Like the universe, which continues to expand since its birth, life on Earth is still constantly evolving. From the first unicellular microorganisms that inhabited the earth, through dinosaurs, until today, life always finds holes to follow its path. Therefore, when some species disappear, others that occupy their place arrive. While the passage through the land of human beings, as well as that of all species, it will have its end (throughout history there have been 5 great extinctions), if we speak in terms of life expectancy, ours does not To grow. Our species lives more years as generations are going through.

But living more means living better?

Advances in hygiene, technological development or the reduction of infant mortality are some of the causes for life expectancy in the last century (in Spain we have doubled life expectancy in the last century). However, although we have managed to stretch the limits of biology compared to the rest of the species, this does not always translate into the older enjoying life in fullness. For example, in America, in 1990 a 65 -year -old person lived average 17 more. That is, until 82. In 2019, 19 more years, until 84. However, the hope of healthy life, the time we live in the absence of illness, barely grows. In 1990 he was 12 years (which means living 5 years with some disease or disability) and in 2019 of 13.5 (5 and a half years living with some disease) (1). We live more, but a large part of recent years in dependency conditions.

Although we imagine reaching major with health and independence, reality is very different in much of the population. We all know someone older of our environment that the last years of their life becomes a blurred reflection of what was young. Memory loss, or the inability to move independently and perform their daily tasks (eg , go to the bathroom, see or simply eat), make life in these conditions differ much from what we imagine as a good old age. Therefore, perhaps the question we should ask ourselves is: What can we do to be able to live more years in the best possible health conditions?

The recipe to live more and better, does it exist?

To a greater or lesser extent, we all know what life habits we must lead to be healthier. Moving more, not smoking or drinking alcohol, carrying a balanced diet rich in fruits and vegetables, or improving our dream are some of the measures that we know are essential to get healthy at adulthood. But what real impact does it have on life expectancy to include each of these ingredients? How many more years can we live if we take care of ourselves?

Various investigations have addressed this issue. For example, as we saw in a previous article , a study that analyzed more than 120 thousand people saw that those who carried a healthy diet did not smoke, had a healthy body mass index, reduced alcohol consumption and made the Less 30 minutes a day of moderate or vigorous physical activity, they could live 10 years more than those that did not lead a healthy life (2). And following this same line of research, a recent study provides more information and gives us really interesting details that show that, if we want to change our lifestyle, it is never too late.

The study, carried out in Japan, analyzed 20,373 men and 26,247 women from 40 to 80 years of age (3). With the aim of quantifying how it influences to lead a healthy lifestyle in life expectancy, researchers analyzed the following factors:

• Diet : Frequency with which fruits, fish and milk were consumed.
• Regular physical activity : frequency with which sports was walking or practiced.
• Body mass index. 
• Not smoking.
• Do not drink alcohol.
• Sleep duration . Sleep on average between 5.5–7.4 hours a day.

Depending on whether or not they met each factor studied, they were given a score. A greater score meant a better lifestyle. For example, if they ate a piece of fruit per day, they were given 1 point. If they did sports at least 1 hour a week, another point. If they walked 1 hour a day, another point. If they smoked, 0 points. If they drank alcohol, 0 points. If they had a body mass index between 21 and 25 (Normapeso range), 1 point. That is, the more criteria they met, the greater the score obtained.

The results were very striking. After tracking 20 years, those who had obtained more score, as expected, had greater life expectancy. Thus, at age 40, men who had achieved 7 or more points lived 47 more years, while women with the highest score, 51. For example, a 40 -year -old woman with a healthy lifestyle could live up to 91 years, while one that does not take care of would arrive to 85 (0-2 points). This means living 6 more years compared to not having led a healthy lifestyle. And surely with higher quality of life. The remarkable thing about the study is that these benefits are also seen in very advanced ages. As can be seen in Figure 2, having a score greater than 4 to 80 years has a very positive impact on life expectancy. That is, it's never too late to start taking care of yourself.

An important detail that the study saw was that the greatest benefits were obtained in the case of people with a disease. That is, if people were sick (cancer, cardiovascular disease, diabetes, kidney disease), leading a healthy lifestyle increased life expectancy very significantly compared to patients who barely had healthy habits (Figure 3) . And this is vital to understand it. For example, a woman with cancer with a score of more than 6 could live 11 years more than a patient with a score of 2. Bringing a healthy lifestyle is even more important if she is sick. Although it may seem obvious, these results can be highlighted. Enjoying life 4 more years is not an insignificant fact.

Why is this study important?

This research is important for several reasons. Analyzes a large number of people (20,373 men and 26,247 women) and in a wide range of age, from 40 to 80 years. In addition, it is carried out in Japan, a country that represents a model of society towards which many developed countries tend: aging population and with a low birth rate. Therefore, these results show us the path that we should probably follow if we want to have a long -lived society and with the ability to fully live in the last years of their life. 

Conclusions

The recipe to live more years seems clear: staying active, eating fresh foods (especially fruit and vegetables), prioritizing nighttime rest, not smoking, not drinking alcohol and maintaining an optimal body composition. In this sense, and recognizing the importance of each of them, there are factors that are decisive and that we must take into account so as not only to live, but also better. Maintaining muscle function and cardiorespiratory capacity should be a priority objective (in these two articles we analyze the impact of VO2max and power on aging) if we want to get old healthy. For an elderly person, having strength to get up from the chair or to be able to walk normally can mean the difference between being independent or not . To prescribe exercise and resistance exercise in adulthood should be a priority if we want our society to be a healthy and active society and not a dependent society.

References:

1. Martinez R, Morsch P, Soliz P, Hommes C, Ordunez P, Vega E. Life Expercy, Healthy Life Expercy, and Burden of Disease in Older People in the Americas, 1990–2019: A Population-Based Study. Rev Panam Public Health. 2021; 45. 

2. Yanping L, An P, D. WD, Xiaoran L, Klodian D, H. Fo, et al. IMPACT OF HEALTHY LIFESTYLE FACTORS ON LIFE EXPECTES IN THE US POPULATION. Circulation. 2018 Jul 24; 138 (4): 345–55. 

3. Sakaniwa R, Noguchi M, Imano H, Shirai K, Tamakoshi A, ISO H, et al. IMPACT OF MODIFIABLE HEALTHY LIFESTYLE ADOPT ON LIFETIME GAIN FROM MIDDLE TO OLDER AGE. Ageing [Internet]. 2022 May 1; 51 (5): AFAC080. Available from: https://doi.org/10.1093/ageing/afac080