Wellness Database

Wellness Database: Life Expectancy

Life expectancy is largely determined by nutrition and lifestyle. Heart disease and cancer are leading causes of death around the world and both can be prevented by simple lifestyle changes. Regular exercise, eating fruit and vegetables, using olive oil, following a Mediterranean Diet, and not smoking are all critical to life expectancy.

Related: Heart Disease/a>, Cancer, , Mediterranean Diet, Smoking

Related Studies

Vitamin D Supplementation Found to Reduce Mortality in the Elderly

Summary: In a meta-analysis of prospective, population-based, cohort studies, researchers found that an increase in vitamin D levels was associated with a lower mortality rate in the general elderly population. Review and meta-analysis followed studies (n=12) involving elderly participants (n=32,142) whose vitamin D levels were measured. An inverse association was found between vitamin D levels and all-cause mortality in all but two studies. A 20 nmol/l increase in vitamin D levels was inversely associated with all-cause mortality. These findings suggest that an increase in vitamin D levels is associated with an 8% lower mortality in the general elderly population. These results add to the growing data on the importance of attaining adequate vitamin D levels.

Reference: "Serum 25-hydroxyvitamin D levels and overall mortality: A systematic review and meta-analysis of prospective cohort studies," Schöttker B, Ball D, et al, Ageing Res Rev; 2012 Feb 17; [Epub ahead of print]. (Address: Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany. E-mail: .(JavaScript must be enabled to view this email address) ).

Vitamin D Supplementation May Reduce Mortality in Subjects with the Metabolic Syndrome

Summary: Optimal 25-hydroxyvitamin D (25[OH]D) may be protective in individuals with the metabolic syndrome. Subjects (n=1,801) with the metabolic syndrome were investigated and mortality was tracked for a median of 7.7 years. Authors found that most subjects (92%) had suboptimal levels of 25(OH)D, with 22.2% being severely deficient. 462 deaths were recorded, 267 (57.8%) of which were cardiovascular in origin. Patients with optimal 25(OH)D levels showed a substantial reduction in all-cause and cardiovascular disease mortality compared to those with severe vitamin D deficiency, along with a strong reduction for sudden death and congestive heart failure. Results indicate that optimal 25(OH)D levels substantially lowered all-cause and cardiovascular disease mortality in subjects with the metabolic syndrome. 

Reference: "Vitamin D Levels Predict All-Cause and Cardiovascular Disease Mortality in Subjects With the Metabolic Syndrome: The Ludwigshafen Risk and Cardiovascular Health (LURIC) Study," Thomas GN, O Hartaigh B, et al, Diabetes Care, 2012 Mar 7; [Epub ahead of print]. (Address: Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK. E-mail: .(JavaScript must be enabled to view this email address) ).

Vitamin D May Help Prevent Early Mortality

Summary: The correlation between circulating vitamin D (vitD) levels and mortality rates in critically ill patients were assessed in this study. Subjects were patients (n=130) admitted to the intensive care units (ICUs) and internal medicine wards in a university-based hospital between 12/08 and 06/09 who required mechanical ventilation. The primary end point was defined as all-cause mortality within 60 days from admission or from acute deterioration. VitD levels were correlated with white blood cell (WBC) count. Among the deceased patients, survival curves indicated that survival of patients with vitD deficiency was shorter. Researchers observed longer survival times among vitD sufficient patients, potentially indicating that vitD concentration may be either a biomarker of survival or a co-factor.

 

Reference: "Vitamin D deficiency is associated with poor outcomes and increased mortality in severely ill patients," Arson Y, Gringauz I, et al, QJM, 2012 Feb 12; [Epub ahead of print]. (Address: Department of Cardiology, Department of Geriatrics, Biochemistry and Immunology Labs, Meir Medical Center, Kfar-Saba, Israel. E-mail: .(JavaScript must be enabled to view this email address) ). 

Mediterranean Diet May Reduce the Risk of Premature Mortality

Summary: In a study involving an analysis of data from 120,852 men and women between the ages of 55 and 69 years, including 9,691 deaths, adherence to a Mediterranean diet was found to be significant associated with lower mortality in women, but not significantly in men. A "healthy lifestyle score" was calculated based on adherence to the Mediterranean diet, nonsmoking, normal weight, and regular physical activity, and this score was found to be strongly and inversely associated with mortality in women and men (comparing the least-healthy to the healthiest lifestyle scores: HR=4.07 in women and HR=2.61 in men), and the mortality rate advancement period ("aging effect") was 15.1 years in women and 8.4 years in men. The authors conclude, "This study suggests that adherence to 4 modifiable healthy lifestyle factors can substantially reduce premature mortality in women and men."

Reference: "The impact of a Mediterranean diet and healthy lifestyle on premature mortality in men and women," van den Brandt PA, Am J Clin Nutr, 2011 Sept; 94(3): 913-20. (Address: Department of Epidemiology, Schools for Oncology and Developmental Biology and Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, Netherlands).

