What to do to gain up to 10 extra years of disease-free life
There is a consensus that a healthy lifestyle can stave off chronic disease. But just how many additional disease-free years might one get from that healthy lifestyle? We know the answer now.
Across the world, people are, on average, living longer. But as populations age, individuals often live with disabilities and chronic diseases like cancer, heart disease, and diabetes.
Lifestyle choices affect both overall life expectancy and the likelihood of chronic diseases. Only a few studies have looked at how a combination of lifestyle factors may relate to life expectancy free from such conditions. To address this evidence gap, researchers analyzed retrospective data on 73,196 US registered female nurses from the Nurses’ Health Study and 38,366 US male health professionals (dentists, optometrists, osteopaths, podiatrists, pharmacists, and veterinarians) from the Health Professionals Follow-up Study, who were free of cancer, cardiovascular disease, and diabetes at enrollment. Five low-risk lifestyle factors - never smoking, healthy weight (BMI), at least 30 minutes of daily physical activity, moderate alcohol intake, and a good quality diet - were used to calculate a healthy lifestyle score. The sum of these five scores together gave a final low-risk lifestyle score ranging from 0 to 5, with higher scores indicating a healthier lifestyle. Participants were assessed regularly for more than 20 years. During this time, new diagnoses and deaths from cancer, cardiovascular disease, and type 2 diabetes were recorded.
Serving size of alcohol in wine is 5 ounces, beer is one glass, can, or bottle and liquor is one drink or shot daily. The amount of alcohol in grams per specified portion size was multiplied by servings per day, determined the midpoint of the frequency category, and summed across all beverages to estimate the average alcohol consumption (g/day). Moderate alcohol consumption was defined as 5-15 g/day for women and 5-30 g/day for men, consistent with the guidelines for moderate alcohol intake in the US. Quality of diet was assessed using the Alternate Healthy Eating Index (AHEI) score, which is significantly associated with the risk of cardiovascular disease and other chronic diseases in the general population. A healthy diet was defined as an AHEI score in the top 40% of each cohort distribution. Physical activity levels were assessed using a validated questionnaire and updated every two to four years. The number of hours per week spent in moderate to vigorous activities (including brisk walking) requiring the expenditure of at least three metabolic equivalents of task (METs) per hour was estimated. Low risk was classified as at least 30 minutes of moderate or vigorous activity daily (3.5 h/week).
After adjusting for age, ethnicity, family medical history, and other potentially influential factors, life expectancy free of cancer, cardiovascular disease, and diabetes at age 50 was 24 years for women who adopted no low-risk lifestyle factors, and 34 years for women who chose four or five low-risk factors. Similarly, life expectancy free of any of these chronic diseases was 24 years among men who adopted no low-risk lifestyle factors, and 31 years in men who chose four or five low-risk lifestyle factors.
Women with four or five low-risk lifestyle factors had 10.6 years’ longer life expectancy free of the major chronic diseases than did women with zero low-risk lifestyle factors. At the same time, men gained 7.6 years’ longer life expectancy free of major chronic disorders over those with zero low-risk lifestyle factors.
Men who smoked heavily (15 or more cigarettes a day) or men and women with obesity (body mass index of 30 or over) had the lowest proportion (75% or less) of disease-free life expectancy at age 50.
The elements of a healthy lifestyle come as no surprise. The surprise is just how many additional disease-free years a healthy lifestyle can add.
Bottomline
Women can add up to 10.6 years, and men can add up to 7.6 years of healthy life by doing the following:
Don’t smoke
Exercise at least 30 minutes daily.
Maintain a healthy weight.
Limit alcohol intake
Eat a healthy diet.
Reference
Healthy lifestyle and life expectancy free of cancer, cardiovascular disease, and type 2 diabetes: prospective cohort study. BMJ 2020; 368 doi: https://doi.org/10.1136/bmj.l6669
Dr. Amar Singh, MD, and Dr. Poonam Singh, MD, are board-certified by the American Board of Internal Medicine and American Board of Obesity Medicine. They specialize in preventing, treating, and reversing chronic diseases using an evidence-based holistic approach. They are specifically interested in weight management, hormone rebalancing, and longevity. The American College of Physicians has recognized them as Fellows, FACP, for their excellence and contributions made to both medicine and the broader community. They enjoy teaching, volunteering, and advocating for their patients