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How long will I live?

Longevity and healthy life depends on lifestyle choices we make, but not all the time

How long will I live?

The one thing most people would like to know is how long will they live. This need has spawned generations of fortune tellers that try to answer this essentially unanswerable question. My favourite story about a rather unfortunate fortune teller is of one such person who was asked by a king, how long will I live and how shall I die. The fortune teller worked his arts, consulted all his star charts and then said, my lord you will die a violent death within the next year.

On hearing this, the king went into a state of terminal depression. The grand vizier watching his monarch feel so sad, asked the fortune teller, my man what do your arts say about your own life? The fortune teller replied, my lord based upon my calculations I will live to a ripe old age and die in my sleep. On hearing this, the vizier took out his sword and killed the fortune teller right there and then. That was the end of the fortune teller and his fortune telling days. And yes the king felt all better and, as kings did, immediately awarded his vizier a heavy gold cloth robe (khalat) and a large estate as a gift.

All said and done, in modern times projections can and are made about life expectancy. Insurance actuaries are modern day fortune tellers and they use their arcane arts to predict the life expectancy of people applying for insurance and on their predictions depend what a person then pays as premiums for his or her insurance. Also such ‘predictions’ form the basis of many government programmes. Perhaps the best demonstration of unintended consequences based on such predictions was the ‘Medicare Act’ passed in 1965 that provided ‘free’ health insurance for all United States (US) citizens above the age of 65.

In 1965 the life expectancy of an average US citizen was around 66 or 67 years and as such I am sure the actuaries employed by the US government did not foresee a prolonged insurance regime. However, because of this new programme and the money that became available, in a few decades medical research was able to ‘increase’ life expectancy by more than a decade virtually throwing this programme into impending bankruptcy. The US government now pays around 13000 dollars per year in medical bills for each US citizen above the age of 65. Serious money that.

The bottom line then is, if you are not fat, you indulge in some exercise like running every day and you don’t smoke, the chances are that you will live a reasonably long life. Unless of course if you get run over by a truck while running.

Today, ‘meta data’ is the new ‘lord and master’ of the known universe. Based upon large amount of information available about individuals, it has become possible to ‘predict’ longevity based upon ‘lifestyle’ choices. Such predictions exclude ‘acute’ or sudden interventions like accidents, infections, war and homicide. Perhaps the most interesting recent compilation of risks and their effect on human longevity are summed up in a book, The Norm Chronicles: Stories and Numbers About Danger and Death by Michael Blastland and David Spiegelhalter. (Basic Books.)

An article by the authors in Slate Magazine (September 8, 2014) titled ‘Measuring Micro Lives’ summarises the authors points of view. What the authors have come up with is the concept of micro-lives, and what they mean by that is that every day is divided into half hour periods called micro-lives and that leads to 48 micro-lives in a day. The basic presumption is that every adult has a million micro-lives to live. They then examine the effect of different lifestyle choices on these micro-lives.

Based upon the author’s evaluation of lifestyle choices, smoking 15 to 24 cigarettes per day cuts down the micro-lives by ten for each day. What this means is that smoking that many cigarettes decreases life expectancy by five hours for every day. This then leads to a decrease in life expectancy by a little less than eight years. This is one of the major causes of decreased life expectancy in their calculations.

After smoking, the next lifestyle choice if that can be called one that decreases life expectancy is obesity. Being ‘fat’ cuts down life expectancy by around two and a half years. An interesting part of this particular situation is that having a waist size in excess of half of your height decreases life expectancy. Of the other factors that decrease life expectancy by a year or less include eating ‘red meat’, being ‘sedentary’, living in a place with air pollution, and consuming alcoholic beverages.

On the other side, lifestyle choices that increase life expectancy include at the top, eating multiple servings of fruits and vegetables every day. This can add around four years to your life expectancy. This is followed by exercise that can add up to three years to how long you live. Interestingly, taking a Statin (medicine that decreases blood Cholesterol level) adds about a year. The same is true of drinking two to three cups of coffee every day!

There are however two important non-lifestyle choices that are significant. First is that of ‘gender’. Women live almost four years longer than men just because they are women. This is a fact borne out by actuarial survival data. Most of us live in male dominated societies where men are the lords of all that they survey. Yet it is women that live longer than men in even the most male dominated societies. Go figure.

The other non lifestyle choice that is the most important in terms of longevity is where we live. In the author’s calculations, living in Russia rather than Sweden decreases life expectancy by more than 14 years for a male and about ten years for a female. Of course, if we compare Sweden to Pakistan, the difference in life expectancy would probably be worse.

The problem for countries like Russia is that there is a diverse population that, as they say, ‘falls through the cracks’. Unlike countries with small populations like Sweden, Russia or for that matter countries like India, Pakistan and much of the developing world, a universal healthcare system that is available in the Scandinavian countries is just not possible. It is not just healthcare but also a social safety network that provides education, adequate financial support and employment opportunities for all citizens.

Therein lies the problem with calculating longevity for readers of this column. Since most of them can read English it is therefore obvious that they are not poor. That of course also presumes that they know well enough about the harmful effects of smoking, the advantages of exercise and the bad effects of obesity. Most of them evidently eschew consumption of red meat which perhaps is the reason why they now consume chicken ‘everything’ including the abomination of chicken seekh kababs. Sadly, they donrealise that consuming large amounts of chicken in whatever form can still push their waist lines to above half of their heights.

The bottom line then is, if you are not fat, you indulge in some exercise like running every day and you don’t smoke, the chances are that you will live a reasonably long life. Unless of course if you get run over by a truck while running.

Syed Mansoor Hussain

syed mansoor hussain
The author has served as Professor and Chairman, Department of Cardiac Surgery, King Edward Medical University.

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