Vitamin D May Decrease Mortality In Elderly

Summary: In a Cochrane systematic review of placebo-controlled randomized trials assessing the effect of vitamin D (vitamin D3, vitamin D2 or an active form of vitamin D, calcitriol) at any dose, duration, and route of administration on prevention of mortality, 50 trials involving 94,148 subjects were included in the analysis. Most of the trials involved elderly women (over 70 years of age) and vitamin D was administered for a median 2 years. Vitamin D3 (cholecalciferol) was found to significantly decrease mortality (RR=0.94), while vitamin D2, alfacalcidol, and calcitriol did not have such an effect. The authors conclude, "Vitamin D in the form of vitamin D(3) seems to decrease mortality in predominantly elderly women who are mainly in institutions and dependent care."

Reference: "Vitamin D supplementation for prevention of mortality in adults," Bjelakovic G, Gluud LL, et al, Cochrane Database Syst Rev, 2011 July 6; (7): CD007470. (Address: Department of Internal Medicine - Gastroenterology and Hepatology, Medical Faculty, University of Nis, Zorana Djindjica 81, Nis, Serbia, 18000).

Iron and Folic Acid Supplements Reduce Child Mortality in Developing Nations

Summary: In a study involving data collected from 52,917 singleton live-born infants and from the deaths of 1,525 children under the age of 5 years, risk of death of children under the age of 5 was significantly reduced by 34% if the mother consumed iron-folic acid supplements (adjusted HR=0.66), with the greatest effect found for deaths on the first day of life (adjusted HR=0.40. Reduction in neonatal deaths during days 1-30 was also found (adjusted HR=0.69), as was a reduction in postneonatal deaths (adjusted HR=0.74). A strong dose-response relationship was found with increasing numbers of iron-folic acid supplements consumed linked to an even greater protection from death in children < 5 years of age. The authors state,"In developing countries increased use of antenatal iron-folic acid supplements will reduce deaths of children <5 y of age, especially in the first year of life."

Reference: "Iron and folic acid supplements in pregnancy improve child survival in Indonesia," Dibley MJ, Titaley CR, et al, Am J Clin Nutr, 2012 Jan; 95(1): 220-30. (Address: Sydney School of Public Health, University of Sydney, New South Wales, Australia).

Vitamin D May Decrease Mortality Risk

Summary: In this meta-analysis of prospective cohort studies investigating the effects of vitamin D status on risk of mortality, the evidence suggest that as circulating 25(OH)D levels increase, the risk of mortality decreases in a non-linear manner, with optimal concentrations between 75 and 87.5 nmol/L. Results from 14 prospective cohort studies which involved 5,562 deaths (out of 62,548 subjects) and which included data on relative risks for mortality at different 25(OH)D concentrations were analyzed and it was found that the estimated summary RR of mortality was 0.71 for the highest 25(OH)D level versus the lowest. The authors applied parametric modeling to 11 studies which included data from 59,231 subjects and results of these found the estimated summary RRs of mortality to be 0.86, 0.77, and 0.69 for individuals with an increase of 12.5, 25, and 50 nmol/L 25(OH)D serum values/L, respectively, from a median reference category of approximately 27.5 nmol. No significant decrease in mortality was found when an increase of ~87.5 nmol/L above the reference category occurred. The authors conclude, "Data suggest a nonlinear decrease in mortality risk as circulating 25(OH)D increases, with optimal concentrations ~75-87.5 nmol/L."

Reference: "Vitamin D deficiency and mortality risk in the general population: a meta-analysis of prospective cohort studies," Zitterman A, Iodice S, et al, Am J Clin Nutr, 2012 Jan; 95(1): 91-100. (Address: Clinic for Thoracic and Cardiovascular Surgery, Heart Centre North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany).

Vitamin D Supplementation and Healthy Weight May Reduce Female Mortality

Summary: This study sought to examine associations between 25-hydroxyvitamin D [25(OH)D] concentrations and cardiovascular disease (CVD), cancer, and all-cause mortality in postmenopausal women. 2,429 postmenopausal women, with 25(OH)D concentrations measured at baseline, were followed for 10 y for death from CVD, cancer, and all-cause mortality. Proportional hazards models were performed to evaluate quartiles of month-adjusted 25(OH)D concentrations, with adjustment for potential confounders. The effects of central adiposity were evaluated on the association of low 25(OH)D with all-cause mortality. Of the 2,429 women, 224 deaths occurred, with 79 deaths from CVD and 62 deaths from cancer. Multivariate-adjusted HRs that compared quartiles 1 (lowest) to 4 (highest) of 25(OH)D for all-cause mortality (HR: 1.25), CVD mortality (HR: 1.27), and cancer mortality (HR: 1.39) were not significant. There was a potential interaction between abdominal obesity and low 25(OH)D concentrations that showed an increased risk of the lowest quartile of 25(OH)D concentrations (HR: 1.85) with increased mortality in women with a normal waist circumference but no increased risk in women with abdominal obesity (HR: 0.96). These results suggest that body fat distribution may play an important role in the modulation of the effect of low vitamin D concentrations on health.

