Dr. Madhab Prasad Lamsal


An overwhelming amount of scientific research clearly demonstrates that our daily choices affect our likelihood of living a long and healthy life. Each day most all of us make decisions that ultimately have a bearing on life and health. We may not commit  suicide in a single deliberate act, but we may put harmful substances into our bodies that will prematurely cause death or decrease our quality of  life.

Many mistakenly believe that inherited traits(genetic factors) are the primary factors determining their quality of life and how long they will live. For the vast majority of us , our health is primarily dependent on two other factors: (1) what we put in to our bodies, and (2) what we do with our bodies. A simple word that encapsulates both of these concepts is life style. The good news that even though we cannot change our genetics , we can change our lifestyle. Those life style choices can prevent or forestall the development of disease for which we are  genetically predisposed. Dr. Lamont Mordoch has put  it aptly “Faulty genetics loads the gun, life style pulls the trigger”.

It is wonder why people take better care their cattle , cars etc than their bodies. We recognize the necessity of proper care to get the longest life and best performance out of our cattle and automobiles. When will we realize that proper care also gives our bodies the longest life and best performance?

According to journal of the American  medical Association (JAMA) the nine leading causes of  American death are  poor diet and inadequate exercise(582,000), Tobacco(486,000), Alcohol(107,000), Infectious Disease(90,000), Toxic agent (60,000),  Firearms(35,000), Sexual behavior(30,000), Motor vehicles(25,000), and Illicit Drugs(20,000) for the year 1990(JAMA 1993). Excluding infectious disease, toxic agent and motor vehicles are related to  life style choices: what we put into our bodies and what we do with our bodies which is over half of the total number of death. Many deaths due to infectious disease are caused by an immune system that is weakened by poor life style. These are only premature death not  included and explain about quality of life.

Today, a wealth of scientific research has confirmed that most of the leading causes of death are preventable. Just what are these life style factors that will help us to live a longer life?  Drs. Nedra Belloc and Lester Breslow present a convincing answer on their research study. In their classic study of nearly 7000 individuals living in Alameda Country, California, they found that there were seven lifestyle factors that influenced how long people lived.


  1. sleep 7 to 8 hours
  2. No eating between meals
  3. Eat breakfast regularly
  4. Maintain proper weight
  5. Regular exercise
  6. Moderate or no use of alcohol
  7. No smoking

The number of these habit that an individual followed made a tremendous impact on their longevity. One way of looking at the impact of lifestyle on longevity is by considering something referred to as “health age”. As an example , a 50 year old who embraces enough healthful lifestyle factors may have the same health or physiologic age as the average 35year old person. We could say that this individual has a “Health age” of 35. On the other hand , another 50 year old who had no regard for a healthful lifestyle may have a much older health age , perhaps as high as 72. In other words a person’s health age can be lower or higher than the  actual chronological age, depending on the number of lifestyle factors adopted.

Health age tables have been created from the  Alameda Country statistics. They cover the chronological age, range from 20 years to 70 , and are based on the same seven health habits listed above. One such table is depicted in following figure. You can use this figure as a guide to get a feel for your own health age.


Age Habits












20 +14.3 +7.4 +0.5 -1.1 -4.2 -9.4
30 +16.9 +9.1 +3.0 -0.6 -4.7 -11.1
40 +19.4 +10.7 +5.4 -0.1 -5.2 -12.9
50 +22.0 +12.4 +7.9 +0.3 -5.7 -14.7
60 +24.5 +14.0 +10.4 +0.8 -6.2 -16.4
70 +27.1 +15.7 +12.8 +1.3 -6.8 -18.2

For example , assume you are an average 40 year old Alameda Country resident. If you are following only two of the seven Belloc and Breslow’s health habits, Your health age is 40 plus 19.4, or about 59, indicating a dramatic shortening of your life expectancy. You would have the same life expectancy as the average individual 19 years older. If you continue the same lifestyle for 10 more years, when you are 50 your health age will be 50 plus22, or 72.At age 40, you had a 19 year health handicap, but at age 50 the handicap will even be worse by 3 years. In 10 years you will age 13 years!

On the other hand , if you, at 40, are consistently following all seven of  Belloc and Breslow’s health habits, your health age is only 27(40 minus 12.9). Furthermore at age 50 your health age will be only 35. In 10 years , you will only 8 years! The concept of health age illustrates how much our lifestyle can either hasten or slow the aging process.

Many people think that because of their genetics or because of some celestial clock, the day and hour of death are fixed in stone. This fatalistic attitude forces them to conclude that they can do nothing to prolong their lives. Belloc and Breslow summarized their findings in these words “These data are consistent with the idea………that a life time of good health practices produces  good health  and extends the period of relatively good physical health status by some 30 years.” These seven health principles are simple but they are extremely effective. Furthermore , they have no adverse long term side effects and offer profound benefits in the quality of life.

Primordial prevention is the action to do something about it before the epidemic occurs special attention in the prevention of chronic disease and its efforts are directed towards discouraging children from adopting harmful lifestyles. Disease prevention or reduction is both a social and  an economic necessity. As a central leading government hospital Kanti Children’s Hospital have to be focused on such program which promote healthy life style choice to attain the highest quality of life and optimal longevity including curative services. The main intervention is through individual and mass education.


Nedley, Neil. Proof positive: how to reliably combat disease and achieve optimal health through nutrition and lifestyle, 1998, ISBN 0-9661979-3-3

 K. Park, Park’s Textbook of Preventive and Social Medicine,2009,

ISBN No 978-89-906079-4-0