The Alameda study gave us seven habits of healthy people

1. Avoiding snacks
2. Eating breakfast regularly
3. Exercising
4. Maintaining desirable weight for height
5. Not smoking
6. Drinking less than five drinks in one sitting
7. Sleeping 7-8 hours a night

These seven habits can be divided into three major categories: Eat well, Be Active and Smoke-Free, and Minimize Drinking.

Eat Well:

Our bodies require 46 nutrients to remain healthy. Water is essential to transport nutrients through the bloodstream, remove wastes, and regulate the body’s temperature. Although need varies by individual, most people stay well hydrated with eight 8-oz glasses of water a day. You will know you are drinking enough if you need to pee every two to four hours and the urine is a light color. The other nutrients are divided into five categories: proteins, fats, carbohydrates, minerals, and vitamins.

The U.S. Department of Agriculture suggests dividing your plate into five food groups with approximately 30% vegetables, 30% grains, 20% fruits, 20% protein, and a small circle of dairy. What you eat is just as important as what you don’t eat. Try to buy and eat foods that are minimally processed. The best way to do this is to shop the outskirts of the grocery store. You’ll notice that the outskirts tend to be the fresher, less processed foods.

Here are some power foods that are loaded with nutrients:

• Low-fat Yogurt
• Eggs
• Nuts
• Kiwi
• Quinoa
• Beans
• Salmon
• Broccoli
• Berries

If you want to read more about recommended diets, check out:

https://www.choosemyplate.gov/

Be Active and Smoke-Free

Adults should engage in 150 minutes of moderate intensity or 75 minutes of high-intensity activity per week. This activity can be a combination of 10-minute episodes spread through the week. The guidelines also suggest muscle-strengthening activities for all muscle groups at least twice a week. You have 10 minutes a day to dedicate to your health, right? Physical activity not only reduces mortality from different diseases but also increases life expectancy, improves cardiovascular recovery from stress. Psychologically, physical activity has been correlated with reduced symptoms of depression, less anxiety, and increased self-esteem.

Cigarette smoking is the most preventable cause of illness, disability, and premature death in the United States. A lit cigarette releases 4000 different chemicals into the body. Smoking is also a cause of cancer, causes an increased risk of dementia, and can contribute to the development of cardiovascular disease. Even secondhand smoke isn’t safe.Exposure to secondhand smoke is correlated with an increased chance of developing lung cancer, chronic illness, and sickness-related work absences. It’s easy to say, best to stay away.

Minimize Drinking

Moderate alcohol consumption has been shown to reduce the risk for coronary heart disease by raising the drinker’s levels of high-density lipoprotein (HDL) cholesterol. Higher levels of HDL cholesterol help to keep the arteries free of blockage. Moderate alcohol consumption is defined as a 12-ounce serving of beer, a 5-ounce glass of wine, or a 1.5-ounce gin, vodka, rum, or scotch. However, chronic alcohol abuse weakens the immune system, promotes the formation of fat deposits on the heart muscle, impairs judgment, and makes it harder for drinkers to focus on multiple stimuli.

These three big categories will help you establish a healthy lifestyle. Keep in mind that these are all physical changes you can make. However, you can also make mental changes to increase your well-being. Here are 10 other little habits to get into:

1. Be physically active
2. Be spiritual
3. Nurture relationships
4. Find meaning
5. Be mindful
6. Commit to your goals
7. Go with the flow
8. Be thankful
9. Practice kindness
10. Savor joys

Straub, R. O. (2017). Health psychology: A biopsychosocial approach. New York: Worth, Macmillan Learning.

Dr. Frank Speizer, with funding from the National Institutes of Health, took on the challenge of investigating potential long-term consequences of oral contraceptives. However, the Nurses’ Health Study became much more than that.

Dr. Speizer used nurses as the study population because of their knowledge about health and their ability to provide complete and accurate information regarding various diseases due to their nursing education. Nurses are also relatively easy to follow over time and motivated to participate in a long-term study. Participants were limited to married women due to the sensitivity of questions about contraceptive use at the time. The original population of the study was 121,700 registered women nurses between the ages of 30-55.

While the original focus of the study was on contraceptive methods, it has expanded over time to include research on other lifestyle factors, behaviors, personal characteristics, and diseases. Every two years, participants receive a follow-up questionnaire with questions about diseases and health-related topics, including smoking, hormone use, and menopausal status. A food frequency questionnaire was added in 1980 and is now mailed out every four years. A quality-of-life questionnaire was added in 1992.

