Unhealthy lifestyle choices can reduce one's life expectancy by 7.5 – 20 years, depending on modifiable risk factors, including body weight and composition, diet quality, alcohol intake, smoking, and physical activity.

Smoking, sedentary lifestyle, poor dietary choices, and heavy alcohol consumption decrease life expectancy by 7.4 – 17.9 years and account for 60% of premature deaths.

A prospective cohort study that included 73,196 participants from the Nurses’ Health Study and 38,366 participants from the Health Professionals Follow-Up Study identified five vital lifestyle factors that reduced the risk of having type 2 diabetes, cancer, or cardiovascular disease.

These five low-risk lifestyle factors are no surprise:

1. Never smoking
2. Body Mass Index (BMI) of 18.5-24.9
3. 30 minutes or more of moderate to vigorous physical activity per day, including brisk walking
4. High-quality diet with an Alternate Healthy Eating Index (AHEI)* score in the top 40%)
5. Moderate alcohol intake of 5-15 grams per day for women and 5-30 grams per day for men [a standard drink contains 14 grams of alcohol, equivalent to 12 ounces of 5% beer, 5 ounces of 12% wine, or 1.5 ounces of 40% distilled liquor]

In general:

• A healthy dietary pattern, high levels of physical activity, no smoking, moderate alcohol consumption, and an optimal BMI were all associated with longer life expectancy free of cancer, cardiovascular disease, and type 2 diabetes
• The lowest proportions of years of life expectancy free of cancer, cardiovascular disease, or type 2 diabetes as a percentage of total life expectancies was observed among men who smoked heavily (≥15 cigarettes/day) and obese men and women (BMI≥30), for whom 75% or less of life expectancy at age 50 years was lived free of these chronic diseases
• When only four lifestyle factors were included (without alcohol), women who adhered to all four low-risk lifestyle factors had 9.5 years’ (men: 8.8 years) longer life expectancy free of the major chronic diseases than did those with none of these factors
• After further inclusion of moderate alcohol consumption, women who adhered to all five low-risk factors had 12.5 years’ (men: 9.6 years) longer life expectancy free of the major chronic diseases than did those with none of these factors
• The cardiovascular benefits of moderate alcohol consumption have been consistently observed in large cohort studies, but alcohol consumption and risk of cancer showed a dose-response relation.
• Thus, current guidelines do not encourage a non-alcohol drinker to start drinking just for the benefit of preventing cardiovascular disease.

Optimal Takeaways

• Avoid smoking
• Maintain a healthy body weight
• Spend at least 30 minutes per day engaging in moderate to vigorous physical activity
• Choose a high-quality diet incorporating fruits, vegetables, whole grains, nuts, healthy protein, and a multivitamin-mineral supplement.
• Avoid trans fats and excess animal-based saturated fat
• Limit alcohol intake to no more than one drink/day for women and no more than two/day for men

Eat, drink, and be merry…But remember to eat well, drink moderately at most, and smile often!

Source: Serra-Majem, Lluís et al. “Updating the Mediterranean Diet Pyramid towards Sustainability: Focus on Environmental Concerns.” International journal of environmental research and public health vol. 17,23 8758. 25 Nov. 2020, doi:10.3390/ijerph17238758 This article is an open-access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license

*Alternate Healthy Eating Index (AHEI) (Patel 2021) is a modified version of the USDA healthy eating diet score based on intake of 9 factors, i.e., vegetables, fruits, nuts and soy, white to red meat ratio, cereal fiber, trans fat, polyunsaturated to saturated fatty acids, alcohol use, and multivitamin use.

Reference

Li, Yanping et al. “Healthy lifestyle and life expectancy free of cancer, cardiovascular disease, and type 2 diabetes: prospective cohort study.” BMJ (Clinical research ed.) vol. 368 l6669. 8 Jan. 2020, doi:10.1136/bmj.l6669 This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license,

NIH. https://rethinkingdrinking.niaaa.nih.gov/how-much-too-much/whats-standard-drink

Patel, Yash R et al. “Mediterranean, DASH, and Alternate Healthy Eating Index Dietary Patterns and Risk of Death in the Physicians' Health Study.” Nutrients vol. 13,6 1893. 31 May. 2021, doi:10.3390/nu13061893