TUESDAY, Oct. 27, 2020 — Many married couples or domestic partners share a lot: the same house, bills, pets and maybe children. A new study found they often also share the same behaviors and risk factors that can lead to heart disease.
Researchers assessed heart disease risks and lifestyle behaviors of nearly 5,400 U.S. couples enrolled in an employee wellness program.
They used the risk factors spelled out in the American Heart Association Life’s Simple 7: smoking status, physical activity, healthy diet, total cholesterol, blood pressure, fasting blood sugar and body mass index (BMI, a measure of body fat based on height and weight). They categorized participants’ results individually and as couples as poor, intermediate or ideal for each risk factor and overall.
“The good news is that some of them, 1 out of 5 [couples], were both ideal, but the fact that 4 out of 5 were in the non-ideal category is really worrisome,” said study co-author Dr. Samia Mora, a cardiologist at Brigham and Women’s Hospital in Boston.
Even more concerning: The study population tended to be entering or in middle age. Men ranged from 41 to 57 years old; women, from 39 to 55.
“We know that risk factors get worse with age and also that our risk for cardiovascular disease increases a lot with age,” Mora said “So, what you do earlier in life really matters for the future.”
The couples had joined a corporate health assessment program between October 2014 and August 2015. Their health status was assessed through questionnaires, exams and lab tests. Researchers also followed about 2,200 of those couples through five risk assessments that continued through 2018.
The wellness program was similar to those many companies offer their employees. This one included spouses and partners, and data was available for both, Mora said. Participants came from all over the United States and represented diverse economic and racial backgrounds.
Only 12% of individuals had ideal scores for heart health, the study found. Though more than half were in the ideal category for smoking, total cholesterol and fasting blood sugar, more than a quarter rated poor for BMI and adequate exercise.
About 79% of couples had less-than-ideal scores for heart risk — mainly due to unhealthy diets and inadequate exercise, the study found.
The findings were published Oct. 26 in JAMA Network Open.
Jannie Nielsen, an assistant professor at Emory University’s Rollins School of Public Health in Atlanta, reviewed the findings.
She said people often choose a partner who is quite similar to them, whether because they have similar economic status or share interests, like exercise. And once they are together, they tend to share habits, especially what they eat, Nielsen said.
Other studies have shown that spouses of individuals who participated in a weight-loss program also lost weight during that time, she said.
“You could hypothesize that because one person is in an intervention, they may change what they eat at home,” Nielsen said.
Several factors could influence what a person chooses to eat, including the foods one grew up with, their economic status and in-store marketing that may steer a shopper to certain food choices, she said.
“I think it’s based on how you grew up, it’s based on what you can afford, but also on time,” Nielsen said. “If you’re working, do you want to cook a big meal from scratch or do you want to buy something you can just heat up? A lot of factors [are] playing there.”
While most health and prevention programs are focused on individuals, Mora said this study showed that behavioral modification may benefit both the targeted individual and his or her significant other.
“The key here is that if we are able to expand our approach for prevention and not just focus on individuals, but focus on household or even potentially bigger units like communities, we may have a lot more benefit,” she said. “We know that having a support system really helps people to change their behavior because behavior is hard to change.”
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