BOSTON-Do Harvard doctors practice what they preach? The Harvard Health Letter, the country's first health newsletter for the general public, recently surveyed more than 15,000 Harvard Medical School faculty physicians about their health habits and found that, in many cases, yes, they do.
In this 30th anniversary year for the Harvard Health Letter, the editors decided to revive a tradition-two similar surveys were conducted in 1982 and 1992. Results from the 2,115 faculty members (1,185 male and 930 female) who responded were reported in the October issue. Highlights include:
Diet and exercise Most (82 percent) eat breakfast regularly and many get at least three servings of fruit or vegetables a day. Few (12 percent) regularly eat at fast-food restaurants, about half drink alcohol in moderation (one to five drinks per week), and a solid majority (57 percent) use olive oil over less healthy fats.
As for activity level, more than half claimed to exercise at least three times a week at a moderate intensity or higher. These good habits pay off. The faculty's average body mass index (BMI) was 23.9, which is on the high end of the 18.5-25 healthy range.
There were some outliers. The survey found 119 couch potatoes who reported exercising less than once a week for under 30 minutes at mild intensity. About half of these non-exercisers also reported eating less than two servings of fruit or vegetables on most days. With about a third of the respondents overall either overweight or obese, it's not surprising that almost half said they've tried to lose weight sometime in the past five years. "The members of the faculty that answered our survey seem to eat a little less, and to weigh a little less, than most people their age in the U.S.," said Dr. Anthony Komaroff, Editor-in-Chief of the Harvard Health Letter.
Vitamins
Experts suggest taking a multivitamin as a nutritional safety net, and 77.7 percent of the faculty members who filled out the survey said they were heeding that advice. Calcium supplements are also popular, especially among women (48.6 percent) and those over age 50 (36.2 percent). However, only 8.4 percent of respondents take Vitamin D, which may be more important than calcium for osteoporosis prevention. The percentage was higher among women and older faculty members.
Alternative medicine
Surveys report that about a third of Americans routinely use some form of alternative medicine. What about Harvard doctors? Less than 13 percent of respondents have had chiropractic or acupuncture, but more than a quarter have taken an herbal supplement. Half chose "curious," "open-minded," or "enthusiastic" to describe their attitude towards alternative medicine. Older doctors were more likely to be skeptical of alternative treatments than younger ones, as were male doctors compared to female ones.
Menopause
Of the approximately 930 women who answered the survey, only 141 said they had menopausal symptoms worth treating. Most used either low-dose estrogen alone or low-dose estrogen with progestin. A majority taking hormones kept taking them despite negative results from the Women's Health Initiative, which found that post-menopausal hormones increase the risk for heart disease and breast cancer.
"We can only speculate as to why some faculty continue to take hormone therapy despite the recommendations of the Women's Health Initiative," said Dr. Komaroff. "Most likely, they tried going off, bothersome symptoms recurred, and they made the personal decision that the benefit from reducing their symptoms was greater to them than the risks reported by the study."
Heart disease
The 174 respondents (8 percent) who rated their heart disease risk as moderately high or above were taking many of the right steps to lower their risk: exercise and eating less saturated fat and more fiber.
Surprisingly, only 42.2 percent were taking a statin drug. The editors surmise that ignorance of their cholesterol levels might be the problem-41 percent of those in the higher risk category didn't know their LDL level. Aspirin use among the men ages 50 and older (the group most likely to get the heart disease benefit) with self-rated elevated risk was high (83 percent).
"It may be that some younger members of the faculty believe there is no benefit from checking your cholesterol levels until you reach age 50 or 60," speculated Dr. Komaroff. "If so, they're wrong: people with other cardiac risk factors should know whether their cholesterol levels also put them at risk."
Cancer
Just 39 of the faculty members who answered the survey said they smoke. A larger group (24.1 percent) smoked sometime in the past, though. That number gets larger with age; in the ages 70 and older group, exactly half answered yes.
The faculty members are conscientious about cancer screening tests. Over 75 percent of those ages 50 and over said they'd gotten a colonoscopy. Two-thirds of women ages 40 and over indicated that they get a mammogram every year. Among women ages 50 and over, that fraction grew to three-quarters. Despite the debate about the PSA test for prostate cancer, 84 percent of the male faculty ages 50 and over had been tested.
"PSA screening has not been shown to reduce the risk of suffering or death from prostate cancer," said Dr. Komaroff, "although studies of that question are underway. Some doctors probably figure that it's worth getting the blood test until and unless it is definitively shown not to be of value."
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