The behaviours and factors that threaten longevity

The behaviours and factors that threaten longevity
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Most people hope for a long, healthy life. And researchers across many disciplines are continually seeking new information on ways to extend the human life span. In a 2020 study published in the journal Proceedings of the National Academy of Sciences (PNAS), researchers examined a wide variety of risk factors related to life expectancy. They identified 57 social and behavioural elements that contribute to an increase in early mortality.

They ultimately pinpointed six factors that have the most impact:

  • smoking,
  • alcohol abuse,
  • lack of physical activity,
  • economic/financial difficulties,
  • social adversity, and
  • negative psychological characteristics.

They say these predictors can be used to understand individual mortality risk, and we need to step back and look at why some first world countries are doing so poorly in terms of life expectancy, says study co-author David Rehkopf, associate professor of medicine at Stanford University. “What you are doing right now matters for your health, it is never too late to begin to be healthy.”

The study, which was based on 13,611 adults ages 50 to 104 who died between 2008 and 2014, didn’t analyse every possible adverse component, but the data give an indication of specific childhood and adulthood factors associated with a reduced life span.

“Social factors and conditions come out as important for mortality, and they are factors that we should pay more attention to,” Rehkopf says.

A healthy life expectancy is defined as the number of years a person at a given age can expect to live in good health. To that end, we spoke with experts in each of the six main categories to determine potential interventions and solutions in order for people to live their longest, healthiest lives.




According to the PNAS study, current smokers and those with a history of smoking had the greatest risk of early mortality. The latest data on smoking from the Centers for Disease Control and Prevention (CDC) support this finding on a grand scale, which includes secondhand smoke. Smokers die approximately 10 years sooner than non-smokers. The high concentration of nicotine in cigarettes drives an addiction in the brain that has a massive impact on the lungs and heart. Smoking not only causes lung damage, it weakens the immune system, causing further infections.

“The chemicals in cigarettes result in a constant attack on the lungs,” says Dr Panagis Galiatsatos, assistant professor at Johns Hopkins School of Medicine and a pulmonary and critical care doctor. In addition to cancer, smoking can cause many interstitial lung diseases (ILD), including respiratory bronchiolitis (RBILD) and pulmonary langerhans interstitial lung disease (PLCH), as well as chronic obstructive pulmonary disease (COPD) (which includes emphysema), and pneumonia.

“If people who actively smoke get a viral or bacterial infection, they have more severe symptoms,” says Dr Galiatsatos. “SARS-CoV-2 and Covid-19 are worse in people who smoke.”

Smoking: What you can do

Smoking: What you can do

Dr Galiatsatos says to keeps the definition of a smoker simple: “Either you smoke or you don’t.” Severity depends on a brand’s nicotine and tar concentrations, the burn rate, and whether a smoker deeply inhales or gets just a few puffs in before putting it down.

“People ask, ‘Am I a mild, moderate or super smoker?’ I don’t know. It’s the way your body responds,” says Dr Galiatsatos. “It’s like playing Russian roulette. Every time you do it, you expose yourself to dire outcomes. You may smoke once a week; that can still result in cancer. Someone else may have the genetics that even if they smoke daily, they won’t get cancer. You don’t want to play those odds.” (Smoking marijuana or e-cigarettes may pose the same risks around infection and cancer development.)

Dr Galiatsatos says dependence on tobacco is a disease “no different from diabetes … you have to manage it.” As the co-author of new guidelines for smoking cessation, he recommends smokers first surround themselves with people who can empathise. Second, they should talk to a healthcare professional to determine if medical intervention is necessary. Finally, understand that quitting takes time.

“The nicotine replacement therapy patch works, but all have a variable impact of when they’ll work.” Generally, a former smoker is someone who has established six months or more without smoking, while independence is 10 years of not smoking.

Discover 15 mind-blowing ways your body heals when you quit smoking.

Alcohol abuse

Alcohol abuse

Alcohol abuse is one of the leading causes of preventable death. George Koob, director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), says there are around 200 types of disorders and injuries that alcohol has a role in which can cause death, as reported by the World Health Organization (WHO).

“Even indirectly, people lose their lives due to alcohol. Of the people who died in traffic alcohol-related accidents in 2018, only 60% of them were alcohol-impaired drivers,” says Koob. “It’s often the passenger or the person in the other vehicle. Alcohol, when misused is a toxin, both behaviourally and physiologically.” Beyond intoxication-related accidents and injury, alcohol also increases the risk of cirrhosis, liver disease, and cancer of the liver, larynx, pharynx, oesophagus, and breast in women.

Alcohol abuse: What you can do

Alcohol abuse: What you can do

John F. Kelly, professor of psychiatry at Harvard Medical School, defines alcohol use disorder as “a condition characterised by heavy and frequent use of alcohol, resulting in impaired ability to successfully cut down or stop alcohol use despite physical, psychological and social problems caused by its use.” He recommends free resources that can help those who struggle with alcohol, such as Alcoholics Anonymous. Additionally, Koob notes that alcohol abuse is a spectrum disorder, meaning a patient may have a mild, moderate or severe disorder depending on the number of criteria they meet as diagnosed by the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders).

Due to the social isolation related to the COVID-19 pandemic, Koob says many people use alcohol to cope with daily stress, to help sleep, or to deal with trauma. He suggests some ways to help ease stress instead, such as keeping a regular sleep schedule, exercise, proper nutrition, and social interaction (even virtually, like Zoom and phone calls).

“Exercise is really good for your brain and for your mental health. There are plenty of videos online for different kinds of exercise programs. Walking is very good exercise. Walk the dog a lot,” says Koob.

Here are 10 healthy alternatives to drinking alcohol to destress.