Reference: "Prospective association of vitamin D concentrations with mortality in postmenopausal women: results from the Women's Health Initiative (WHI)," Eaton CB, Young A, et al, Am J Clin Nutr, 2011 Dec; 94(6): 1471-8. (Address: Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, RI, Seattle, WA, USA).

Heart Disease Facts from the CDC

America's Heart Disease Burden

• In 2006, 631,636 people died of heart disease. Heart disease caused 26% of deaths—more than one in every four—in the United States.
• Heart disease is the leading cause of death for both men and women. Half of the deaths due to heart disease in 2006 were women.
• Coronary heart disease is the most common type of heart disease. In 2005, 445,687 people died from coronary heart disease.
• Every year about 785,000 Americans have a first heart attack. Another 470,000 who have already had one or more heart attacks have another attack.
• In 2010, heart disease will cost the United States $316.4 billion. This total includes the cost of health care services, medications, and lost productivity.

Deaths Vary by Ethnicity

Heart disease is the leading cause of death for people of most ethnicities in the United States, including African Americans, American Indians or Alaska Natives, Hispanics, and whites. Below is the percentage of all deaths caused by heart disease in 2004, listed by ethnicity.

Race of Ethnic Group	% of Deaths
African Americans	25.8
American Indians or Alaska Natives	19.8
Asians or Pacific Islanders	24.6
Hispanics	22.7
Whites	27.5
All	27.2

Deaths Vary by Geography

Across the United States, death rates due to heart disease in 2006 were highest in Mississippi and lowest in Minnesota.

Risk Prevention

• For people with heart disease, studies have shown that lowering cholesterol and blood pressure levels can reduce the risk of—
  • Dying from heart disease.
  • Having a nonfatal heart attack.
  • Needing heart bypass surgery or angioplasty.
  • For people without heart disease, lowering cholesterol and blood pressure levels can reduce the risk for developing heart disease.

Americans at Risk

Below is the percentage of U.S. adults with heart disease risk factors in 2005-2006.

Risk Factor	%
Inactivity	39.5
Obesity	33.9
High Blood Pressure	30.5
Cigarette Smoking	20.8
High Cholesterol	15.6
Diabetes	10.1

In 2003, approximately 37% of adults reported having two or more of the risk factors listed above. 

 

Dr. Andrew Myers: Antioxidants

Antioxidants

Antioxidants have the distinction of possibly being the most powerful nutritional supplements available to us while also being the most heavily marketed. It is impossible to walk down a grocery store aisle without seeing claims of the powers of antioxidants on products from juice and tea to candy bars and breakfast cereal. But do you really know what an antioxidant is and what it does? Are manufactured food products touting the power of antioxidants really healthy or is this merely marketing?

What are Antioxidants?

Antioxidants are molecules that pair their own electrons with “free radicals,” the rogue electrons that can damage cellular structures, neutralizing them. Oxidation in your body is similar to other types of oxidation. Oil becomes rancid and Iron rusts due to this process of nature. For a quick hands-on example of oxidation and the effects of antioxidants, try the following: Cut an apple into quarters. Squeeze lemon juice over two of the 4 pieces. Wait 5 minutes. You will notice, as you probably have before, that the cut apple begins to turn brown as oxidation occurs. The apple covered with lemon juice, however, does not turn brown nearly as quickly. This is how antioxidants work in the body.

Antioxidants for Prevention

Antioxidants are considered possible preventative agents for aging, cancer, diabetes, cardiovascular health, and Alzheimer’s disease. Studies have shown that antioxidant intake is associated with increased levels of “good” HDL cholesterol and lowered blood pressure. These are critical components to cardiovascular health and metabolic syndrome. One study from the University of Florida found that supplementation with antioxidants effectively reduces vascular damage caused by obesity and diabetes. Another study, from Oxford University, showed that cognitive function is higher for individuals who consume increased levels of antioxidants.

Are All Sources Equal?

Due to the many studies confirming the benefits of antioxidants, many producers of “food products” have begun to make claims of health and longevity that could be attributed to their products. Not all of these products are as beneficial as they claim. Nutritional supplements containing antioxidants are a fantastic way to consume increased levels of antioxidants. Drinking a soda or eating a pastry that claims to have antioxidant power is generally not an effective way to receive the health benefits of antioxidants. The very best way to receive these benefits is to eat fresh fruits and vegetables.

Antioxidant Foods

These are the best foods to eat and the antioxidant they contain:

• Carrots and green leafy vegetables: carotenoids
• Berries: anthocyans
• Apples, citrus fruit, and tea: flavonoids
• Vegetable oil, nuts and avocados: tocopherols
• Red wine and red grapes: resveratrol
• Dark chocolate: epicatechin
• Green tea, cinnamon, and turmeric: catechins
• Radishes and mustard: isothiocyanates
• Citrus and strawberries: Vitamin C
• Broccoli and Bruseels sprouts: indoles

Recommended Dosage

• Vitamin E: 800-1000 IU daily
• Vitamin C: 1000-2000 mg daily
• Zinc: 15-30 mg daily
• Selenium: 200 mcg daily
• Zinc: 15-30 mg daily

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