A study of middle aged and older people living in Norfolk, UK, has suggested that not smoking, being active, eating enough fruit and vegetables and drinking only moderate amounts of alcohol can increase lifespan by an average of 10 years compared to people who do none of these things.

The study is published in the online open access journal Public Library of Science Medicine (PLoS Medicine) and is the work of researchers based at the University of Cambridge, and the Medical Research Council, in the UK.

The purpose of the study was to give members of the public and health professionals some clear straightforward information about healthy behaviours and their likely impact on longevity, because much of what is currently available is confusing and appears contradictory. What is a healthy diet? What is enough exercise? How much alcohol is harmful? Also, while there is plenty of research on the impact of individual factors, there is very little on combined effects.

By focussing on four simple health behaviours, as a combination, the researchers hoped to motivate people to make the small changes that can make a big difference to their lives.

The study is part of a European research initiative called the European Prospective Investigation into Cancer and Nutrition (EPIC) that is collecting data on lifestyles, disease and health outcomes in a number of European locations.

The EPIC data allowed the researchers to investigate a cohort based in Norfolk, UK, comprising some 20,000 men and women aged 45 to 79 who were examined and completed lifestyle questionnaires between 1993 and 1997. Deaths among the participants were recorded until 2006. None of the participants had cancer, heart disease or circulation disorders when they took part in the study.

Four types of data were recorded from each participant which resulted in a health score of 0 to 4. One point was given for each of the following health behaviours: non-smoker, physically active, moderate alcohol intake, consuming the equivalent of five servings of fruit and vegetables a day.

Non-smoker was defined as currently not smoking, physically active was having a physically active job (i.e. non-sedentary like plumber or nurse), or having a sedentary job and exercising. Moderate alcohol intake was defined as having between 1 and 14 units a week (a unit is about half a pint of beer, a small glass of wine, or a shot of spirit). Fruit and vegetable intake was assessed from the participant’s blood vitamin C.

After taking into account age, the results showed that people with a health behaviour score of 0 were four times more likely to have died by the end of the follow up period as people with a score of 4. The most common cause of death was cardiovascular disease.

People with a score of 2 were twice as likely to have died in the follow up period.

The researchers said these findings suggest that if middle aged or older people were to adopt 4 simple healthy behaviours, they could make a 4-fold improvement to their chances of surviving for another decade or more.

They also suggest that the risk of death goes down as the number of positive healthy behaviours goes up, especially death from cardiovascular conditions.

Another way to look at this result is a person who does none of the four healthy behaviours (scores 0 on this simple scale) has the same risk of dying as a person who is 14 years older who does all of them (scores 4 on this scale).

Although the participants in this study came from all walks of life and social backgrounds, they were predominantly white. The findings need to be confirmed with other populations and the analysis needs to look into impact on quality of life as well as risk of death, suggested the researchers.

Nonetheless, the study is intriguing and helps to pin down in a user friendly and informative way some simple changes that middle aged and older people can make with a reasonable expectation of making a significant impact on their lifespan.

Spread the word. Even Homer Simpson could do this!

“Combined Impact of Health Behaviours and Mortality in Men and Women: The EPIC-Norfolk Prospective Population Study.”
Khaw KT, Wareham N, Bingham S, Welch A, Luben R, et al.
PLoS Medicine January 2008, Vol. 5, No. 1, e12.
doi:10.1371/journal.pmed.0050012.

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Written by: Catharine Paddock