The 80:20 For Longevity

The Pareto Principle (named after the 19th century Italian economist Vilfredo Pareto) states that 80% of the effects generally come from 20% of the causes.

Applied to health, this principle would look like ‘80% of the results come from 20% of the effort’.

For longevity a recent research article came across my desk that strikes me as defining the 80:20 principle for longevity.

Using combined data from 123,219 people followed for 30+ years in two of the best American longitudinal studies, the researchers defined 5 low-risk lifestyle factors:

1. never smoking
2. Body mass index of 18.5 to 24.9 kg/m2
3. ≥30 min/d of moderate to vigorous physical activity
4. moderate alcohol intake, and
5. a high diet quality score (upper 40% of the Alternate Healthy Eating Index Score - AHEI)

... and assessed the effects on longevity.

The results were clear:

For a 50 year old man, adopting these 5 simple lifestyle measures would add 12.2 additional years of life, increasing life expectancy to 87.6 years as compared 75.5 years for someone adopting none.

For a 50 year old woman, these 5 measures add 14 years, bringing life expectancy to 93.1 years vs 79 years.

While this study, focused on lifespan rather than healthspan, it is clear that overall vitality and health would be superior with these same measures.

The rationale behind the measures is clear and compelling:

• 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.
• 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, and its potential health benefits have been replicated in clinical trials.
• Physical activity and weight control significantly reduced the risk of diabetes mellitus, cardiovascular risk factors,and breast cancer.
• 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.

It was also clear that these lifestyle factors are synergistic - the larger the number of low-risk lifestyle factors the longer the life expectancy benefit.

For most measures the definitions were very clear; for :

• Diet - low risk was defined as being in the top 40% of people on the AHEI score which assigns 0-10 points, with 10 indicating adherence to the recommended levels of servings per day across 10 components:
  • high intakes of vegetables,
    • fruit,
    • nuts,
    • whole grains,
    • polyunsaturated fatty acids, and
    • long-chain omega-3 fatty acids and
  • low intakes of
    • ​​​red and processed meats,
    • sugar sweetened beverages,
    • trans fat, and
    • sodium
• Alcohol - moderate drinking was defined as
  • 5-15 mg/day (0-1 drinks) for women and
  • 5-30 mg/day for (0-2 drinks) for men - 1 standard drink = 15g

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In summary - the Pareto for longevity is to never smoke, be moderate with alcohol consumption, exercise regularly, eat well with common sense (eat real food, not too much, mostly plants) and maintain a normal weight.

As I sometimes need to remind the optimizers in our practice - simple lifestyle measures deliver most of the benefit - be sure that you are doing these things first.

At Wellness Garage - we can help you understand and take control of your health.  Our comprehensive medical, fitness, nutritional and behavioral assessments give you baseline from which to measure your progress.  Our coaching helps you improve your behaviors, one habit at a time.

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Reference:
Impact of Healthy Lifestyle Factors on Life Expectancies in the US Population - Li et al. Circulation. 2018;138:345–355. DOI: 10.1161/CIRCULATIONAHA.117.032047

Details showing the cumulative effect of 1 or more measures on longevity: