ATLANTA -- Women who actually follow all of the standard health advice -- eat sensibly, don't smoke, get some exercise, keep the weight down, have an occasional drink -- can reduce their chance of heart disease an astonishing 82 percent, according to a study released Monday.
Many studies over the years have shown the importance of specific habits such as kicking cigarettes or cutting out saturated fat. But Harvard researchers say theirs is the first to show what happens when people do everything they are supposed to.
However, the study also shows this isn't easy. The research was done on middle-aged female nurses, who presumably are fairly health-conscious. Yet just 1 percent of them actually followed all the rules.
The data are the latest to emerge from the landmark Nurses' Health Study, conducted at the Harvard School of Public Health. They were presented in Atlanta at a meeting of the American Heart Association.
The researchers defined a heart-healthy lifestyle this way:
-- Don't smoke.
-- Avoid being overweight. This means having a body-mass index of 25 or less. (A woman 5-foot-4 who weights 145 pounds has a BMI of 25.)
-- Get at least a half-hour a day of moderate to vigorous exercise.
-- Average half a drink or more of alcohol a day.
-- Eat healthy food. This means avoiding saturated fats and getting relatively large amounts of fish oil, folate, fiber, vegetable oils and whole-grain products.
Dr. Frank B. Hu said those who followed all these rules reduced their risk of heart attacks, congestive heart failure and stroke by 82 percent compared with the other women in the study.
While genes can play a role in early heart attacks, they largely result from unhealthy living habits, he said.
The study results "are very dramatic, because these are not drastic changes for people," he said. "Premature heart disease can be virtually eliminated by these lifestyle changes."
The study was conducted on 84,129 nurses who were between 34 and 59 years old when it began in 1980. During 14 years of follow-up, 1,129 of them developed heart disease.
Even though all the participants were female, Hu said he thinks the results would be similar for men.
Hu said while following all the rules is the best, that was clearly hard for most people. But being less than perfect is better than making no attempt at all at healthy living.
Getting enough exercise and keeping weight off were areas where the nurses most often failed, he said. Only 20 percent reported getting an hour or more of vigorous exercise weekly. Sixty percent were overweight.
Hu said the researchers were surprised that so few of the nurses actually got a perfect score -- and added the proportion of people in the general population who would get a perfect score is probably a lot smaller.
Dr. Richard Pasternak of Massachusetts General Hospital said the research is important because it suggests that controlling heart disease is possible without any new technology or discoveries.
"There is a good chance that we could wipe out this epidemic if we do everything we already know about," he said.
Dr. Alice H. Lichtenstein of Tufts University in Boston said one of the biggest difficulties is getting people to restore some of the exercise that has been eliminated by technological advances.
"We don't have to chop wood or get up to change the channel on the television anymore," she said.