BMJ:健康的生活方式能延长无重大慢性疾病的预期寿命

在过去的几十年中,世界人口的平均预期寿命大大增加了。人口的老龄化导致诸如糖尿病,心血管疾病和癌症等慢性病的高发。尽管人们的寿命更长,但老年人却经常患有慢性病。为了研究健康的生活方式与无重大慢性疾病的预期寿命之间的关系,近期BMJ杂志发表了一项前瞻性队列研究。

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该研究的数据来源于两项队列研究,从中分别纳入了73196名美国注册女护士和38366名美国男性健康专业人员。此项研究定义的五种低风险生活方式包括:不吸烟,保持健康体重(BMI 18.5-24.9),定期锻炼(每天≥30分钟中等或剧烈运动),适度饮酒(女性酒精摄入量5-15克/天,男性酒精摄入量5-30克/天)和健康饮食(量表评估得分前40%)。主要终点指标为无糖尿病,心血管疾病和癌症的预期寿命。


该研究发现没有采取低风险生活方式的女性,在50岁时没有癌症、心血管疾病和糖尿病的预期寿命为23.7年(95%置信区间22.6至24.7),而遵循4-5种低风险生活方式的女性,无病预期寿命为34.4年(33.1至35.5)。没有采取低风险生活方式的男性,在50岁时没有慢性疾病的预期寿命为23.5年(22.3至24.7),而遵循4-5种低风险生活方式的男性,无病预期寿命为31.1年(29.5至32.5)。对于目前大量吸烟(≥15支香烟/天)男性或肥胖人群(体重指数≥30),其无病预期寿命在50岁时所占预期寿命的比例最低(≤75%)。

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该研究认为更健康的生活方式不但有助于降低癌症、心血管疾病和糖尿病这些主要慢病的发病风险,也与总预期寿命和无病预期寿命更长相关。





摘要原文


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.



参考文献:


Li Y, Schoufour J, Wang D D, et al. Healthy lifestyle and life expectancy free of cancer, cardiovascular disease, and type 2 diabetes: prospective cohort study[J]. BMJ, 2020, 368: l6669.






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