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5 åtgärder som gör att du lever 14 år längre
 
Forskare vid Harvard har analyserat 34 års data från 78 865 kvinnor samt 27 års data från 44 354 män. Samtliga hade deltagit i två av varandra oberoende studier, Nurses´Health Study respektive Health Professionals Follow-up Study.
 
Forskarna analyserade hur fem olika livsstilsfaktorer påverkade dödligheten. Som lågriskindivider definierades personer som
• inte röktevar normalviktiga
• (BMI 18,5–24,9)
• motionerade minst 30 minuter per dag
• alkohol I liten mängd
• åt hälsosamt
 
För personer som inte anammade något av dessa råd var den genomsnittliga återstående livslängden vid 50 års ålder 29 år för kvinnor och 25,5 år för män. '
 
De som uppfyllde alla ”lågriskkriterier”, däremot, hade hela 43,1 respektive 37,6 år kvar att leva vid fyllda 50.
Med andra ord kan kvinnor och män som anammar dessa fem råd troligen räkna med att leva 14 respektive 12 år längre, jämfört med personer som inte följer något av dem.
 
Forskningen visar också att det finns ett ”dos-respons-förhållande” mellan varje livsstilsfaktor och risken att dö i förtid. För att förlänga sin förväntade livslängd behöver man alltså inte uppfylla alla kriterier, men bäst effekt får man om man tar till sig alla fem.
 
Notera dock att detta är en observationsstudie, alltså inte en klinisk studie som kan bevisa orsakssamband. Men dock intressant att sambandet i studien är så pass starkt mellan livslängd och dessa grundläggande hälsofaktorer.
 
Läs artikeln i sin helhet poch download pdf free for you
http://circ.ahajournals.org/content/early/2018/04/25/CIRCULATIONAHA.117.032047
 
ORIGINAL RESEARCH ARTICLE
Impact of Healthy Lifestyle Factors on Life Expectancies in the US Population
Yanping Li, An Pan, Dong D. Wang, Xiaoran Liu, Klodian Dhana, Oscar H. Franco, Stephen Kaptoge, Emanuele Di Angelantonio, Meir Stampfer, Walter C. Willett, Frank B. Hu
 
Abstract
Background—Americans have a shorter life expectancy compared with residents of almost all other high-income countries. We aim to estimate the impact of lifestyle factors on premature mortality and life expectancy in the US population.
 
Methods—Using data from the Nurses' Health Study (1980-2014; n=78 865) and the Health Professionals Follow-up Study (1986-2014, n=44 354), we defined 5 low-risk lifestyle factors as never smoking, body mass index of 18.5 to 24.9 kg/m2, ≥30 min/d of moderate to vigorous physical activity, moderate alcohol intake, and a high diet quality score (upper 40%), and estimated hazard ratios for the association of total lifestyle score (0-5 scale) with mortality. We used data from the NHANES (National Health and Nutrition Examination Surveys; 2013-2014) to estimate the distribution of the lifestyle score and the US Centers for Disease Control and Prevention WONDER database to derive the agespecific death rates of Americans. We applied the life table method to estimate life expectancy by levels of the lifestyle score.
 
Results—During up to 34 years of follow-up, we documented 42 167 deaths. The multivariable-adjusted hazard ratios for mortality in adults with 5 compared with zero low-risk factors were 0.26 (95% confidence interval [CI], 0.22-0.31) for all-cause mortality, 0.35 (95% CI, 0.27-0.45) for cancer mortality, and 0.18 (95% CI, 0.12-0.26) for cardiovascular disease mortality. The population-attributable risk of nonadherence to 5 low-risk factors was 60.7% (95% CI, 53.6-66.7) for all-cause mortality, 51.7% (95% CI, 37.1-62.9) for cancer mortality, and 71.7% (95% CI, 58.1-81.0) for cardiovascular disease mortality. We estimated that the life expectancy at age 50 years was 29.0 years (95% CI, 28.3-29.8) for women and 25.5 years (95% CI, 24.7-26.2) for men who adopted zero low-risk lifestyle factors. In contrast, for those who adopted all 5 low-risk factors, we projected a life expectancy at age 50 years of 43.1 years (95% CI, 41.3-44.9) for women and 37.6 years (95% CI, 35.8-39.4) for men. The projected life expectancy at age 50 years was on average 14.0 years (95% CI, 11.8-16.2) longer among female Americans with 5 lowrisk factors compared with those with zero low-risk factors; for men, the difference was 12.2 years (95% CI, 10.1-14.2).
 
Conclusions—Adopting a healthy lifestyle could substantially reduce premature mortality and prolong life expectancy in US adults.
 
Discussions from the article
DISCUSSION
We estimated that adherence to 5 low-risk lifestylerelated
factors could prolong life expectancy at age
50 years by 14.0 and 12.2 years for female and male
US adults, respectively, compared with individuals who
adopted zero low-risk lifestyle factors. These estimates
suggest that Americans could narrow the life-expectancy
gap between the United States and other industrialized
countries by adopting a healthier lifestyle. In 2014,
the life expectancy for American adults at age 50 years
was 33.3 years for women and 29.8 years for men.28 We
estimated that the life expectancies were 29.0 years for
women and 25.5 years for men if they had zero low-risk
factors but could be extended to 43.1 years for women
and 37.6 years for men if they adopted all 5 low-risk
factors. However, in US adults, adherence to a low-risk
lifestyle pattern has decreased during the last 3 decades,
from 15% in 1988 to 1992 to 8% in 2001 to 2006,29
driven primarily by the increasing prevalence of obesity.
 
