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Session: Nutrition-related Factors in Aging and Chronic Disease (Poster Theater Flash Session 7)

(PTFS07-07-23) Eight Modifiable Lifestyle Factors Associated With Increased Life Expectancy Among 719,147 U.S. Veterans

Monday, July 24, 2023

8:25 AM – 8:29 AM ET

Location: Fairfax

Presenting Author(s)

Xuan-Mai T. Nguyen, MS4 (she/her/hers)

Medical Student
Carle Illinois College of Medicine
Champaign, Illinois, United States

Disclosure(s): No relevant financial relationship(s) with ineligible companies to disclose.

Co-Author(s)

YL

Yanping Li

VA Boston Healthcare System
DW

Dong D. Wang, ScD

Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School
Boston, Massachusetts, United States
SW

Stacey B. Whitbourne

VA Boston Healthcare System
SH

Serena Houghton

VA Boston Healthcare System
Frank B. Hu, MD, MPH, PhD

Chair, Department of Nutrition Harvard T.H. Chan School of Public Health Fredrick J. Stare Professor of Nutrition and Epidemiology at Harvard T.H. Chan School of Public Health Professor of Medicine, Harvard Medical School and Brigham and Women’s Hospital
Harvard T.H. Chan School of Public Health
Boston, Massachusetts, United States
WW

Walter c. Willett, DrPH, MPH, MD

Professor
Harvard T.H. Chan School of Public Health
Boston, Massachusetts, United States
JG

J. Michael Gaziano

VA Boston Healthcare System
KC

Kelly Cho, PhD, MPH

VA Boston Healthcare System
Jamaica Plain, Massachusetts, United States
PW

Peter WF Wilson, MD

Atlanta VA Healthcare System
Jamaica Plain, Massachusetts, United States

Disclosure(s):

Xuan-Mai T. Nguyen, MS4: No relevant financial relationship(s) with ineligible companies to disclose.

Frank B. Hu, MD, MPH, PhD: No relevant financial relationship(s) with ineligible companies to disclose.

Objectives: Chronic diseases are associated with over 80% of all healthcare costs and are the dominant cause of morbidity and mortality in the United States (US). Lifestyle medicine has been proposed as a potential way to address the root causes of chronic disease and their associated health care costs. This study aims to estimate mortality risk and longevity associated with individual therapeutic lifestyle factors and comprehensive lifestyle therapy in a large cohort of US veterans.

Methods: Prospective cohort study of 719,147 participants aged 40-99 years enrolled in the Million Veteran Program (MVP) between 2011-2019. We calculated age- and sex-specific mortality rates and hazard ratio (HR) for mortality. Eight therapeutic lifestyle factors included never smoking, being physically active, not regularly binge drinking, good sleep hygiene, good diet, minimal stress, positive social relationships, and no opioid addiction. Study outcome was all-cause mortality and estimated reductions in life expectancy.

Results: Based on 1.13 million person-years of follow-up with 33,375 deaths, we observed a mortality rate per 1000 person-years of 72.6, 46.3, 36.3, 29.8, 25.2, 20.8, 15.7, 12.3 and 7.4 among veterans who adopted 0, 1, 2, 3, 4, 5, 6, 7 and 8 lifestyle factors, respectively. Multi-adjusted HR for mortality was 0.95 (95%CI: 0.93-0.98) for those with positive social relationships, 0.82 (0.80-0.84) for those with good sleep hygiene, 0.81 (0.79-0.83) for non-binge drinkers, 0.79 (0.77-0.80) for those with good diet, 0.78 (0.77-0.80) for those with minimal stress, 0.71 (0.69-0.73) for non-smokers, 0.62 (0.59-0.66) for those with no opioid use disorder, and 0.54 (0.53-0.56) for physically active veterans, compared with their counterparts. Compared to those with no adopted lifestyle factors, veterans with a combination of 8 individual therapeutic lifestyle factors had a 13% reduction in all-cause mortality. Men and women who adopted 8 therapeutic lifestyle factors could gain 23.7 or 22.6 years of life expectancy, respectively, at age 40 years compared to those with no adopted lifestyle factors.

Conclusions: Therapeutic lifestyle factors were independently associated with a significantly lower risk of premature mortality, and the combination of these factors was associated with a multiplicative lower mortality risk.

Funding Sources: VA Office of Research and Development