Barts-MS rose-tinted-odometer ★★★★★
It is a no-brainer. A healthy lifestyle is one of the most effective preventive health interventions available. The study below shows that you can increase your chances, by a factor of over 20, of a life expectancy free of diabetes, cardiovascular diseases, and cancer at age 50 by making ensuring you maintain 4 or 5 low-risk lifestyle factors; i.e. not smoking, staying trim, doing moderate to vigorous physical activity, keeping your alcohol intake moderate and eating a quality diet.
Although this study has implications for the general population the message is applicable to pwMS. All these lifestyle factors have been linked in some studies to MS outcomes. In other words, everyone with MS should assess their lifestyle to see if they can change things to maximise their longterm outcome.
Another thing you can do is to ask your HCP to score themselves on these five factors. I maintain that HCPs have a responsibility to lead by example and they should be practising what they preach. This is why I am determined this year to max-out on all five of these factors so that I can look my patients in the eye and say “I am with you all the way”.
What is not discussed in this paper is the fact that what determines your ability to live a ‘healthy life’ is often down to the social determinants of health (SDoH) and these are usually beyond the control of the individual. Education, poverty, inequality, social isolation, a poor environment, lack of self-control, a sense of helplessness, chronic stress, etc. are all factors that make adopting a healthy lifestyle almost impossible. This is why our #ThinkSocial campaign is really a political campaign. Without politicians acknowledging the importance of the SDoH little will change.
Please let us know if you are managing to adopt and maintain a healthy lifestyle and how you have done it; success stories are more motivating than pontificating from a soap-box.
Objective: To examine how a healthy lifestyle is related to life expectancy that is free from major chronic diseases.
Design: Prospective cohort study.
Setting and participants: The Nurses’ Health Study (1980-2014; n=73 196) and the Health Professionals Follow-Up Study (1986-2014; n=38 366).
Main exposures: Five low-risk lifestyle factors: never smoking, body mass index 18.5-24.9, moderate to vigorous physical activity (≥30 minutes/day), moderate alcohol intake (women: 5-15 g/day; men 5-30 g/day), and a higher diet quality score (upper 40%).
Main outcome: Life expectancy free of diabetes, cardiovascular diseases, and cancer.
Results: The life expectancy free of diabetes, cardiovascular diseases, and cancer at age 50 was 23.7 years (95% confidence interval 22.6 to 24.7) for women who adopted no low-risk lifestyle factors, in contrast to 34.4 years (33.1 to 35.5) for women who adopted four or five low-risk factors. At age 50, the life expectancy free of any of these chronic diseases was 23.5 (22.3 to 24.7) years among men who adopted no low-risk lifestyle factors and 31.1 (29.5 to 32.5) years in men who adopted four or five low-risk lifestyle factors. For current male smokers who smoked heavily (≥15 cigarettes/day) or obese men and women (body mass index ≥30), their disease-free life expectancies accounted for the lowest proportion (≤75%) of total life expectancy at age 50.
Conclusion: Adherence to a healthy lifestyle at mid-life is associated with a longer life expectancy free of major chronic diseases.