Lifestyle and Life Expectancy

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Lifestyle and Life Expectancy: Five Factors to Minimize Health Risks

An international team of scientists just released an original research article, “Impact of Healthy Lifestyle Factors on Life Expectancies in the US Population” published April 30, 2018 in Circulation1. The abstract for this important paper is available at:
http://circ.ahajournals.org/content/early/2018/04/25/CIRCULATIONAHA.117.032047

This international team from the US, UK, Netherlands, and China identified five low-risk, life-style related factors: never smoking, BMI < 25, mod-vigorous activity > 30 min/day, moderate alcohol intake, and high-quality diet. To examine these factors, along with rates of mortality, they used data from over 120,000 participants who originally took part in the NHANES and Health Professionals Follow-up studies. In these studies, they documented over 42,000 deaths in 34 years following participants. Examining non-adherence to the five low-risk factors they noticed significant relationships with cancer, cardiovascular, and all-cause mortality. They calculated that at age 50, participants who adopted all of the low-risk behaviors tended to live about 18 years longer (93.1 years for women; 87.6 years for men) than those who adopted zero low-risk lifestyle related factors. For reference, these lifespans are comparable to the average American life expectancy of 78.8 years (in 2014). The authors added, combinations of any low-risk factors (but less than all) also yielded prolonged life expectancy regardless of which lifestyle behaviors were examined. They did not differentiate between the strength of individual factors but instead considered each of the five low-risk behaviors essentially equal in their discussion. They determined that more than half of cancer-related, and three-quarters of cardiovascular-related, premature deaths are attributed to poor adherence to a low-risk lifestyle. Despite several limitations, this is very high-powered study with a clear and not-so-surprising conclusion: Life expectancy can be extended, particularly in the USA, by adopting improved health-related lifestyle behaviors.

While providing a very strong case for promoting a low-risk lifestyle (high-quality diet, exercise, avoid smoking, moderate alcohol consumption, and maintain healthy BMI), this impactful article does not address interventions to encourage patients to adopt, or improve, their practice of healthy lifestyle behaviors. Not addressing such an important issue almost leaves the impression behavior change is as simple as the standard physician advice: “just stop smoking, eat right, and exercise more.” Decades of such advice, however, has proven essentially fruitless and we recognize healthy behavior change is difficult but possible. In fact, organizations exist primarily to emphasize the importance of a healthy lifestyle (e.g., American College of Lifestyle Medicine-ACLM) and making related behavior changes (e.g., Wellcoaches). Health and Wellness Coaches in particular, know healthy, sustainable behavior change can decrease burdens associated with protracted chronic lifestyle-related diseases but it is hard work. In this context, it is especially relevant to mention the ACLM and Wellcoaches recently launched (May, 2018) a partnership offering a Lifestyle Medicine Coaching credential to certified health and wellness coaches. The on-line course is open to all, however, only previously certified coaches can earn the advanced professional credential.

When a major medical journal (Circulation) and two world-class organizations (ACLM, Wellcoaches) recognize the same important issue at nearly the same moment in time (the same month!) then the topic must be a highly relevant and timely matter. Adopting healthy lifestyle behaviors is the key to drastically reducing the individual and societal suffering associated with chronic lifestyle-related diseases. Health and wellness coaches have much to offer in this regard and now have lots of scientific and professional training support on their side.

References
Li Y, Pan A, Wang DD, Liu X, Dhana K, Franco OH, Kaptoge S, Di Angelantonio E, Stampfer M, Willett WC, Hu FB. Impact of Healthy Lifestyle Factors on Life Expectancies in the US Population. https://doi.org/10.1161/CIRCULATIONAHA.117.032047.

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