University of Vermont

HEART MONTH: Cushman Links Research on Lifestyle Improvements and AHA Advocacy

Mary Cushman, M.D., M.Sc.
University of Vermont Professor of Medicine Mary Cushman, M.D., M.Sc. (Photo by Raj Chawla, UVM Medical Photography)

In the past ten years, improvements have been achieved in the prevalence of ideal levels of smoking, blood pressure, and cholesterol and declines in ideal rates of body mass index and fasting glucose, according to the American Heart Association (AHA). Still, the AHA reports that an estimated 83 million U.S. adults suffer from such life-threatening cardiovascular diseases as coronary heart disease, heart failure, stroke, and high blood pressure, and the national obesity epidemic is a major contributor to these conditions.

Longtime AHA volunteer and University of Vermont Professor of Medicine Mary Cushman, M.D., M.Sc., specializes in studying people’s risk for cardiovascular disease and often, the results she and colleagues uncover provide evidence that informs policy. She maintains that while the medical field has become skilled at treating cardiovascular diseases, the larger public health issue of reducing death from heart disease, stroke and other health conditions, needs much more work.

“Prevention must be our focus so that we can all live healthier lives,” says Cushman, who is president of the AHA Vermont board of directors, “and we have a research-proven and easy way to make changes that can result in long-term benefits – the AHA’s Life’s Simple 7 assessment.” This online tool measures an individual’s health, and then provides tips to improve the areas that need to change.

Research published by Cushman and colleagues assessed the risk of dying in a population of more than 17,000 adults over four years, based on Life’s Simple 7 measures for good health: get active; control cholesterol; eat better; manage blood pressure; lose weight; reduce blood sugar; and stop smoking. They found that by making a small improvement in just one part of the Life’s Simple 7, death from all causes was reduced by 14 percent.

“When we looked at just the lifestyle factors in Life’s Simple 7 – healthy body weight, non-smoking, good levels of physical activity and healthy diet – the death risk was 21 percent lower for a one level improvement,” Cushman says.

Of all of the seven Simple 7 metrics, “healthy diet” poses the biggest challenge. Less than one percent of Americans meet the AHA criteria for ideal diet, which means there is a great opportunity for improvement. In an effort to positively impact diet, the AHA and 37 other Vermont organizations are involved in a campaign to reduce sugar-sweetened beverage consumption via a tax. AHA-supported research, as well as a UVM study, show that changes in prices seem to alter behavior, and an increased cost of the price of a sugary beverage could lead to a nearly 20-percent decrease in demand for that beverage.

"In fact, the AHA metric for measuring 'healthy diet' includes a component on level of intake of sugary beverages," Cushman says. "This is because we know that these products provide calories without satiety, and explain about 20 percent of the current obesity epidemic."

Cushman recently published a “My Turn” column in the Burlington Free Press advocating for support for this tax in Vermont.

“This health threat [obesity] impacts more than a quarter of Vermont’s kids and over one-half of adults,” she says in the column. “We must tackle obesity on all sides, and reducing the population’s intake of sugary drinks is a strong step in the right direction.”

Cushman’s letter also calls attention to the healthcare costs related to obesity, citing that $163 million per year in Vermont’s Medicare and Medicaid expenses are attributed to obesity.

The AHA has set a 2020 goal of improving the cardiovascular health of all Americans by 20 percent.

“The one-level improvement in the Life’s Simple 7 measures would get people halfway to this goal,” she says. “The research backs up how useful this can be!”

UVM Food Systems will be hosting a webinar about the Sugar-Sweetened Beverage Tax initiative on Monday, February 25, 2013 at 2 p.m.