Maximum Wellness, Episode 49: A Healthy Lifestyle Increases Years Lived Without Chronic Disease

With Covid-19 a major player in the health care arena—immune modulation, diagnostic testing, comorbidities (concurrent health issues), social distancing, masks, gloves, and so forth—the controlling factor to a best outcome is to develop a healthy lifestyle.

JAMA (Journal of the American Medical Association) Internal Medicine published in April 2020 an original investigation—Association of Healthy Lifestyle with Years Lived Without Major Chronic Diseases—which sought to estimate the association between a healthy lifestyle and the number of disease-free years.

It was determined that four basic lifestyle characteristics—smoking status, body mass index (weight in kilograms divided by height in meters squared), physical activity level, and alcohol consumption—would be compared to the number of years between 40 to 75, without chronic diseases, such as type-2 diabetes, coronary heart disease, stroke, cancer, asthma, and chronic obstructive pulmonary disease (COPD).

In order to assess the disease impact on healthy years, the study evaluation included 116,043 people from a multicohort European population (Working Populations Consortium), who had a mean age of 43.7 years—with 70,911 women (61.1%) represented in the sample.

“Participants were included in the analyses, if they were free from the 6 chronic diseases at baseline and had information available on sex, age, socioeconomic status, lifestyle factors (weight, height, smoking, physical activity, and alcohol consumption), and follow-up for chronic diseases. Study baseline ranged from August 7, 1991, to May 31, 2006, and data analysis was conducted from May 22, 2018, to January 21, 2020,” as noted in the study methods.

A scoring system was established based on recognized standards. Here’s how the parameters were established—directly taken from the JAMA paper.

BMI: < 25 optimal, 25-25.9 intermediate, and > or = to 30 poor; smoking: never optimal, former smoker, intermediate, and current smoker, poor; leisure-time physical activity: meeting world health organization recommendations of > 2,5 hours of moderate weekly activity or > 1.25 hours of vigorous weekly activity was optimal, activity between optimal and poor was intermediate, while no or very little moderate /vigorous leisure-time physical activity was labelled as poor.

As for total, weekly alcohol consumption (1 drink = 10 grams of ethanol), 1 to 14 (women) or 1 to 21 (men) weekly drinks was classified as optimal, no alcohol was intermediate, while > than or = to 15 drinks for women and 22 for men was poor.

The researchers then, “computed an overall healthy lifestyle score by aggregating responses for the 4 individual lifestyle factors: optimal (2 points), intermediate (1 point), or poor (0 points). This scale resulted in a healthy lifestyle score ranging from 0 (lowest healthy score, highest risk) to 8 (highest healthy score, lowest risk).”

It was determined that, “all of the 4 lifestyle profiles that were associated with the highest number of disease-free years included a body-mass index less than 25, and at least 2 of the following factors: never smoking, physical activity, and moderate alcohol consumption. Participants with 1 of these lifestyle profiles reached age 70.3 to 71.4 years disease free, depending on the profile and sex.”

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