In 1989, Dr. Walter Willett and colleagues started the Nurses’ Health Study II. This was created because the younger generation of nurses started using oral contraceptives during their adolescence and therefore exposed during their early reproductive life. Case studies had suggested that such young exposure might be associated with increases in breast cancer risk. NHS II also gathered information on physical activity and diet in early adult life.

In 2010, Dr. Jorge Chavarro and colleagues launched the Nurses’ Health Study 3. It is entirely web-based and includes different types of health workers, as well as men and women. NHS 3 attempts to include nurses from more diverse ethnic backgrounds. This study examines how dietary patterns, lifestyle, environment, and nursing occupational exposures impact men’s and women’s health.

This study has made many contributions to our understanding of health. Not only have they validated questionnaires relating to health habits, but the biospecimens (e.g., blood, urine, toenails) collected from participants have allowed for research into disease mechanisms. The pictures below show just a few of the key research findings from the Nurses’ Health Study.

History. (n.d.). Retrieved from http://www.nurseshealthstudy.org/about-nhs/history

The Alameda County Study was designed to investigate normal daily routines and social-support factors to determine which might be risk factors for poor health and mortality in a real community. In 1965, Lester Breslow invited a sample of the population of Alameda County, California to participate in a longitudinal study on health status, social networks, and other personal characteristics. The behavior of the 6,928 people was examined over 20 years.

This study discovered seven health habits, now known as the “Alameda 7,” to be associated with physical health status and mortality in the long run. Here are the 7 habits of highly healthy people:

1. Having never smoked
2. Drinking less than five drinks in one sitting
3. Sleeping 7-8 hours a night
4. Exercising
5. Maintaining desirable weight for height
6. Avoid snacks
7. Eat breakfast regularly

Breslow found that a 45-year-old who followed at least 6 of the 7 habits had a life expectancy of 11 years longer than that of a person who followed 3 or fewer. And these weren’t years stricken with disease and complication. These were strong, functional years.

What happened to Lester Breslow? He died peacefully in his home at the age of 97. He did not smoke or drink, walked regularly, practiced moderation and enjoyed tending his vegetable garden. Not a bad life.

Schoenborn, C. A. (1986). Health Habits of U.S. adults, 1985: The “Alameda 7” revisited. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1477675/

Alameda County Study. (n.d.). Retrieved from http://www.epi.umn.edu/cvdepi/study-synopsis/alameda-county-study/

In the 1940’s cardiovascular diseases were the number one cause of mortality in Americans. Prevention and treatment were so poorly understood that “most Americans accepted early death from heart disease as unavoidable.” However, the death of President Franklin Roosevelt spurred a movement in research of cardiovascular disease.

In 1944, President Roosevelt was diagnosed with “hypertension, hypertensive heart disease, and cardiac failure.” This diagnosis was given to him by a cardiologist, but his personal physician denied anything being out of the ordinary. His high blood pressure ultimately led to his untimely death nearly a year later. The death of President Roosevelt shows just how little was known about cardiovascular diseases in the mid-20th century. Just over two years later, President Harry Truman signed into law the “National Heart Act,” and the Framingham Heart Study began.

The objective of the Framingham Heart Study was to identify common factors or characteristics that contribute to cardiovascular diseases by following its development over a long period of time with a large group of participants who had not yet developed symptoms of cardiovascular disease or suffered a heart attack or stroke. More than 5,000 male and female residents of Framingham, Massachusetts, were enrolled as the first group of participants. Every two to four years, participants underwent extensive medical, physical examinations and lifestyle interviews. All were later analyzed for common patterns related to cardiovascular disease development. In 1971, the study enrolled a second generation, using the original participants’ adult children and spouses. In 1994, the study participants were revised to include a more diverse population (OMNI). In 2002, the second group of OMNI participants were enrolled.

The Framingham study has led to the identification of major cardiovascular disease risk factors, including high blood pressure, high blood cholesterol, smoking, obesity, diabetes, and physical inactivity. The Framingham Heart Study corrected clinical misconceptions, showed that there is no essential and sufficient cause, developed a multivariable risk assessment profile (the Framingham risk score) and introduced the concept of preventive cardiology to physicians.

