Most clinical trials follow their patients for a matter of months, usually at best a few years. But what happens when we revisit these patients decades later? How do we adapt to our illnesses, and how much control do we really have over them?

A new study by researchers at Northwestern Medical School in Chicago challenges the notion that patients are unwilling to make lifestyle changes to improve their health or that the body, under the right conditions, can’t heal itself. The Coronary Artery Risk Development in Young Adults (CARDIA) study assessed 5 “healthy lifestyle factors” (not overweight/obese, low alcohol intake, healthy diet, physically active, nonsmoker) in more than 3500 people between the ages of 18-30 and again 20 years later, along with measuring their blood vessels for atherosclerosis—the process of “hardening” of the arteries linked to heart disease and stroke.

A quarter of the participants in the study increased their number of healthy lifestyle factors (for example by quitting smoking), about a third stayed the same, and the rest (40% of participants) got worse (gained weight, began drinking more, etc.). For every healthy lifestyle change that a person made, his or her risk of atherosclerosis dropped significantly. In other words, on their own, one in four people made the positive changes necessary to prevent or even reverse heart disease, and people who had unhealthy lifestyles when they were younger were able to effectively “erase” the damage they’d done by becoming healthier as they grew older.

Although many people did not improve their lifestyle, we can only speculate on how these percentages would change if people received more encouragement and guidance on how to make these healthier choices.

(Source: Circulation, 2014, doi: 10.1161/CIRCULATIONAHA.113.005445 [link to abstract].)