True or false? Bad diets cause more deaths than smoking

ou may have seen the shocking headlines recently: “Bad diets kill more than smoking.” But could it be true? Is a daily trip to the drive-thru more likely to lead to an early death than a pack-a-day habit?

Not necessarily, says Jeffrey Hooper, DO, obesity medicine specialist at MultiCare Center for Weight Loss and Wellness.

“Neither one is good for you,” Dr. Hooper says.

But if you smoke, kicking that habit should be your first goal. When patients here want to improve their overall health, “the first thing we start with is smoking,” he says. “In cases where we are trying to do the best for their overall health, that’s the best approach.”

And yes, he includes vaping in that category. Even with the weight gain that often comes when people stop smoking, it’s still an overall health win to quit.

So what’s with the headlines? It’s no surprise the studies show bad diets kill more than smoking, simply because worldwide, more people have unhealthy diets than smoke, Dr. Hooper points out.

The eye-catching study, conducted by researchers at the University of Washington, looked at populations in 195 countries.

“It’s really hard to compare a healthy diet in a third-world country to a healthy diet in a first-world country,” Hooper says. “In a third-world country, you’re looking at access to good, clean water and enough food. In first-world countries we’ve got food everywhere.”

If you’ve stopped smoking (or never started), the big three health factors are (1) diet, (2) exercise and (3) sleep, Dr. Hooper says.

The easiest way to improve your diet may be less about what you eat than what you drink. Cut out sugary sodas and even diet sodas, he says. Carbonated water is fine if you miss the fizz, but make sure it doesn’t have a lot of added sweeteners, whether sugar or artificial.

“My goal is to get you as close to plain water as possible,” says Dr. Hooper.

Although eliminating sugary drinks and diet sodas is one of the “low-hanging fruits” of dietary change, people may find it’s not enough on its own.

“But you just reduced your chance of developing (type 2) diabetes,” he says. “Little changes absolutely make a difference and they can be cumulative as you start making them.”

Reduce your alcohol consumption as well.

“If you have a glass of wine every night to unwind, it becomes that thing you turn to,” he says.

Instead, aim for an alcoholic beverage once every couple of months or weeks, he says.

Focus on a largely plant-based diet, high in fiber and low in sugar and processed foods.

“That doesn’t mean everyone has to be a vegetarian,” he says.

But be mindful and try to get five servings of fruits and vegetables a day. Keep an eye on portions. Food tastes good and we tend to eat too much of it, particularly when we are busy and stressed. Be mindful of portion control, especially with high-carbohydrate foods, and you’ll probably start feeling better overall, Dr. Hooper says.

And don’t get overwhelmed. Small changes add up.

“We call it the 80-20 rule,” he says. “That means 80 percent of the time try to make healthy food choices.”

When it comes to exercise, “You can get it in little pieces and have it accumulate,” Dr. Hooper says. “There’s every reason to think that will still make a big difference.”

Take a walk after a meal. Get up and walk down the hall at work. Wear a fitness tracker and keep a count of your daily steps.

“When you keep an eye on it, you do more,” he says.

The third important health factor is sleep.

“It becomes a self-fulfilling prophecy,” he says. “If you exercise, you sleep better.”

Don’t let scary headlines put you in a panic and make sudden, drastic changes you can’t maintain.

“Just because we’re trying to describe how to eat healthy, we’re not trying to poo-poo every fun thing you do,” Dr. Hooper says. “It’s all about moderation.”

And if you need help, figuring out where to start, the Center for Weight Loss and Wellness can help.

“We offer much more than surgery,” Dr. Hooper says. “We can help you get on a better lifestyle track and often that’s all you need to do. The goal of our program is to make improvements in your health and the best way to do this is to optimize your lifestyle.”