Maximizing Your Longevity By Removing Certain Risk Factors

Senior people doing exercises in gym to stay fit


By removing certain risk factors in your life, you can statistically extend it. This article provides a brief overview of those factors and their impacts on longevity. The most important factors across demographics are: smoking cessation or avoidance, managing blood pressure, removal of excess body weight, reduction of blood sugar, and adequate exercise. Managing these risk factors well can extend life by approximately 9 years.


I want to thank Elliott Fisher for his time and work on this research and for pushing my own thinking around improving Medicare and population health.

Key Risk Factors

In their research on predictive models for modifiable risk factors of death as published in Population Health Metrics, Fisher, et al. studied data from more than 8,000 patients to isolate and determine key factors that might predict longevity. Their results (below) indicate that certain key factors can extend life expectancy and that joint effects of those factors can lead to differences of almost 9 years. 


Table 1: Life expectancy gains in the US population (in years) by removing risk factors
Risk Factor




High blood pressure



Excess body weight



High blood sugar



High cholesterol



Low physical activity



Low nut intake



Low vegetable intake



Low fruit intake



Low omega-3 intake



Alcohol intake



Inadequate seat belt use



Joint effects



In more practical and population health terms, clinicians and patients might think about how they can improve performance around the following variables to extend life expectancy. 

Key Risk Factors Defined

Table 2: List of risk factors with the corresponding exposure metric
Risk Factor
Exposure Metric

Excess body weight

Body mass index (kg per m2)

High blood pressure

Systolic blood pressure (mmHg)

High cholesterol

LDL cholesterol (mg/dl)

High blood glucose

Fasting plasma glucose (mg/dl)

Seat belts

How often a seat belt is worn:

  • Always or does not drive or ride in a car
  • Nearly always
  • Sometimes
  • Seldom
  • Never

Tobacco use

Three smoking categories:

  • Non-smoker
  • Current smoker
  • Former smoker

Alcohol use

Includes both average consumption and pattern of drinking (binge drinking)

Average consumption:
  • Abstainer not having had a drink containing alcohol in the last 30 days;
  • 0–19.99 g of pure alcohol daily (females) and 0–39.99 g (males)
  • 20–39.99 g (females) and 40–59.99 g (males);
  • ≥40 g (females) and ≥60 g (males)

Binge drinking was defined as having at least one occasion of five or more drinks in the last month (men) or four or more drinks in the last month (women)

Physical activity

Based on physical activity during the past 30 days:

  • Inactive, no moderate or vigorous physical activity;
  • Low-active, <2.5 h/wk of moderate activity or <600 MET min/wk;
  • Moderately active: either ≥2.5 h/wk of moderate activity or ≥1 h of vigorous activity; and ≥600 MET min/wk;
  • Highly active: ≥1 h/wk of vigorous activity and ≥1,600 MET min/wk.

Binge drinking was defined as having at least one occasion of five or more drinks in the last month (men) or four or more drinks in the last month (women)

Fruit intake

Dietary fruit intake over the past 30 days (average grams per day)

Vegetable intake

Dietary vegetable intake over the past 30 days (average grams per day)

Omega-3 fatty acids intake

Dietary omega-3 fatty acids during the past 30 days (average milligrams of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) per day)

Nut intake

Dietary nut and seed intake, including peanut butter during the past 30 days (average grams per day)

Top Opportunities for Population Health Improvement

  1. Smoking — avoidance or smoking cessation is the strongest individual variable affecting human longevity, according to this study.
  1. High blood pressure — avoiding and managing high blood pressure conditions is the second most significant factor.
  1. Excess body weight — helping patients or focusing on proper body weight is the third most significant criterion. This can be a hard-to-measure concept; excess fat or BMI indices have often been used as proxies for this.
  1. High blood sugar — normal blood sugar levels (and avoidance of high blood sugar or diabetic conditions) is linked to more than 1 year of longevity.
  1. Physical activity — at least 2.5 hours per week of moderate physical activity or more than 1 hour per week of vigorous physical activity can substantially extend longevity. Beyond those amounts, there aren’t clear indications of gained longevity benefits.
Risk Factors andLife Expectancy Gains

About Pearl Health

Pearl Health’s mission is to democratize access to value in healthcare. Pearl empowers primary care physicians to deliver better quality care for their patients at a lower cost via a physician enablement technology platform and a value-based payment model, starting with Medicare’s ACO REACH Model. Pearl’s technology provides simple financial reporting, visibility into patient panel health, and recommendations to allocate time and resources to deliver care to patients who need it most.

Learn more at, and follow us on LinkedIn and Twitter.

Media Contact

Madison Klein
Director of Product Marketing
[email protected]

Michael Kopko

Michael Kopko

Chief Executive Officer, Pearl Health