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A health related risk factor is a circumstance that increases your risk for certain illnesses. There are twelve commonly recognized risk factors that contribute to a person’s overall health and wellness and risk for chronic illnesses. Nine of these risk factors are considered to be modifiable, meaning we can control them through lifestyle and three of these factors we cannot control. The following are controllable or modifiable health risk factors (12,13 &14):
- Obesity (Body Fat % >32 for women & 25 for men or BMI >30)
- Poor Diet
- Abnormal Cholesterol Levels (Dyslipidemia)
- High Blood Pressure
- Physical Inactivity
- Tobacco Use
- Alcohol Abuse
- Impaired Fasting Glucose
- Poor Stress Management
With regard to the risk factors we cannot control there are only three (15):- Family History (some chronic illness are more prevalent in certain ethnic groups)
- Age (risk for any type of ailment goes up with age)
- Gender (men typically get heart disease at earlier ages than women)
When analyzing health risk factors in this light it once again reinforces the notion that we have control of our present and future health status. When we weigh it out, 9 controllable risk factors is far more powerful than the 3 we can’t control. A brief explanation of each risk factor is given below.
Overweight and Obesity: As discussed earlier, excess body fat is considered a principle root cause or a contributing risk factor for a substantial amount of chronic illnesses. We have observed that as the obesity rate in America has risen, so has the incidence of heart disease, type 2 diabetes, cancer, arthritis and many other co-morbidities. The most common ways to measure overweight and obesity are percent body fat (% BF) and body mass index (BMI). Body fat percentage can be most accurately measured through underwater weighing or skinfold caliper measurement (the pinch test), DEXA body scanning and air displacement machines. Electronic handheld or scale devices that claim to measure body fat can be off by as much as 10% so its wise not to put too much stock into those measurements. Obesity can be determined when an accurate method of measurement greater than 32% for women and greater than 25% for men is obtained (16). Body Mass Index (BMI) is the most common method of determining whether an person is under weight or obese. Values for BMI are determined by using dividing the weight of a person by their height squared. Values for men and women are the same and a BMI of 30 or greater is considered obese (17). While BMI can be a flawed measurement for people who have a lot of muscle mass from strength training or “big boned” individuals the scientific literature does validate it on a general level as being a good predictor of health status. You can find your BMI by doing an online search for “BMI calculator” and plugging in our height and weight.
Poor Diet: Generally speaking, a healthy diet that is conducive to health and chronic illness prevention is one that contains multiple servings of fruits and vegetables per day, lower in saturated fat as compared to un-saturated fat, beans, legumes, nuts, grains, lean protein and food containing the omega fatty acids(18). Conversely, a diet that places a person at higher health risk is one that does not contain these foods and or consists of high amounts of processed foods, ultra-processed foods, refined sugar, trans fat and salt. Specific detail on nutrition can be found in the Nutrition section.
Abnormal Cholesterol: We all have cholesterol in our blood as part of the human body’s design for cellular function and metabolism. The common cholesterol measurements in our blood that are measured for health risk status are total cholesterol, HDL, LDL and triglycerides. Dyslipidemia can occur when total cholesterol levels are above >200, LDL >130 or HDL < 40 (19). LDL (low density lipoprotein) cholesterol and triglycerides, when high contribute to fatty plaque formation in the arteries leading to heart attack and stoke (19) HDL (high density lipoprotein) is what we call the “good cholesterol” as the H stands for “Happy”. If the HDL levels are too low < 40 it puts us at an increased risk for stroke and heart attack. If the HDL levels are high (> 60) it is such a benefit to the body that it is considered a positive risk factor, meaning it cancels out one of the other risk factors for heart disease and stroke (ACSM pg22).
High Blood Pressure: High blood pressure also called hypertension, when left uncontrolled over time will greatly increase your risk for heart attack, stroke, blindness, heart failure and kidney failure. This risk factor is commonly known as the silent killer as many times a person can have extremely high blood pressure for years and not experience any symptoms. High blood pressure is confirmed when a reading for the systolic (top number) pressure is > 140 or diastolic (bottom number) is > 90 on at least 2 separate occasions (20).
Physical Inactivity: It is commonly recommended that a person get at least 30 minutes of light to moderate physical activity on most days of the week, although some health and wellness institutions recommend up to 60 minutes for effective and sustained weight loss (21). Current statistics indicate that 80 % of American adults do not get recommended amounts of exercise each week and children spend more than 7.5 hours in front of a TV or electronic device each day (22 & 23). The American College of Sports Medicine reports that physical activity and structured exercise are scientifically proven to prevent occurrences of heart disease, stroke, high blood pressure type 2 diabetes, osteoporosis, certain cancers, gallbladder disease, obesity, anxiety, depression and early death (24).
Tobacco Use: Tobacco products, both smoked and smokeless, are a proven cause of death and many health problems. Tobacco smoke contains over 4,000 chemicals and 400 toxins, of which many are known to cause cancer (25). Tobacco use is estimated to increase the risk of heart attack and stroke 2 to 4 times and cancer risk by 25 times (26). Other health problems linked to tobacco use are high blood pressure, rheumatoid arthritis, brittle bones, and reproductive problems in women (27).
Alcohol Abuse: Alcohol related health problems include liver damage, increased cancer risk, blood sugar abnormalities, heart disease, stroke, mental and emotional disturbances due to brain damage, weakened immune system and obesity (28). In addition to empty calories, alcohol can contribute to obesity by slowing down the metabolism of the liver. Alcohol also enhances the cancer causing effects of tobacco when used together.
Impaired Fasting Glucose: We all have sugar in our blood, but it becomes a problem when we have too little or too much. Higher levels of fasting blood glucose levels (>100-125) or Hemoglobin A1c (long term blood sugar average) levels of 5.7-6.4 are an indication that a person may have pre-diabetes and strong risk of developing type 2 diabetes (29). Research proves that losing as little as 5 % of a person’s body weight can prevent, delay and even reverse pre-diabetes (30).
Poor Stress Management: There are a slew of health problems related to un-managed chronic stress. The most well documented stress related ailments include a weakened immune system, gastro-intestinal illnesses, heart disease, stroke, abdominal obesity, muscular pain, reproductive irregularities in men and women, psoriasis, eczema, hair loss, depression, anxiety and asthma (31& 32). There is also a growing body of research that suggests leaving chronic stress un-managed can increase the risk for cancer (33).