I believe healthy lifestyle adds 2-5 years to life expectancy. What about healthspan, or whatever they call it? How much pain and disability free years does it add?
Part of the problem when I read into it is that the definition of ‘healthy’ seems way too strict. I don’t think diabetes or hypertension are disabilities by default. I’ve known people who controlled them well with lifestyle and medicine. Until you actually have pain, disability, disease, etc I don’t know if poor metrics alone (especially ones that can be easily corrected) make you disabled. A person on metformin and an arb who lives free of pain and disability isn’t disabled Imo.
Do those that live healthy add 2-5 years free of pain, disability and suffering or is it more like 10-20 years?
A so-called “healthy lifestyle” can in some ways do the opposite. People who are overly-zealous about cleanliness and purity, never acquire any resistance or immunity to the ordinary pathogens that are wandering around the environment. They become a helpless sterile body waiting for disease to find it.
There is a particular caveat regarding statistical data in the USA. In this country, a very large number of people have little or no pre-emergency access to any kind of health care, and this number (I suspect) disproportionately encompasses people whose lifestlyle would fall outside any definition of “healthy”. So those with a “healthy lifestyle” would very probably be among the insured, who have access to health care, another obvious contributor to longevity.
I’m inclined to think genetics has a great deal more to do with longevity than anything a person can do during his lifetime, barring a preventable or communicable disease or accidental trauma, the principal causes of death in the third world. – where many people literally work themselves to death trying to earn a living…
I’ve been in an ambulance 3 times all directly from riding a bicycle (hit by car, heart attack, crash in a race - in that order).
All this exercise is going to kill me!
At 60 YO, I still ride my bike about 4K miles a year and do the occasional half marathon. I’m more physically fit than many of my coworkers half my age. They seem to avoid pain at all costs whereas I embrace it. As to whether I live longer because of my lifestyle, only time will tell.
Anecdotally, the two people I know who have the healthiest lifestyle, are both seriously compromised, medically.
One has spent her entire life eating conscientiously and organically, has remained active and exercised regularly, and used no abusive substances. She was diagnosed with idiopathic congestive heart failure at age 55, and has an implanted defibrillator.
The other was a good athlete, worked out in the gym all his life, walked many miles every day, chose diet very carefully, used no substances, and became a diabetic, and has been on the waiting list since age 60 for a kidney transplant and is on daily dialysis…
The converse is also found. Unhealthy choices clearly are associated not only with shorter lives but poorer function in the years lived. The more poor choices made, the worse the function.
Note these studies are from a variety of countries and cultures. Similar results in the UK, Japan …
The reality is that even with unhealthy choices most people in developed countries with acsess to modern medical care can expect to live significantly longer than those of previous generations. Sure those with diabetes (yes, assuming treated) are likely to die significantly younger than those without (“[d]iabetes cuts about 8.5 years off the life span of the average 50-year-old compared to a 50-year-old without diabetes …”) but the greater impact is on the quality of the years you have (“patients with the disease are less likely to be employed and more likely to have other health problems, such as heart disease, depression, and disabilities that get in the way of normal life activities”).
Hard to give a hard number of the impact on disability-free years of life, on average, “a healthy lifestyle” (assume that means moderate exercise, not smoking, eating lots of vegetables and fruits and avoiding the processed crap, no more than moderate alcohol intake, etc.) has, but my read is that the impact on lifespan is probably the 2 to 5 years and the impact on disabilty-free (and even more so significantly disability reduced) is in the 10 to 20 years.
Of course a healthy lifestyle affects quality of life. How is this even a question? Hell, every time I carry a 50lb sack of grain to the barn I think how difficult life must be for people who are 50lbs overweight. It’s exhausting carrying around 50 extra pounds. And lots of people are much more overweight than that. I recently went through a several month period where I wasn’t exercising much. I quickly lost core strength and found myself with an aching back. Any time I eat junk food I feel icky for several hours afterwords. It’s self-evident that taking care of your body, which you have to live in your whole life, is vitally important for quality of life.
