Addressing Causes of Chronic Disease

Top health and longevity threats linked to lifestyle

We have an appalling burden of chronic disease in this country. According to the Centers for Disease Control and Prevention (CDC), six out of ten Americans have a chronic condition such as heart disease, cancer, diabetes, stroke or Alzheimer’s disease. Four in ten Americans have two or more chronic conditions. Data show that 38 percent of Americans will be diagnosed with cancer during their lifetimes. Half of all Americans have cardiovascular disease. About 88 million Americans have prediabetes and 34 million have diabetes. In addition, 72 percent of Americans are overweight or obese—putting them at increased risk for heart disease, diabetes and cancer.¹ What’s the driver behind all of this chronic disease?

Chronic disease risk-factors

An article in the Journal of the American Medical Association found that seven out of the top ten risks for disease are lifestyle-related. Diet was the leading factor in the U.S. and globally.² A global health survey report showed that eight risky behaviors cause 15 chronic conditions that comprise 80 percent of healthcare visits, hospitalizations and healthcare costs. Those risky behaviors were poor diet, physical inactivity, smoking, lack of health screening, poor stress management, insufficient sleep, low standards of care, and excessive alcohol consumption.³ The latest CDC report determined that 90 percent of total healthcare costs in the U.S. come from treating chronic health conditions.⁴ A Mayo Clinic study of 5,000 people found less than three percent of Americans had a healthy lifestyle based on their survey scores for exercise, diet, body fat percentage and smoking.⁵

Declining life expectancy

Until recently, data from the CDC and the U.S. Mortality Database showed that life expectancy at birth has increased steadily in this country for the last 60 years. But that started changing about ten years ago. Our life expectancy plateaued in 2010, and has declined since 2014, even though U.S. healthcare spending still exceeds that of most other nations.

What’s the culprit? Some sources have blamed decreased life expectancy on increased deaths from illegal drugs. But an analysis in the Proceedings of the National Academy of Sciences found a much larger cause: The outcomes for heart attacks and strokes are not continuing to improve in the U.S. Even while cardiovascular results are still getting better in nations like the U.K., Germany and France, in the U.S. the very same outcomes have stalled out.⁶ The most likely cause is unhealthy lifestyle habits.

“Despite advancing cardiovascular drug and device development, and despite our hope for the genetics revolution, what’s really needed is investment in lifestyle management for patients to reverse the current plateau and decline in life expectancy,” says Cate Collings, MD, a cardiologist and immediate past president of the American College of Lifestyle Medicine. “We must not be waiting for the next drug or device.”

The top six solutions

Lifestyle interventions need to become the first line and foundation of healthcare, says Collings. For both the prevention and treatment of chronic disease, the American College of Lifestyle Medicine recommends these six powerful lifestyle steps.

Eat a whole food, plant-based diet. The Mediterranean diet as well as the Nordic, Ornish, DASH, flexitarian and vegetarian diets emphasize unrefined plant foods. Eating this way increases your consumption of nutrients and antioxidants and lowers your dietary-toxin exposure.

Prioritize physical activity. Adults should get at least 150-300 minutes of moderate-intensity activity every week. For vigorous activity, the requirements are half of that, or 75-150 minutes per week. Two or more days of strength training weekly are also important. If you’re unaccustomed to exercise or have health concerns, first get an okay from your health care provider.

Get enough sleep. Adults need at least six to eight hours of sleep every 24 hours. Cellular repair, restoration and replenishment of bodily tissues and organs occur while you sleep.

Manage stress levels. Relaxation techniques such as meditation, mindfulness, breathwork and biofeedback help improve resilience to stress.

Get help for addiction. An estimated 40 million Americans misuse or are addicted to tobacco, alcohol or other drugs. If you are misusing addictive substances, see your health care provider for help.

Keep connected socially. Isolation and loneliness are associated with increased disease and death. Ensuring you have regular human connection is important for your overall health.

This newsletter is for educational purposes only. It is not intended as a substitute for medical advice or treatment; before adhering to any recommendations in this newsletter consult your healthcare provider.

1. Lifestyle Medicine & Food as Medicine Essentials Course Bundle. American College of Lifestyle Medicine, credentialed through 9/14/2025.

2. The U.S. Burden of Disease Collaborators. The State of U.S. Health, 1990-2016. Burden of Diseases, Injuries and Risk Factors Among U.S. States. JAMA, 2018. 319(14): 1444-1472.

3. Global Risks 2010: A Global Risk Network Report. World Economic Forum, 1/14/2010. weforum.org

4. Health and Economic Costs of Chronic Disease. Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, 6/23/2021. cdc.gov

5. Loprinzi PD, Branscum A, Hanks J, Smit E. Healthy Lifestyle Characteristics and Their Joint Association with Cardiovascular Disease Biomarkers in U.S. Adults. Mayo Clinic Proceedings, 2016. 91(14): 432-442.

6. Mehta NK, Abrams LR, Myrskyla M. U.S. Life Expectancy Stalls Due to Cardiovascular Disease, not Drug Deaths. Proceedings of the National Academy of Sciences USA. 2020. 117 (13); 6998-7000.