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Regular exercise, healthy eating, non-smoking, obesity, and moderate drinking can extend the lives of women aged 14 and over by 14 years and men by 12 years.

This is the conclusion of the first study that thoroughly analyzes the relationship between low-risk lifestyle factors and life expectancy in the US.

A paper on the research, led by the Harvard TH Chan School of Public Health in Boston, MA, will be published shortly in the journal Circulation.

Although the United States is one of the richest nations in the world, it is far behind in terms of life expectancy, ranking 31 in 2015.

This may seem surprising to a country that spends more on health than any other – that is, until it becomes clear – the new study authors suggest that most of the money is spent on drug development and treatment instead of preventing them.

Yet, many of the most common and expensive diseases to treat – such as cancer, cardiovascular disease and other chronic diseases – are „largely preventable,“ they note.

To what extent could a focus on prevention contribute to increasing life expectancy in the US, which averages 79.3 years, compared to 83.7 years in Japan?

Abstract
Background Americans have a shorter life expectancy than residents of almost all other high-income countries. We want 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, one Body mass index of 18.5 to 24.9 kg / m2, ≥ min / d with moderate to strong physical activity, moderate alcohol consumption and high diet quality (upper 40%), as well as estimated overall lifestyle associa- tion risk rates (0 -5 scale) with mortality. We used data from the NHANES (National Health and Nutrition Examination Surveys, 2013-2014) to estimate the lifestyle distribution and the US Centers for Disease Control and Prevention Wonder database to derive Americans‘ age-specific mortality rates. We used the Life Table method,

Results – In up to 34 years of follow-up, we documented 42 167 deaths. The multivariable adjusted hazard ratios for adult mortality with 5 compared to 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 mortality in cardiovascular disease. The population-based risk of non-compliance with 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 the Cancer mortality and 71.7% (95% CI, 58.1-81.0) for cardiovascular mortality. We estimated life expectancy at the age of 50 years to be 29.0 years (95% CI, 28.3-29.8) for women and 25.5 years (95% CI, 24.7-26.2) for men, who did not take a low-risk lifestyle. In contrast, for those who have taken all 5 low-risk factors, we have a life expectancy at the age of 50 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 predicted life expectancy at the age of 50 years was on average 14.0 years (95% CI, 11.8-16.2) longer in Americans with 5 low risk factors compared to those with zero risk factors; in men, the difference was 12.2 years (95% CI, 10.1-14.2). The predicted life expectancy at the age of 50 years was on average 14.0 years (95% CI, 11.8-16.2) longer in Americans with 5 low risk factors compared to those with zero risk factors; in men, the difference was 12.2 years (95% CI, 10.1-14.2). The predicted life expectancy at the age of 50 years was on average 14.0 years (95% CI, 11.8-16.2) longer in Americans with 5 low risk factors compared to those with zero risk factors; in men, the difference was 12.2 years (95% CI, 10.1-14.2).

Conclusions – A healthy lifestyle could significantly reduce premature mortality and adult life expectancy in the US.

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