Physical inactivity

Physical inactivity

Many adults are physically inactive. A 2018 CDC study found that a significant portion of deaths among adults aged 40-69 years (9.9%) and adults over 70 (7.8%) can be attributed to physical inactivity; approximately 3.2 million deaths globally each year are attributable to physical inactivity according to the World Health Organization (WHO).

Dr Eudene Harry, defines physical activity as “moving your body with enough force to supply blood, oxygen and nutrients to every organ system in the body to help them function at optimal capacity.”

To reduce risk of chronic illnesses, basic activity recommendations start at 150 minutes of moderate-intensity exercise per week.  This includes brisk walking, swimming, dancing, or cycling. Dr Harry says a lack of physical activity has the potential to impact the entire body, “from the brain to the bones and every gastrointestinal system.”

Dr Harry emphasises that prolonged sitting is linked to an increased risk of obesity, high blood pressure, heart disease, and type 2 diabetes, and many more chronic conditions that may increase the risk of premature death. Other potentially lethal conditions related to physical inactivity include osteopenia (loss of bone mass), sarcopenia (excessive muscle loss), hip fractures (which carry an increased rate of mortality for older adults), depression, dementia, and stroke.

Physical inactivity: What you can do

Physical inactivity: What you can do

People should stop thinking about exercise as only a means to weight loss and instead see it as one of the most effective health tools available, says Dr Harry. Physical activity can help manage depression, anxiety symptoms and stress. “Exercise generates feel-good neurotransmitters such as serotonin, oxytocin and has been shown to increase BDNF (brain derived neurotrophic factor), which has been linked to a decreased risk of depression and maintaining healthy brain cells,” says Dr Harry.

She recommends exercising to improve mood, enhance brain function, and lower blood pressure. Just 20 minutes of aerobic exercise immediately lowers blood pressure (and keeps it lower for 22 hours).

Dr Harry says people tend to be more consistent with exercise when they think of it as part of a healthy lifestyle, not just for weight management. “I love the term ‘physical activity’ v exercise. For many, exercise implies obligation and rigidity. We may feel that if we can’t commit 45 to 60 continuous minutes, why bother? The good news is research tells us 10-minute increments work, getting up every 30 minutes just to move around works.”

She highlights pleasurable activities such as gardening, biking, and hiking. Dr Harry also reminds us that children love to play, “so let’s call [exercise] playing. Children look forward to the word ‘recess’, but dread the words ‘physical education’.” While a high antioxidant diet, meditation, and a good night’s sleep all have some benefits similar to physical activity, Dr Harry says “there is no good alternative, right now, for staying physically active.”

To get the most out of your exercise, here are 8 tricks to make your daily walking habit even healthier

Economic and financial difficulties

Economic and financial difficulties

Financial stress can affect anyone, regardless of individual wealth – although obviously that stress is greater for some people than others. A 2014 study published in BMC Public Health looked at financial stress in late adulthood. Researchers found that an individual’s financial wellbeing, which includes lower wealth, unemployment history and reported financial difficulties, may increase the risks of cardiovascular disease and all-cause mortality, particularly among men.

Stephanie W. Mackara, financial socialisation expert defines financial stress as “a state of being where you lack control over your day-to-day, month to-month finances. You are not in a position [to] absorb a financial shock and have constant worry over paying bills and sustaining your lifestyle.”

Mackara says that nearly everyone stresses about whether they’ve saved enough, invested wisely, losing their nest egg, or outliving their money. Job loss is another major stressor, especially during the pandemic. Worrying about having the financial resources to go months without income is overwhelming for many individuals and families. “Those who’ve experienced lower wealth since childhood often don’t have a fall-back plan or financial buffer, so the impact can be much more devastating,” says Mackara. The stock market is yet another source of stress for many, especially in uncertain times.

Financial difficulties: What you can do

Financial difficulties: What you can do

While you can’t always control the factors that determine whether or not you have financial problems, engaging children in “positive financial socialisation early and often” may help with future financial wellness in the next generation, according to Mackara. A study published in 2018 in the Journal of Financial Counseling and Planning found that children with bank accounts and those whose spending was monitored by parents were “more likely to own financial assets and had more positive attitudes towards personal finance as young adults.”

Likewise, research published in 2018 in Cogent Social Sciences suggests both parental teaching and personal finance classes were associated with positive financial behaviours of college students. “Financial wellness is not separate from a person’s overall wellbeing,” says Mackara. “We must begin to incorporate all aspects of wellbeing into our daily lives: emotional, social, physical and financial in order to optimise our personal health. Money tends to be a touchy subject. We need a perspective shift; financial wellbeing is inextricably intertwined with our overall health.”

Consider these 9 tips that financial advisors wish you knew.

Social adversity

Social adversity

Adverse socioeconomic and psychosocial experiences during childhood, as well as divorce and social connection are all factors investigated by the new PNAS study. The National Institutes of Health Office of Behavioral and Social Sciences designates both behavioural and social sciences as “fundamental to our understanding of disease pathogenesis and mortality.” Dr David L. Hill, adjunct assistant professor of paediatrics at University of North Carolina School of Medicine and co-author of Co-parenting Through Separation and Divorce: Putting Your Children First, says negative social experiences are termed “adverse childhood events” (ACEs) in paediatrics.

Adverse events, including being a victim of physical abuse, sexual abuse, emotional abuse, physical or emotional neglect, witnessing household domestic violence, substance abuse, mental illness, parental incarceration, separation or divorce, experiencing racism and poverty all cause stress and may have lifelong consequences for both mental and physical health.

Dr Hill says toxic stress “causes the prolonged release of stress hormones, including cortisol, that can ultimately damage the DNA in our cells through a chemical process called methylation. Methylation turns genes on and off, and many researchers believe that these changes underlie the remarkable decreases in life expectancy related to toxic stress.”

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