It's hardly news that if you take care of yourself you'll live longer and if you don't, you won't. This is  nonetheless something men—who continue to lag behind women in life expectancy—need to be reminded of. Now, a new study takes one of the most exhaustive looks ever at just which risk factors spell the most trouble for men and how that translates into the amount of years they can expect to stay alive.

In research just published in the Journal of the American Medical Association, investigators at the Pacific Health Research Institute and Kaukini Medical Center in Honolulu, Hawaii followed 5,820 Japanese-American men for up to 40 years, from 1965 to 2005, looking for which ones lived the longest and why. All of the men were free of serious illness when the study began and all of them were then evaluated in terms of either survival to particular ages or what the researchers called exceptional survival. Exceptional survival was defined as being alive at a given age without significant cognitive or physical impairment and without any of six major ailments: heart disease, cancer, stroke, obstructive pulmonary disease, Parkinson's disease or diabetes. On average, 42% of the men survived to 85 years old, but only 11% exceptionally survived—or made it there disease-free.

What it means: The true significance of the study is in the variables that distinguished the survivors from all of the other men and the exceptional survivors from even that long-lived group. On the whole, all of the men who survived to 85 avoided smoking, excessive alcohol consumption, hyperglycemia, hypertension and excessive weight as early as middle age and kept those healthy habits up over the years. They were also, as a rule, married. The exceptional survivors had all of these qualities and were also well-educated and avoided high triglycerides.

As the researchers teased the numbers apart they discovered precisely how powerful these good-health variables could be. People with none of the critical risk factors had a 69% chance of making it to 85 years, while people with six risk factors or more clocked in at just 22%. Among exceptional survivors at 85 years old, 55% had no risk factors and a mere 9% had six or more.

The idea that if you want a healthy old age you'll have to work for it may not surprise anyone. But it's eye-opening to learn just how reliable a thing that actuarial payoff can be. What's more, with the 85-plus population representing the fastest-growing age group in most industrialized nations, and with health care at that age often costing more than ay any other time in life, the dividends are paid to everyone.

From the Archive:

Aug. 30, 2004: How to Live to Be 100
Nov. 25, 1996: Can We Stay Young?