I recently read about a new Healthy Lifestyle study in the prestigious New England Journal of Medicine.1  When a top medical journal reports such a study it tends to strongly influence the way doctors and other experts think about the value of “Lifestyle Medicine.” I’m excited to declare that the new findings strongly support the critically important role of healthy lifestyle habits for preventing premature cardiovascular disease, especially in people with an increased “genetic risk.”

The article is titled “Genetic Risk, Adherence to Healthy Lifestyle, and Coronary Disease.” Using DNA from 55,685 men and women, the study authors determined a “genetic risk score” ranging from lowest to highest risk of future heart disease. As expected, those with the highest genetic risk scores were most likely to develop premature heart disease throughout the study. Each individual was also given a “Healthy Lifestyle Score” ranging from highest to lowest according to whether they did not smoke, did not have obesity, exercised regularly, and/or followed a healthy eating pattern. Indeed, those with the highest healthy lifestyle scores were least likely to develop premature heart disease over 20 years of follow-up.

I’m pleased to report that this study confirms that healthy lifestyle habits can dramatically reduce your risk of premature heart disease, no matter your level of “genetic risk.” Our future is NOT dictated entirely by uncontrollable factors such as our genes and the DNA we’ve inherited from our ancestors. Our future health is dictated largely by the CHOICES we make and our behaviors. I interpret this to mean we live life to the fullest if and when we find a way to consistently follow healthy lifestyle behaviors. For some individuals, smoking, obesity, lack of exercise, and/or unhealthy eating can be very difficult to avoid, but that does not mean they are entirely out of our control. It is never too late to address and improve unhealthy behaviors and choices. The medical benefit of healthy lifestyle habits persists throughout life.

In life, we all get “dealt a hand” of uncontrollable factors that can and will impact our future. Our genes, parents, childhood, environment, and hundreds or thousands of other factors are determined for us, especially in our first years of life. Nevertheless, whether you feel “lucky” or “unlucky” or “advantaged” or “disadvantaged” by factors that were never in your control, the key to happiness (and longevity) is not determined primarily by those factors. The key to happiness (and longevity) is determined primarily by the factors you DO control. Your attitude, behaviors, and choices have all the impact, and determine what kind of life you lead.

In summary, we all need to “do the best we can with what we have” in order to address preventable health problems and live our best lives. In the words of the 18th century French philosopher Voltaire: “Each player must accept the cards life deals him or her: but once they are in hand, he or she alone must decide how to play the cards in order to win the game.”


Michael Dansinger, MD



  1. https://www.nejm.org/doi/full/10.1056/NEJMoa1605086#t=article