Following five lifestyle-related factors is associated with a gain in average life expectancy (Li et al. 2018). What are these factors? Not smoking, having a BMI between 18.5 to 24.9 kg/m2, engaging in more than 30 minutes of moderate to vigorous physical activity (at a minimum, walking ~3 miles per hour; 30 minutes of that = 1.5 miles of walking per day), moderate alcohol intake (5 to 15 g/d for women and 5 to 30 g/d for men), and a high diet quality score.
Starting at age 50y, having all 5 of these factors was associated with a life expectancy of an additional 43.1 years for women, and 37.6 years for men, which is an increase in average life expectancy of 14 years for women and 12 years for men, respectively:
Quantifying whether or not you have the first 4 factors is easy, but what qualifies as having a high dietary score? The alternative healthy eating index (AHEI; McCullough et al. 2002) was used to define the dietary score. An AHEI score of more than 43.5 in women and 50 in men qualifies as having a high dietary quality. How is the AHEI defined?
If you eat more than 5 servings of vegetables (1 serving = ~3 ounces, or 80g) per day, you get 10 points. Similarly, more than 4 servings of fruit gets you 10 points. If you eat 1 serving (= 1.5 ounces, or 42 grams) of nuts and or soy protein (tofu) you get 10 points. If your intake of white meat (including fish, poultry) divided by red meat is greater than 4, you get 10 points. If you eat > 9 grams of cereal fiber (not 9 grams of grains, but the actual fiber content) per day, you get 10 points. For example, 9 grams of cereal fiber corresponds to 90g/day of dry oats. Alcohol is also included within the AHEI: if you have 1.5 – 2.5 servings of alcoholic drinks per day (for men) or 0.5 – 1.5 servings/day for women, that’s 10 points. Zero points would be not consuming alcoholic drinks, or > 3.5 drinks for men, and > 2.5 drinks per day for women. Having a polyunsaturated/saturated fat (P:S) intake > 0.5 yields 8 points, whereas a ratio > 0.7 yields 10 points. Consuming < 0.9 grams of trans fat per day yields 10 points, and finally, using a multivitamin for more than 5 years yields 10 points. To determine your score, have a a look at the median AHEI values reported for men:
And for women:
How many of the 5 factors do I have? I don’t smoke, my BMI is within the BMI range (my body weight was 158 this morning, so barely!), and I easily walk more than an hour/day + 3-4 days of exercise/week, so I qualify for the first 3 factors. However, I rarely drink alcohol, so I don’t qualify for that factor. What about the diet quality factor? To determine that, I’ll need to calculate if I have more than 50 AHEI points.
For the AHEI index, getting 5, 4, and 1 servings of veggies, fruit, and nuts per day is easy for me, so I’ve got 30 points so far. I eat oats once or twice/week, but not enough to get 9g of cereal fiber/day, so 0 points there. I eat 80 grams of sardines every day (560 grams/week), and ~150 grams of red meat per week, for a ratio of 3.7. That wouldn’t qualify me for 10 points, but 8 instead (see Quintile 4), where the white/red meat ratio would need to be higher than 2.5. I rarely drink alcohol, so 0 points for me there. Using last week’s dietary data, my P:S ratio is about 0.5, and my trans fat intake (almost exclusively from full-fat dairy) is 0.7 g/day, so I get 8 points and 10 points, respectively. In terms of multivitamin use, I only supplement with Vitamin D in the winter, and with a methylfolate-methylcobalamin-B6 stack (to reduce my homocysteine by ~10%). I haven’t been supplementing with that stack for more than five years, so I get a 0 there. Nonetheless, my score is 56 points, which would qualify me as having a high diet quality score.
Collectively, I have 4 of the 5 lifestyle factors that are associated with an increase in life expectancy. Based on the data from Li et al., my average life expectancy would be 85.4y. Adding in moderate alcohol intake would give me all 5 factors, and would result in a life expectancy gain of an additional 2.2 years. I’ve included 1-2 glasses of wine in my diet in the past, but it had no effect on my HDL or other circulating biomarkers, so I removed it. For me, the risk related to alcohol intake may not be worth the gain in life expectancy. Also note that these are average, population-based values, and I expect an additional gain in life expectancy gain because of my continuous quest for biological age optimization (https://michaellustgarten.com/2019/09/09/quantifying-biological-age_!
If you’re interested, please have a look at my book!
Li Y, Pan A, Wang DD, Liu X, Dhana K, Franco OH, Kaptoge S, Di Angelantonio E, Stampfer M, Willett WC, Hu FB. Impact of Healthy Lifestyle Factors on Life Expectancies in the US Population. Circulation. 2018 Jul 24;138(4):345-355. doi: 10.1161/CIRCULATIONAHA.117.032047.
McCullough ML, Feskanich D, Stampfer MJ, Giovannucci EL, Rimm EB, Hu FB, Spiegelman D, Hunter DJ, Colditz GA, Willett WC. Diet quality and major chronic disease risk in men and women: moving toward improved dietary guidance. Am J Clin Nutr. 2002 Dec;76(6):1261-71.