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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

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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.


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.


Some lifestyle habits are strongly related to lifetime mortality and longevity.

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Correspondence to Paolo Emilio Puddu.

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None of the authors report any conflict of interests in relation to this MS and related analyses.

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The initial field examination was held only a few months after the Helsinki Declaration and acceptance from the subjects was implied in participation. All methods were carried out in accordance with relevant guidelines and regulations at the time of the study start, although institutional or licensing committees were not still present in the Country and accordingly were not consulted.

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Informed consent was obtained from all subjects during subsequent examinations.

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Menotti, A., Puddu, P.E. & Catasta, G. 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. Aging Clin Exp Res 33, 3091–3098 (2021).

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