Thing is though Renee that what is “self-evident” is sometimes not true when looking at the evidence. This time though, well, yeah.
That said JerrySTL’s comment raise the point that I’ve wondered about regarding road cycling when I ride. Pretty much every serious cyclist I know has had at least one significant accident. A few have been seriously hurt. And these are careful riders, respectful of the rules of the road, wear helmets, aware of the craziness of some drivers, so on. Sure, cycling will keep us fit and by so doing add years and function to the end years … but one single serious accident with early death or lasting disability at an early age offsets a bunch of folks adding a couple of years of life or several more of disability free life at the end. (Mind you this concern is not enough to get me to not ridesome, but it does give me pause.)
Yes it affects quality of life, but by how much. That is the question. Do people who live shitty lifestyles end up with 30 years of pain, disease and disability while those with good lifestyles only have 5-10, or is the gap smaller? How many extra years of pain free living, flexibility, autonomy, etc. does a healthy lifestyle provide. There is a massive difference between 2 and 20 years.
As far as being 50 pounds overweight, I don’t think it matters that much for stamina. For every 2-3 pounds of fat a person gains they gain 1 pound of LBM to carry it around. If you are exercising (pilates, weight lifting, aerobics) you should be able to carry yourself around if you are fatter. If you are fat and can’t walk up a flight of stairs it is because you aren’t exercising. I walked up about 15 flights of stairs in 5-6 minutes once and I’m obese.
When was the last time you were normal weight and fit? I can see being used to being obese and not thinking that carrying around a lot of extra weight is affecting you, but during my exercise slump I gained 5 lbs, and that affected my energy and quality of life. This has sort of been on my mind the past week, after spending time with a relative who is about 100lbs overweight. It clearly causes her problems, from swollen ankles and high blood pressure, to not being able to fit into restaurant booths or easily get out of a chair. Her stamina is very reduced. There is a lot of suffering from the weight on her part. She isn’t willing to do the work to get rid of it, but she hates her body, and that’s a pretty unpleasant feeling, I think. She is 5 years older than me, and I am pretty sure I’ll be much healthier in 20 years than she is now. I’ve spent quite a bit of time with obese people (lots of family), and they’ve all struggled to get around.
But this is anecdote, and I guess doesn’t really belong in this forum.
I think about this a lot because I walk so much. Walking itself is pretty low-impact and safe. But all that PM2.5 I’m breathing in can’t be good for me. Neither is all that sun exposure.
But I can’t think of any other form of exercise that I’d be so disciplined with keeping up.
No, but they are permanently chained to a lifelong expenditure and/or an unfriendly government bureaucracy if they can’t afford it on their own. Do you think that sort of thing adds to quality of life? I don’t personally like to spend money on unfun things or spend time filling out intrusive forms.
There are other cascading issued as well. My father has subcutaneous pacemaker which in and of itself is “no big deal”. However because of it, he can’t have an MRI – so when he hurt his knee he had to spend a miserable 6 weeks resting it, as the doctors could not be 100% sure what was wrong. That affected his quality of life quite a bit – and if it hadn’t gotten better the next step was exploratory surgery which would have been even shittier. So you have a minor cardiac problem, but it impacts your life in so many unexpected ways.
Lots of forms of exercise can result in injury when taken to extreme, or even result in accidental injury at “average” levels. But you can also seriously hurt yourself tripping on a sidewalk so that’s not precisely an argument against moderate exercise, given its other established benefits.
Evidence already cited that the person who is on metformin may not be disabled by virtue of being on metformin but is much more likely to become disabled at an earlier age and die at an earlier age than someone who does not have diabetes.
And indeed the consideration of injury from cycling, for example, is not an argument against exercise. It does raise the question of whether certain choices will be give a better statistical result than others though. Your tripping comment may be more cogent than you realize btw … regular exercise decreases the loss of balance that occurs with aging (and certain other conditions) and falls are a major cause of disability onset.
