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Research Article

Combined Impact of Health Behaviours and Mortality in Men and Women: The EPIC-Norfolk Prospective Population Study

  • Kay-Tee Khaw mail,

    To whom correspondence should be addressed. E-mail: kk101@medschl.cam.ac.uk

    Affiliation: Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom

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  • Nicholas Wareham,

    Affiliation: Medical Research Council, Epidemiology Unit, Cambridge, United Kingdom

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  • Sheila Bingham,

    Affiliation: Medical Research Council, Dunn Nutrition Unit, Cambridge, United Kingdom

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  • Ailsa Welch,

    Affiliation: Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom

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  • Robert Luben,

    Affiliation: Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom

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  • Nicholas Day

    Affiliation: Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom

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  • Published: January 08, 2008
  • DOI: 10.1371/journal.pmed.0050012

Reader Comments (6)

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Salicylates, reduced disease risk, survival advantage and telomere length

Posted by plosmedicine on 31 Mar 2009 at 00:24 GMT

Author: Gareth Morgan
Position: Secretary
Institution: Welsh Aspirin Group
E-mail: morgan@fforrdbeck.fsnet.co.uk
Submitted Date: March 28, 2008
Published Date: April 1, 2008
This comment was originally posted as a “Reader Response” on the publication date indicated above. All Reader Responses are now available as comments.

Five years ago, my Kaplan-Meier survival curve model suggested that taking daily low-dose aspirin (acetylsalicylate) from the age of 50 years might double the chances of surviving into the tenth decade of life (1). A more recent observational study of 20,000 men and women aged 45 – 79 years in east England found that 4 factors namely regular exercise, 1-14 units of alcohol per week (unit = glass of wine or half pint of beer), eating 5 servings of fruits and vegetables per day and not currently smoking might prolong life by 14 years (2). From my model, low-dose aspirin started at the age of 50 years might prolong life by 6-9 years. Of importance and interest would be the combined effect of the 4 factors and low-dose aspirin on survival.

Telomeres are unique protective protein–DNA structures found at the end of chromosomes. Telomere length decreases with age but lifestyle appears to influence this, for example individuals who take regular exercise have longer telomere length compared to less active individuals (3). Smoking and obesity are also associated with reductions in telomere length (4) although the latter may also have a genetic influence (5). Perhaps low-dose aspirin, or more generally the intake of dietary salicylate in fruits and vegetables, could help prolong survival and slow the ageing process by reducing the rate of telomere shortening (6). Experimentally, this hypothesis may be tested in the adult population given the wide usage of aspirin but perhaps children may also benefit from increased exposure to salicylate, for example by having reduced risk of diseases like asthma (7) and childhood cancer (8). If salicylate does beneficially effect telomere length then this might strengthen the case to reclassify it as an essential micronutrient possibly with the name of ‘vitamin s’ (8).

References

1. Khaw HT, Wareham N, Bingham S, Welsh A, Luben R. Combined impact of health behaviours and mortality in men and women : the EPIC-Norfolk Prospective Population Study. PLoS Med 2008;5(1):e12.

2. Morgan GP. A quantitative illustration of the public health potential of aspirin. Medical Hypotheses 2003;60(6): 900-2.

3. Cherkas LF, Hunkin JL, Kato BS, Richards JB, Gardner JP, Surdulescu GL, Kimura M, Lu X, Spector TD, Aviv A. The association between physical activity in leisure time and leukocyte telomere length. Arch Intern Med. 2008 Jan 28;168(2):154-8.

4. Valdes AM, Andrew T, Gardner JP, Kimura M, Oelsner E, Cherkas LF, Aviv A, Spector TD. Obesity, cigarette smoking, and telomere length in women. Lancet. 2005 Aug 20-26;366(9486):662-4.

5. Wardle J, Carnell S, Haworth CMA, Plomin R. Evidence for a strong genetic influence on childhood adiposity despite the force of the obesogenic environment. American Journal of Clinical Nutrition, Vol. 87, No. 2, 398-404, February 2008.

6. Mitteldorf J. How evolutionary thinking affects people's ideas about aging interventions. Rejuvenation Res. 2006 Summer;9(2):346-50.

7. Varner AE, Busse WW, Lemanske RJF. Hypothesis : decreasing use of pediatric aspirin has contributed to the increasing prevalence of childhood asthma. Ann. Alergy Asthma Immunol. 1998;81:347-51.

8. Morgan GP. Perhaps salicylate (vitamin S) may protect against childhood cancer. Medical Hypothesis 2005;64(3):661.

Gareth Morgan, Welsh Aspirin Group Secretary. 41 Fforrd Beck, Gowerton, Swansea, SA4 3GE. Email : morgan@fforrdbeck.fsnet.co.uk

No competing interests declared.