Simple behavioural changes could extend life expectancy by 14 years, study shows

People who adopt four healthy behaviours, namely not smoking; taking exercise; moderate alcohol intake; and eating five portions of fruit and vegetables a day, live on average 14 years longer
than people who do not adopt any of these behaviours, according to new research.

The study, which is published in the journal PLoS Medicine, forms part of the EPIC (European Prospective Investigation of Cancer) study. Covering thousands of people in ten European countries,
EPIC is the largest study of diet and health ever undertaken.

Although many studies have looked at the impact on health of individual behaviours, few have investigated the combined impact of changes in lifestyle. In this latest piece of research,
scientists from the University of Cambridge and the Medical Research Council used a simple questionnaire to assess four behaviours.

Under the system, one point was given four each of the following: not currently smoking; not being physically inactive (with physical inactivity being defined as having a sedentary job and not
doing any recreational exercise); a moderate alcohol intake (of between 1 and 14 units a week); and a blood vitamin C level consistent with eating five portions of fruit and vegetables a day.

Between 1993 and 1997, 20,000 men and women aged between 45 and 79 and living in Norfolk, UK, completed the questionnaire. They were then followed up for an average of 11 years.

The results revealed that people with lower scores on the questionnaire were more likely to have died in the intervening years than those with higher scores. After factoring in age, the
scientists found that people who had scored zero at the start of the study were four times more likely to have died than people who scored four. The scientists calculated that this means that a
person who has a score of zero has the same risk of dying as someone 14 years older who scored four.

The effect was strongest for deaths from cardiovascular causes, but an effect on deaths from cancer and other causes could also be seen.

People with chronic conditions such as cancer or heart disease at the start of the study were excluded from the analysis; nevertheless they also appeared to live longer if they engaged in more
of the behaviours studied.

The scientists emphasise the fact that the behaviours concerned are all within the normal range found in the population. ‘Though relatively modest and achievable, their combined impact was
associated with an estimated four-fold difference in mortality risk, equivalent to 14 years in chronological age,’ they write. ‘These results may provide further support for the idea that even
small differences in lifestyle may make a big difference to health in the population and encourage behaviour change.’

‘This is good news and shows that by living a healthy life, people can reduce their risk of dying from heart and circulatory disease,’ said Judy O’Sullivan, cardiac nurse and the British Heart
Foundation, which supported the study. ‘By not smoking, drinking alcohol in moderation, taking regular physical activity and eating a diet rich in fruit and vegetables, people can improve their
chances of living longer.’

An accompanying editorial discusses the policy implications of the findings. The authors note that for people to change their lifestyle, governments have to create an environment that enables
behavioural change. For example, studies have shown that legislation banning smoking in public spaces has a much stronger effect on the health of bar workers than any simple public health
message could.

Meanwhile in the US, studies of physical activity in low income areas reveal that people living there do very little walking because they fear for their safety, especially at night.

‘We look forward to seeing whether policy makers will act upon Khaw’s findings,’ the editors conclude. ‘But perhaps in the meantime it would be wise, for those of us who are able to do so, to
make a few New Year’s resolutions in the light of these findings.’

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