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New health diagnoses prompt participants to change lifestyle behaviors
Diagnosis of serious health conditions served as a wake-up call for most participants, resulting in more quitting smoking, slimming down.
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Overweight or obese participants who were newly diagnosed with diabetes, heart disease or lung disease were more likely to lose weight (2 lb to 3 lb) compared with those who did not receive a diagnosis, according to a report in the Archives of Internal Medicine.
The rate of behavior change was even greater for participants who were habitual smokers — 3.2 times the odds of quitting if they received at least one of five diagnoses (diabetes, heart disease, lung disease, cancer or stroke) vs. no new diagnoses (P<.001).
Patricia S. Keenan, PhD, MHS, assistant professor at Yale School of Medicine and Yale School of Public Health, analyzed data from the Health and Retirement Study, a longitudinal survey of middle-aged and older adults. The analysis included 20,221 overweight or obese participants aged 75 years and younger and 7,764 smokers who were surveyed at least twice between 1992 and 2000.
During the course of the survey period, 18% of smokers quit and average BMI increased by 0.04 U in the overweight and obese group. About 13% of smokers were diagnosed with one of the five adverse health conditions, while 8% of overweight or obese participants received a diagnosis of lung disease, heart disease or diabetes.
“Changes were particularly pronounced in smokers with stroke, cancer or heart disease and in overweight individuals with diabetes,” Keenan wrote.
Multiple diagnoses were associated with a greater magnitude of behavior change. Following one diagnosis, smokers had 2.9 times greater odds of quitting; following multiple diagnoses, smokers had 6.1 times greater odds of quitting. Similarly, overweight or obese participants who received one diagnosis experienced a 0.34 U reduction in BMI compared with a 0.64 U reduction for those who received more than one diagnosis.
“Identifying windows of opportunity for patient receptiveness to lifestyle changes could help guide physicians as to when counseling will have the greatest effect,” Sherry Pagoto, PhD, and Judith Ockene, PhD, both of the University of Massachusetts Medical School, wrote in an accompanying editorial. “However, the effect of physician advice might only be as good as the availability of supportive services to which patients can be referred for specialized preventive care. Our health care system is incomplete to the extent that patients and heath subjects do not have affordable access to evidence-based preventive services.” – by Katie Kalvaitis
Arch Intern Med. 2009;169:217-218.
Arch Intern Med. 2009;169:237-242.