Lifestyle as determinant of all-cause mortality and age at death. A middle-aged male population followed-up 60 years until the survivors were aged 100 years.

OBJECTIVES: To relate major lifestyle habits with all-cause mortality in an almost extinct male middle-aged population. MATERIAL AND METHODS: A 40-59 aged male population of 1712 subjects was enrolled and examined in 1960 and then followed-up for 60 years. Baseline smoking habits, working physical activity and dietary habits, each subdivided into 3 classes, were related to 60-year mortality, by Kaplan-Meier survival curves, Cox proportional hazards model and to age at death during 60 years by multiple linear regression. RESULTS: Death rate in 60 years was of 99.7% with only 5 survivors and 2 lost to follow-up after 50 years. Two out of three classes of each behavior were significantly protective versus the third class in all the statistical approaches. Cox hazard ratios (and their 95% confidence limits) of never smokers versus smokers was 0.71 (0.63-0.79); that of vigorous physical activity versus sedentary activity was 0.75 (0.64-0.89); that of Mediterranean diet versus Not Mediterranean diet was 0.74 (0.66-0.84). The gain of age at death for never smokers versus smokers was 3.32 years (2.05-4.54); of vigorous physical activity versus sedentary activity was 3.53 years (1.68-5.37); that of Mediterranean diet versus Not Mediterranean diet was 3.67 years (2.32-5.02). Age at death was more than 10 years longer for men with the 3 best behaviors than for those with the 3 worst behaviors. CONCLUSIONS: Some lifestyle habits are strongly related to lifetime mortality and longevity.