in how they feel or how their clothes fit after losing as few as 10 pounds. But real transformations in appearance or health require more significant weight loss, especially for people with greater obesity.

Although the SPRINT study focused on only one factor, blood pressure, we shouldn’t limit ourselves to making only one change when it comes to our health. Indeed, the benefits of increasing activity, losing weight, and eating healthier together far exceed doing only one. And, while even small changes make a difference, doing more will almost always result in bigger benefits.

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