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Ten Years of Life
Is It a Matter of Choice?
Gary E. Fraser, MB, ChB, PhD;
David J. Shavlik, MSPH
Arch Intern Med. 2001;161:1645-1652.
Background Relative risk estimates suggest that effective implementation of behaviors
commonly advocated in preventive medicine should increase life expectancy,
although there is little direct evidence.
Objective To test the hypothesis that choices regarding diet, exercise, and smoking
influence life expectancy.
Methods A total of 34 192 California Seventh-Day Adventists (75% of those
eligible) were enrolled in a cohort and followed up from 1976 to 1988. A mailed
questionnaire provided dietary and other exposure information at study baseline.
Mortality for all subjects was ascertained by matching to state death tapes
and the National Death Index.
Results California Adventists have higher life expectancies at the age of 30
years than other white Californians by 7.28 years (95% confidence interval,
6.59-7.97 years) in men and by 4.42 years (95% confidence interval, 3.96-4.88
years) in women, giving them perhaps the highest life expectancy of any formally
described population. Commonly observed combinations of diet, exercise, body
mass index, past smoking habits, and hormone replacement therapy (in women)
can account for differences of up to 10 years of life expectancy among Adventists.
A comparison of life expectancy when these factors take high-risk compared
with low-risk values shows independent effects that vary between 1.06 and
2.74 years for different variables. The effect of each variable is assessed
with all others at either medium- or high-risk levels.
Conclusions Choices regarding diet, exercise, cigarette smoking, body weight, and
hormone replacement therapy, in combination, appear to change life expectancy
by many years. The longevity experience of Adventists probably demonstrates
the beneficial effects of more optimal behaviors.
From the Center for Health Research, School of Public Health, Loma
Linda University, Loma Linda, Calif.
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