Maximizing Your Longevity By Removing Certain Risk Factors

TL;DR:

By removing certain risk factors in your life, you can statistically extend it. This article provides a brief overview of those factors and their impacts on longevity. The most important factors across demographics are: smoking cessation or avoidance, managing blood pressure, removal of excess body weight, reduction of blood sugar, and adequate exercise. Managing these risk factors well can extend life by approximately 9 years.

Acknowledgement

I want to thank Elliott Fisher for his time and work on this research and for pushing my own thinking around improving Medicare and population health.

Key Risk Factors

In their research on predictive models for modifiable risk factors of death as published in Population Health Metrics, Fisher, et al. studied data from more than 8,000 patients to isolate and determine key factors that might predict longevity. Their results (below) indicate that certain key factors can extend life expectancy and that joint effects of those factors can lead to differences of almost 9 years.

Results

Life expectancy gains in the US population (in years) by removing risk factors

Risk Factor	Male	Female
Smoking	3.20	2.39
High blood pressure	2.50	2.92
Excess body weight	2.30	2.21
High blood sugar	1.57	1.38
High cholesterol	1.33	0.92
Low physical activity	1.27	1.39
Low nut intake	0.87	0.72
Low vegetable intake	0.76	0.70
Low fruit intake	0.72	0.61
Low omega-3 intake	0.62	0.54
Alcohol intake	0.58	0.40
Inadequate seat belt use	0.24	0.23
Joint effects	9.59	8.98
Source: Table 2, Validation of a new predictive risk model: measuring the impact of the major modifiable risks of death for patients and populations

In more practical and population health terms, clinicians and patients might think about how they can improve performance around the following variables to extend life expectancy.

Key Risk Factors Defined

List of risk factors with the corresponding exposure

Risk Factor	Exposure Metric
Excess body weight	Body mass index (kg per m2)
High blood pressure	Systolic blood pressure (mmHg)
High cholesterol	LDL cholesterol (mg/dl)
High blood glucose	Fasting plasma glucose (mg/dl)
Seat belts	How often a seat belt is worn Always or does not drive or ride in a car Nearly always Sometimes Seldom Never
Tobacco use	Three smoking categories Non-smoker Current smoker Former smoker
Alcohol use	Includes both average consumption and pattern of drinking (binge drinking) Average consumption Abstainer, not having had a drink containing alcohol in the last 30 days 0–19.99 g of pure alcohol daily (females) and 0–39.99 g (males) 20–39.99 g (females) and 40–59.99 g (males) ≥40 g (females) and ≥60 g (males) Binge drinking Having at least one occasion of five or more drinks in the last month (men) or four or more drinks in the last month (women)
Physical activity	Based on physical activity during the past 30 days Inactive, no moderate or vigorous physical activity Low-active, <2.5 h/week of moderate activity or <600 MET min/week Moderately active, either ≥2.5 h/week of moderate activity or ≥1 h of vigorous activity; and ≥600 MET min/week Highly active, ≥1 h/week of vigorous activity and ≥1,600 MET min/week
Fruit intake	Dietary fruit intake over the past 30 days (average grams per day)
Vegetable intake	Dietary vegetable intake over the past 30 days (average grams per day)
Omega-3 fatty acids intake	Dietary omega-3 fatty acids during the past 30 days (average milligrams of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) per day)
Nut intake	Dietary nut and seed intake, including peanut butter during the past 30 days (average grams per day)
Source: Table 1, Validation of a new predictive risk model: measuring the impact of the major modifiable risks of death for patients and populations

Top Opportunities for Population Health Improvement

Smoking — avoidance or smoking cessation is the strongest individual variable affecting human longevity, according to this study.

High blood pressure — avoiding and managing high blood pressure conditions is the second most significant factor.

Excess body weight — helping patients or focusing on proper body weight is the third most significant criterion. This can be a hard-to-measure concept; excess fat or BMI indices have often been used as proxies for this.

High blood sugar — normal blood sugar levels (and avoidance of high blood sugar or diabetic conditions) is linked to more than 1 year of longevity.

Physical activity — at least 2.5 hours per week of moderate physical activity or more than 1 hour per week of vigorous physical activity can substantially extend longevity. Beyond those amounts, there aren’t clear indications of gained longevity benefits.

Maximizing Your Longevity By Removing Certain Risk Factors

May 2022

TL;DR:

Acknowledgement

Key Risk Factors

Results

Life expectancy gains in the US population (in years) by removing risk factors

Key Risk Factors Defined

List of risk factors with the corresponding exposure

Top Opportunities for Population Health Improvement

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