The life expectancy of Americans increased from 62.9
years in 1940 to 76.8 years in 2000 and 78.8 years in
2014.28 This increase could be the result of a number
of factors such as improvements in living standards,
improved medical treatment, substantial reduction in
smoking,30 and a modest improvement in diet quality.23
However, some unhealthy lifestyle factors may have
counterbalanced the gain in life expectancy, particularly
the increasing obesity epidemic30,31 and decreasing physical
activity levels.32 In our study, three fourths of premature
CVD deaths and half of premature cancer deaths in
the United States could be attributed to lack of adherence
to a low-risk lifestyle. There is still much potential
for improvement in health and life expectancy, which
depends not only on an individual’s efforts but also on
the food, physical, and policy environments.33,34 A recent
study found that low-income residents in relatively
wealthy areas such as New York and San Francisco had
significantly longer life expectancies than those in poorer
regions such as Gary, IN, and Detroit.35 This phenomenon
suggests that the living environment contributes to life
expectancy beyond socioeconomic status. For instance,
residents in affluent cities have more access to public
health services and less exposure to smoking because
of the more restricted policies on smoking in public.35
Studies36 have linked healthy eating and exercise habits
with built, social, and socioeconomic environment assets
(access to parks, social ties, affluence) and unhealthy behaviors
with built environment inhibitors (access to fast
food outlets), suggesting that supporting environments
for health lifestyle should be 1 part of the promotion of
longevity for the US population. Prevention should be a
top priority for national health policy, and preventive care
should be an indispensable part of the healthcare system.
 
Our estimation of gained life expectancy by adopting
a low-risk lifestyle was broadly consistent with previous
studies. A healthy lifestyle was associated with an
estimated greater life expectancy of 8.3 years (women)
and 10.3 years (men) in Japan,10 17.9 years in Canada,
12 and 13.9 years (women) and 17.0 years (men) in
Germany,14 as well as 14 years’ difference in chronological
age in the United Kingdom.11 Data from 3 European
cohorts from Denmark, Germany, and Norway13
suggested that men and women 50 years of age who
had a favorable lifestyle would live 7.4 to 15.7 years
longer than those with an unfavorable lifestyle. These
estimates were somewhat different because of different
definitions of a low-risk lifestyle and study population
characteristics.10,12–14
 
We observed that a healthy diet pattern, moderate
alcohol consumption, nonsmoking status, a normal
weight, and regular physical activity were each associated
with a low risk of premature mortality. Smoking is
a strong independent risk factor of cancer, diabetes mellitus,
CVDs, and mortality potentially through inducing
oxidative stress and chronic inflammation, and smoking
cessation has been associated with a reduction of these
excess risks.37–39 A healthy dietary pattern and its major
food components have been associated with lower risk
of morbidities and mortality of diabetes mellitus, CVD,
cancer, and neurodegenerative disease,40 and its potential
health benefits have been replicated in clinical trials.41
Physical activity and weight control significantly reduced
the risk of diabetes mellitus, cardiovascular risk factors,
and breast cancer.42–44 Although no long-term trial of alcohol
consumption on chronic disease risk has been conducted,
cardiovascular benefits of moderate alcohol consumption
have been consistently observed in large cohort
studies.45  Results of our sensitivity analysis further indicated
that combinations of the healthy lifestyle factors were
particularly powerful: the larger the number of low-risk
lifestyle factors, the longer the potential prolonged life
expectancy, regardless of the combined factors.5
 
A major strength of this study is the long follow-up
of 2 large cohorts with detailed and repeated measurements
of diet and lifestyle and low rates of loss to follow-
Another important strength is the combination
of the cohort estimates with a nationally representative
study, the NHANES, which improved the generalizability
of our findings. Although the HRs between lifestyle factors
and mortality were estimated from only our cohort
data, they were similar to those published in other populations.
9–14  Because our cohorts included mostly white
health professionals, we could not specifically examine
the overall impact of lifestyle adherence among different
ethnic subgroups; further studies are warranted to
examine the impact of lifestyle factors in other ethnic
and racial groups.
 
The current study has several limitations. First, diet
and lifestyle factors were self-reported; thus, measurement
errors are inevitable. However, the use of repeated
measures of these variables could reduce measurement
errors and represent long-term diet and lifestyle. Second,
we counted the number of lifestyle factors on the basis
of the dichotomized value of each lifestyle factor, although
the lifestyle factors were differentially associated
with mortality. However, our analysis based on an expanded
score considered different levels of each risk factor
and yielded similar results. Third, we did not fully consider
the baseline comorbid conditions and background
medical therapies. Although our stratification analysis by
baseline chronic conditions of diabetes mellitus, hypertension,
and elevated cholesterol provided some support
for the hypothesis that adopting a healthy lifestyle is important
for both healthy individuals and those with existing
chronic conditions, further studies among individuals
with diagnosed cancer and CVDs are warranted.
 
CONCLUSIONS
We estimate that adherence to a low-risk lifestyle could
prolong life expectancy at age 50 years by 14.0 and
12.2 years in female and male US adults compared with
individuals without any of the low-risk lifestyle factors.
Our findings suggest that the gap in life expectancy between
the United States and other developed countries
could be narrowed by improving lifestyle factors.
 
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