To re-address the op as illustrated by your father - modern medicine is fairly likely to keep you alive after your heart attack and your stroke but it cannot keep those gained years disability free. Healthy lifestyle is more about quality of life than it is about length of life.
Is there a distinction between a pro-active “healthy lifestyle”, and a reactive avoidance of a self-destructive lifestyle?
A lot of people engage in a high-risk lifestyle, which cannot really be offset by any amount of organic vegetables and hours on an exercise bike.
By “high risk”, I mean recreational substances, emotional anxiety, job stress, economic debt, physical labor, exposure to danger, adverse social influences, accident exposure. environmental hazards, and on and on.
So you can dial your mindset to reactive, and gain just as many years of life as if you had committed yourself to a “healthy lifestyle” regimen of specialty grocery shopping and hours at the gym.
Thanks. The appeal of living an extra couple years in my 80s doesn’t hold a lot of appeal, but the desire to reduce rates of disability, pain, disease, etc. in my senior years is more appealing.
As far as the diabetes and life expectancy, that article implies that with each decade the reduction goes down. At age 50 it may cut 8.5 years off, but by age 60 it is only 5. That is the problem with life expectancy rates, isn’t it an average? Some people (say 10%) may lose 20 years of lifespan due to disease or lifestyle (people who die in their 50s or 60s who would have lived to their 80s had they been disease free or had better lifestyles) but if you group them together with a bunch of other people (say 90%) who only lose a few months or years it averages out to maybe 2 years. It isn’t like everyone loses 2-5 years, isn’t it more that a small % lose far above the average, and most everyone else loses less than the average. I do not know how they calculate life expectancy if they use mean, median or mode or what.
My grandparents both had diabetes and both lived into their 80s. They didn’t lose 8.5 years of life expectancy since they lived to about the average lifespan for someone who hits 65 (which is early/mid 80s). At the same time I had an uncle die in his late 50s. With better lifestyle and less disease maybe he would’ve lived to his 80s. Aren’t these tables averaging people like my grandparents and uncle out and coming to the conclusion that diabetes cuts 10 years off life expectancy (25 years for my uncle, 1-2 years for each of my grandparents. 25 + 2 + 2 = 29/3 = 9.67) when it is more that a small subset will lose a lot of life expectancy and healthspan but most everyone else will lose less than the average?
Yes Wesley, life expectancy is a mean. That was part of the comment I made about cycling: a few deaths or serious disabilities in younger decades can have impact on the mean life expectancy or disability free lifespan that more than offsets quite a few with two or three years tacked on in their 80s and even a few who avoided the heart attack or stroke in their 60s. It’s the same thing that impacts understanding of populations with high child mortality rates or those who have many deaths due to violence in early adulthood. Big impact on mean life expectancy even the population has the same life expectancy for those who reach 30 as other groups.
In this case though my last comment in my last post is the bigger point. That uncle of yours who died in his 50s? Today he might not have died of that heart attack or stroke or whatever. But had he survived it his quality of life would have been significantly less for those 10 to 30 “extra” years, above and beyond the increased risk of cognitive decline, dementia, and physical decline already discussed in this thread. Thus lifespan is likely impacted by a couple of decades for a few and couple of years for many but healthspan is likely impacted by more than a decade for many.
jtur88, not quite sure I am getting your point. I do not think that “healthy lifestyle” in this thread means organic food or extreme levels of exercise. It is, unless I have misunderstood, the basic stuff: moderate exercise; adequate vegetables and fruits; not smoking; and not drinking to excess. Some would include avoidance of obesity and avoidance of highly processed foods with added sugars, refined carbs, certain saturated fats, so on. Probably avoidance of other risky behaviors, like recreational substances or dangerous activities, could be included as well. Makes sense but those were not included in the studies I cited.
Specialty grocery shopping and hours a day at the gym are not required as part of healthy lifestyle. Canned and frozen veggies, avoiding highly processed foods and added sugars while just avoiding a sedentary lifestyle and exercising very moderately … that’s enough to gain significant healthspan and lifespan impacts.