A recent article in the New England Journal of Medicine predicted that the poor diet, inactivity and expanding waists of most Americans threaten to reverse the trend toward longer life expectancy despite expected continued improvements in medical care. While drugs and surgical treatments continue to be developed, the top 3 killers of Americans (coronary heart disease, cancer and strokes) have not changed in more than 50 years. It is time to consider some alternatives to drugs and surgery.

A recent controlled study of 337 middle-aged and older subjects demonstrated the efficacy of a health education program in a community setting out to significantly improve a variety of risk factors for cardiovascular disease. Half were randomly assigned to the Coronary Health Improvement Project (CHIP). Those in the intervention group participated in a health education program. This CHIP program consisted of 40 hours of interactive health education lectures, shopping trips, and cooking classes spread over 4 weeks. Subjects were taught about to eat a low-fat, low-salt diet consisting largely of whole grains, fruits and vegetables. After 6 weeks CHIP program attendees experienced improvements in a variety of disease risk factors. They saw significant reductions in blood pressure, blood sugar and total and LDL cholesterol. They also improved their knowledge about how diet and inactivity contribute to the development of the diseases that kill most Americans.1 The study discussed above was conducted in Rockford, Ill., and about 30 restaurants in the local area offered CHIP-approved meal options during the study. It seems likely that if America is to turn the tide on diabetes, heart disease, cancer and stroke it will require not only more savvy consumers, but also better support from the food industry to make it easier to adopt a better diet by making more healthful convenience foods available in supermarkets and providing more healthful items in restaurants. By James Kenney, PhD, RD, LD, FACN. FMI see www.chipusa.org. 1. J Am Diet Assoc. 2005;105:371-81