Four Combined Lifestyle Habits Bestow 14 Extra Years


By Tony Cappasso
CAMBRIDGE, England, Jan. 8 -- Four likely ways to an extra 14 years of life have been suggested by investigators here.
The combined umpact of limiting alcohol and tobacco use, getting regular exercise, and eating a diet rich in fruits and vegetables was associated with a fourfold decrease in mortality among 20,244 men and women, reported Kay-Tee Khaw, M.D., of the University of Cambridge Institute of Public Health, and colleagues in PLoS Medicine.
The participants, ages 45 to 79, were enrolled from 1993 to 1997 in the EPIC-Norfolk Prospective Population Study. The researchers used a health behavior questionnaire to rank study participants from zero to four in smoking and alcohol use, getting exercise, and eating five servings daily of fruits and vegetables.
The investigators awarded one point each for not smoking, drinking moderately (one to 14 units per week, a unit is defined as one half-pint of beer, one glass of wine, or a shot of spirit), keeping physically active (meaning a job that involved physical activity or engaging in recreational activity), and having a blood vitamin C level consistent with eating five servings of fruits and vegetables daily.
The researchers then tracked participants' mortality until 2006. Their findings: Participants who didn't smoke, drank alcohol moderately, exercised daily, and ate at least five servings of fruits and vegetables every day lived an average of 14 years longer than those who didn't adopt any of those lifestyle practices.
Rather than focusing on the impact of individual lifestyle choices, the researchers assessed the overall impact of the four together. Previous studies have shown that behavioral choices such as smoking, alcohol use, and exercise can produce large effects on health.
All study participants had health exams to rule out the presence of heart disease, circulatory problems, cancer, or other confounding health conditions prior to enrolling in the study, the authors reported. Dr. Khaw and colleagues then recorded deaths among the participants until 2006.
"After an average 11-year follow-up, the age-, sex-, body mass-, and social class-adjusted relative risks (95% confidence intervals) for all-cause mortality (1,987 deaths) for men and women who had three, two, one, and zero compared with four health behaviors were respectively, 1.39 (1.21 to 1.60), 1.95 (1.70 to 2.25), 2.52 (2.13 to 3.00), and 4.04 (2.95 to 5.54), P< 0.001," the researchers wrote.
They reported that the relationships were consistent in subgroups stratified by sex, age, body mass index, and social class, and after excluding deaths within the first two years.
The trends were strongest for death from cardiovascular causes, they reported. The mortality risk for those with a score of four compared to a score of zero in health behaviors was equivalent to being 14 years younger in chronological age, the researchers wrote.
After allowing for other factors that might have affected their likelihood of dying (for example, age), those with a health behavior score of zero were four times as likely to have died (in particular, from cardiovascular disease) than those with a score of four. Those with a score of two were twice as likely to have died.
The research team admitted that further studies are needed to confirm these findings. But, they added, encouraging these four healthful lifestyle behaviors could have a significant effect on mortality, especially in an aging population.
They also pointed out that only mortality was studied and that these findings need to be extended to an analysis of how these combined health behaviors affect functional health and the quality of life as well as the risk of death.
The authors declared that they had no conflicts of interest.
Additional source: PLoS MedicineSource reference: Khaw K, et al "Combined impact of health behaviors and mortality in men and women: the EPIC-Norfolk prospective population study" PLoS Med 2008; doi:10.1371/journal.pmed.0050012.