I walk my kids to school every morning. And I walk to pick them up. It's a 10 minute walk to get them, so that's about 40 minutes of walking each day. I could drive and get there in 2 minutes then wait in a line. It would probably cut the time in half, but walking is better for the environment (noise, pollution, safety, wear and tear), me, and my relationship with the kids (we, y'know, talk while we walk).
There's people that live even closer that drive their kids to school. One of them lives literally 19 houses down the street from it.
I also have a rule where if I can go somewhere within 20 minutes on a bike, I'm taking my bike. Most places I go fall under this rule, and I live in what most would call a suburban hellscape.
My wife used to drive to work. Driving took longer than walking. But she still drove.
I think it's less about easy vs hard and more about the culture around driving in the US.
That's great - for me the problem is weather. Where I live it's hot, >80s Fahrenheit, >28 celsius, for 4 months a year. So unless I want to always be sweaty, I can't really walk more then 10 minutes at a time.
I tried biking to work for a while - 13 miles. During summer/fall, it was pretty nice, I'd go early in the morning, shower at the gym, and then bike home. 2 workouts a day when the weather was fair.
The sweaty part, you'll get less sweaty as you get more in shape, both exerting less and retaining heat less efficiently due to lower BMI. But - you'll probably never not be sweaty if the distance is anything significant like, say, 13 miles.
Let's talk about colder climates. I was a consultant for a few years, and got to travel all over. I recall visiting Calgary in the winter, and some maniac dev manager biked to work every day, rain, snow or shine. 6 miles he said (helpfully translating units for me).
In the US a large number of people have moved to suburbs in the south. On a bad year our lows are in the 90F range. Add in asphalt architecture and in the sun temps are commonly 125F+
To get a statin you have to go to the doctor, get a blood test, get a prescription for the statin, and start taking it, get blood retested, adjust dose (possibly), etc. Then you have to go to the pharmacy, pay for it and take it every single day.
To exercise you literally have to walk for 30 minutes. That's it.
Walking for 30 minutes/day when you previously walked 0 minutes/day will have a dramatically larger mortality reduction than taking a statin.
For the record adding a statin reduced my (genetically very high) cholesterol by over 50%, and I will almost certainly take it for the rest of my life. Diet and exercise changes led me to lose over 80lbs, required 0 doctor visits, cost $0, and has completely changed my life and my likely health trajectory.
So yes take statins, but no statins aren't 'easy' unless you are very well integrated into a health care system and actively having checkups where your cholesterol levels are being checked and reviewed, which is only true of a very low % of people in the US, even those with gold plated healthcare coverage.
> Walking for 30 minutes/day when you previously walked 0 minutes/day will have a dramatically larger mortality reduction than taking a statin.
It might for all-cause mortality, but it is unlikely to reduce ASCVD mortality more than a statin, or statin + ezetimibe would. Even if your high LDL isn't genetic, once you've done the damage to your arteries, it is basically going to stay there, and treatment targets for preventing further damage at that point (or some regression, if you get really aggressive with combo therapy and get down below 50) aren't often possible with lifestyle changes alone.
Sure, but the primary point of the discussion for the article we're all discussing is around ASCVD, so switching to all-cause mortality is kind of moving the goalposts.
People at risk for ASCVD should also realistically just be doing both. It shouldn't be an either/or.
If someone goes from not exercising at all to walking 30 minutes a day, it will make a definite dent in blood pressure. Changing diet will add another dent. Walking for 90 minutes a day will make a bigger dent than 30. The degree of the changes reflects the degree of the results.
It's only hard because we make it hard.