Bad habits come in pairs

It’s been said that the longer couples stay together the more they look alike. As it turns out, the resemblance may be more than skin-deep. A study published online Oct. 26, 2020, by JAMA Network Open found that couples’ health behavior and heart disease risk factors also look alike — for better or worse.

“We know, even from personal experience, that couples share similar behaviors that can affect health, but it was surprising to find the high levels of shared unhealthy behaviors within couples,” says the study’s lead author, Dov Shiffman, a senior scientific fellow at the medical testing company Quest Diagnostics.

The study found that almost 80% of couples were in the non-ideal category of overall cardiovascular health. “This high percentage was largely driven by sharing an unhealthy diet and insufficient exercise,” he says.

Women don’t always perceive themselves as having high risk for heart disease. “Many women fear cancer, in particular breast cancer,” says Dr. Samia Mora, a cardiologist at Harvard-affiliated Brigham and Women’s Hospital and another of the study’s authors. “Yet heart disease and stroke claim many more women’s lives than breast cancer or cancer in general.” So, these findings definitely warrant some attention.

Sharing risk

The researchers looked at 5,364 couples who underwent an employer-sponsored health assessment at Quest Diagnostics between October 2014 and December 2018. They calculated how well the participants complied with the American Heart Association’s Life’s Simple 7 guidelines, which are used to gauge heart disease risk factors. The researchers considered these seven categories:

  • smoking status
  • body mass index
  • diet
  • exercise frequency
  • cholesterol levels
  • blood pressure level
  • fasting glucose.

Based on laboratory test results, physical examinations, and answers on a health questionnaire, the researchers assigned each participant a score for each category: poor (0), intermediate (1), or ideal (2). They then added up those scores to give participants an overall cardiovascular health score.

Most of the time, both members of a couple scored the same in a given category, either ideal or non-ideal. But how often they matched varied. For example, couples were either both rated ideal or non-ideal 53% of the time when it came to their cholesterol levels, but 95% of the time for diet.

Among the other findings:

  • Nearly 50% of the couples were both overweight.
  • In 53% of cases, both members of a couple failed to get enough exercise.

Over all, 79% of couples had an unhealthy total heart disease risk score, making it more likely that they would develop cardiovascular disease down the road.

A positive force for change

But the news from this study wasn’t all bad. For those people who had an “ideal” score in various categories, chances were good that their partner scored as “ideal” too, meaning that one member of a couple might be able to influence the other in a positive direction.

“Our study suggests that the behaviors of one person in a couple may influence the other,” says Shiffman. That means a woman should be mindful of the effect her partner’s behavior may have on her own health. But she should also feel empowered to change her own behaviors, knowing that doing so will likely influence her partner.

While this study has lessons for women, it has a message for doctors, too, Shiffman says.

“This study shows that physicians should consider the family unit when evaluating an individual patient’s health. The current health system is really built around the individual, which makes it very difficult to address health issues as a family unit. Other studies have shown that a social network in general, and particularly having a spouse, can support and facilitate positive behavioral change,” he says.

Further study is needed to determine the best way to harness this couple dynamic to help both partners achieve better health.

“Behavior modification is hard and remains the major challenge for prevention of heart disease and stroke in 2021. Future studies should examine whether prevention interventions that involve couples or households are better than individual programs,” says Dr. Mora.

But ultimately, these findings may give women even more incentive to make positive change on their own, she says.

“Knowing that our own behavior and choices influence those around us may make us more mindful and willing to go the extra mile to improve our health, especially when we recognize that by improving our health we could improve the health of those around us whom we care about,” says Dr. Mora.

Strategies to improve your heart healthMaking changes to your health habits isn’t easy, and it’s often difficult to know where to start. Looking at the Life’s Simple 7 recommendations from the American Heart Association (AHA) is an easy way to get started. The best strategy is to set realistic goals for yourself and then add new goals as you achieve them.Below is a list of the seven areas the AHA recommends focusing on and some of their tips to help move you along.1. Eat better. Aim to eat a diet rich in vegetables, fruits, whole grains, beans, nuts, plant-based proteins, lean meats, and fish. and avoid processed foods, red meat, sugary foods, excess sodium, and processed grains.2. Lose weight. Focus on controlling your food portions, increasing your activity level and improving your diet.3. Get active. Strive to get at least 150 minutes of moderate aerobic activity a week or 75 minutes of vigorous activity, in addition to weight training or resistance exercises at least twice a week.4. Control cholesterol. Increase your physical activity and replace unhealthy saturated fats, such as butter, with healthier, unsaturated fats like olive oil. (Quick tip: Saturated fats tend to be solid at room temperature.)5. Manage blood pressure. Keep your weight in a healthy range. Don’t smoke. Get enough sleep at night.6. Stop smoking or vaping. Make a plan to help you quit successfully. Seek support from your doctor to help you quit if you need it. Increase your physical activity. Identify healthy ways to manage your stress. Find strategies to help you cope with urges to smoke.7. Reduce blood sugar. Eat a healthy diet. Increase your physical activity. Maintain a healthy weight. Don’t smoke.

Recognizing heart risks

This study also provides an impetus for women to step back and take stock of their health. Often, a shift toward unhealthy habits occurs gradually over time, making it less obvious.

“This study should serve as a wake-up call for older women — who may be in longer-term relationships with well-established habits and routines such as unhealthy cooking or a lack of exercise — that they should consider evaluating behaviors that could affect their heart health,” says Shiffman.

While the participants in this study were mostly middle-aged, the implications for older women are even more relevant, since their chance of having a stroke or heart attack rises with age, says Dr. Mora. “This risk is much greater if the woman also has other cardiovascular risk factors,” says Dr. Mora.

Once you make this assessment, you should either determine the best ways to maintain your behaviors if they are ideal, or improve them if not, says Dr. Mora.

Bible verses for today’s meditation and inspiration: Matthew E. McLaren

But the Lord is faithful, and he will strengthen you and protect you from the evil one. 2 Thessalonians 3:3 NIV 

Look to the Lord and his strength; seek his face always. 1 Chronicles 16:11 NIV 

I love you, Lord, my strength.  The Lord is my rock, my fortress and my deliverer; my God is my rock, in whom I take refuge, my shield and the horn of my salvation, my stronghold. Psalm 18:1-2 NIV 

But I will sing of your strength, in the morning I will sing of your love; for you are my fortress, my refuge in times of trouble. Psalm 59:16 NIV 

Be on your guard; stand firm in the faith; be courageous; be strong. 1 Corinthians 16:13 NIV 

Ah, Sovereign Lord, you have made the heavens and the earth by your great power and outstretched arm. Nothing is too hard for you. Jeremiah 32:17 NIV

The Sovereign Lord is my strength; he makes my feet like the feet of a deer, he enables me to tread on the heights. Habakkuk 3:19 NIV 

For the word of God is alive and active. Sharper than any double-edged sword, it penetrates even to dividing soul and spirit, joints and marrow; it judges the thoughts and attitudes of the heart. Hebrews 4:12 | NIV

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