The high prevalence and burden of cardiovascular diseases (CVD) is largely attributable to unhealthy lifestyle factors such as smoking, alcohol consumption, physical inactivity and unhealthy food habits. Prevention of CVD, through the promotion of healthy lifestyles, appears to be a Sisyphean task for healthcare professionals, as the root causes of an unhealthy lifestyle lie largely outside their scope. Since most lifestyle choices are habitual and a response to environmental cues, rather than rational and deliberate choices, nationwide policies targeting the context in which lifestyle behaviours occur may be highly effective in the prevention of CVD. In this point-of-view article, we emphasise the need for government policies beyond those mentioned in the National Prevention Agreement in the Netherlands to effectively reduce the CVD risk, and we address the commonly raised concerns regarding ‘paternalism’.
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In 'Ecodemocracy in the Wild: If existing democracies were to operationalize ecocentrism and animal ethics in policy-making, what would rewilding look like?' Helen Kopnina, Simon Leadbeater, Paul Cryer, Anja Heister, and Tamara Lewis present a democratic approach to considering the interests of entities and the correlation of rights of nature within it. According to the authors , ecodemocracy's overarching potential is to establish the baseline principles that dethrone single species domination and elevate multiple living beings as stakeholders in all decision-making. They provide insights on how ecodemocracy could become manifest and what it takes to achieve mult-species justice. A unique contribution in this chapter is the notion of ecodemocracy in rewilding , exemplified bij the controversial Dutch rewilding experiment in Oostvaardersplassen. The authors discuss the complexities of decision-making in the interest of different species and the challenges that arise when implementing such politics.
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OBJECTIVE: To examine how a healthy lifestyle is related to life expectancy that is free from major chronic diseases.DESIGN: Prospective cohort study.SETTING AND PARTICIPANTS: The Nurses' Health Study (1980-2014; n=73 196) and the Health Professionals Follow-Up Study (1986-2014; n=38 366).MAIN EXPOSURES: Five low risk lifestyle factors: never smoking, body mass index 18.5-24.9, moderate to vigorous physical activity (≥30 minutes/day), moderate alcohol intake (women: 5-15 g/day; men 5-30 g/day), and a higher diet quality score (upper 40%).MAIN OUTCOME: Life expectancy free of diabetes, cardiovascular diseases, and cancer.RESULTS: The life expectancy free of diabetes, cardiovascular diseases, and cancer at age 50 was 23.7 years (95% confidence interval 22.6 to 24.7) for women who adopted no low risk lifestyle factors, in contrast to 34.4 years (33.1 to 35.5) for women who adopted four or five low risk factors. At age 50, the life expectancy free of any of these chronic diseases was 23.5 (22.3 to 24.7) years among men who adopted no low risk lifestyle factors and 31.1 (29.5 to 32.5) years in men who adopted four or five low risk lifestyle factors. For current male smokers who smoked heavily (≥15 cigarettes/day) or obese men and women (body mass index ≥30), their disease-free life expectancies accounted for the lowest proportion (≤75%) of total life expectancy at age 50.CONCLUSION: Adherence to a healthy lifestyle at mid-life is associated with a longer life expectancy free of major chronic diseases.
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