Hajar, R. (2016). Framingham Contribution to Cardiovascular Disease. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4966216/

While western medicine uses a biomedical approach to health, health psychologists prefer to evaluate health through a biopsychosocial lens. Quite simply, this approach includes the influences of biological factors, psychological factors, and social factors when looking at overall health. The biopsychosocial approach focuses on the biology or physiology underlying health; the psychology of thoughts, feelings, and behaviors influencing health; and the ways that society and culture all influence health. The biopsychosocial approach allows us to see how health changes not only biologically, but how your inner thoughts and feelings and the society around you influences your perception and determination of health.

So, what’s the big difference between a biomedical approach and a biopsychosocial approach? Well, when we break it apart, it comes down to cells vs societal influences. The biomedical approach takes health from a purely biological perspective. If this cell does this, then this is what happens to the body. If this muscle does this, then this must happen. But take a step back…is that really how health works? The biopsychosocial approach suggests that there is more. In 1977, George Engel argued that well-being includes the effects of psychological, behavioral, and social dimensions. His biopsychosocial approach advocates for the necessity of treating and thinking about illnesses by including the social and behavioral factors that play a role in overall health (e.g., poor eating habits and obesity, smoking, stress/anxiety/depression, etc.).

Here is an example of how a biopsychosocial approach differs from a purely biomedical perspective.

Smoking:

• BIOMEDICAL APPROACH: A biomedical approach analyzes smokers from the biological perspective and reasons for smoking: addiction or heritability. However, we can see from a biopsychosocial approach that there are many reasons that people start smoking, and they are not necessarily from a biological origin.
• BIOPSYCHOSOCIAL APPROACH: People may start smoking for PSYCHOLOGICAL reasons, such as thinking it makes them less stressed or because of personality traits (extroverts are more likely to smoke). People may start smoking due to SOCIAL networks or perceived cultural norms. Finally, we still must note that addictions and heritability are BIOLOGICAL components that can contribute to smoking behaviors.

Gurung, R. A. R. (2014). Health Psychology: A Cultural Approach. Belmont, CA: Wadsworth.

The biopsychosocial approach is the main theoretical approach used by health psychologists. It combines the biological, psychological, and social influences on an individual’s health behaviors and overall health (Gurung, 2014). This approach is important to remember the World Health Organization defines health as complete well-being, not just the absence of disease.

Some of the factors that fall under Biological are:

• Gender
• Physical Illness
• Disability
• Genetic Vulnerability
• Immune Function
• Neurochemistry
• Stress Reactivity
• Medication Effects

Some of the factors that fall under Psychological are:

• Learning & Memory
• Attitudes & Beliefs
• Personality
• Cognitions
• Behaviors
• Emotions
• Coping Skills
• Past Trauma

Some of the factors that fall under Social are:

• Social Support
• Family Background
• Cultural Traditions
• Socioeconomic Status
• Education
• Society
• Community

(Gurung, 2014)

There are several reasons why using the biopsychosocial approach is important today. The main causes of death have shifted from being infectious diseases to chronic diseases. Societal features such as SES and culture, are also becoming more pertinent. Medical costs continue to rise, and it is important that medical issues can be prevented and/or detected early (Gurung, 2014).

The biopsychosocial approach can be applied to understand a variety of health behaviors. For example, the biopsychosocial approach can be used to understand the health behavior of excessive drinking. A person may excessively drink because they have a genetic disposition for an addiction to alcohol (Biological). A person may be struggling with negative emotions and use alcohol as a coping mechanism (Psychological). A person may also be prone to drink excessively when they are with friends that also drink excessively (Social).

The Biopsychosocial approach can also be used in understanding what determines health behaviors (Gurung, 2014).

Biological:

• Genes
• Physiology
• Age
• Gender
• Fitness
• Weight

Psychological

• Personality
• Rewards/Punishments
• Cognitive Biases
• Emotion/Motivation

Societal

• Social Support
• Society
• SES

The Biopsychosocial approach can be applied to a variety of aspects of the world of psychology. It can specifically be applied to understanding overall health and health behaviors. It is a beneficial approach to us because it looks at all the possible biological, psychological, and social influences affecting overall health and health behaviors.

Gurung, R. A.R. (2014). Health Psychology: A Cultural Approach. (3^rd Ed.) Wadsworth: Cengage Learning.