3 bad habits may start affecting health as early as age 36

Share on PinterestSmoking, heavy drinking, and being physically inactive may start affecting health negatively earlier than expected. AOosthuizen/Getty Images

• A multi-decade study finds that the damage done by smoking, heavy drinking, and being physically inactive begins at a far younger age than previously understood.
• Although the unwanted health consequences of these habits over the long term are well-known, the research offers evidence that their negative impact, though not as severe, actually occurs over the short term.
• Participants in the study were assessed for depression, sense of well-being, metabolic risk, and sense of healthfulness, all of which suffered as a result of smoking, drinking, and being inactive.

While it is no surprise that a lifetime of smoking, heavy drinking, and physical inactivity is a recipe for ill health later in life.

Now, a new study finds that these habits can result in health issues as young as the age of 36, including their influence on mental health.

The study is an analysis of data from the Jyväskylä Longitudinal Study of Personality and Social Development that had begun tracking individuals’ lifestyles and health as children in the Finnish city of Jyväskylä in 1959. At the beginning of the study, there were 326 participants, with 206 remaining at the end of data collection.

The analysis used mental and physical health data collected from the participants at ages 27, 36, 42, 50, and 61.

Participants responded to surveys regarding symptoms of depression and general psychological well-being.

Individuals’ physical health was tracked as a metabolic risk score that took into account their blood pressure, waist circumference, lipids, cholesterol, and blood sugar levels. All can serve as biomarkers for a various health conditions if they are out of the normal range.

Participants were also asked to rate their health over the previous year.

Heavy drinking is defined as consuming more than eight portions of alcohol per week for women, or 15 for men. Sufficient physical activity is described as 150 minutes of moderate-to-vigorous physical activity per week, plus strength training. The study does not describe any level of cigarette smoking as being healthy.

Individuals who were engaged in all three unhealthy habits at the time of questioning at any age from 36 and older experienced poorer mental and physical health compared to those who did not share these habits.

Their depressive symptoms rose a tenth of a point, psychological well-being fell by the same amount, and their metabolic risk rose by 0.53 points. Their self-rated health declined by 0.45 points.

For people whose smoking, heavy drinking, and sedentary lifestyle persisted over the long term, the results were significantly worse. Their depression scores went up by 0.38, their sense-of well-being dropped further, by -0.15 points, and their metabolic risk spiked to 1.49. Their self-rating of their health likewise suffered, falling to -0.82.

“While all three behaviors are clearly harmful, deciding which is most harmful is challenging. This is because each behavior’s impact can be influenced to varying degrees by other external factors,” said David Cutler, MD, board-certified family medicine physician at Providence Saint John’s Health Center in Santa Monica, CA, who was not involved in the study.

“The risks of smoking will be greater in those who have other respiratory problems. The risks of alcohol [will be] greater in those with other drug use disorders, and the impact of inactivity likely greater in those with other health risk factors like high blood pressure, diabetes, and obesity.”
— David Cutler, MD

Interestingly, “when we analyzed behaviors separately, they were associated with partly different outcomes,” reported the study’s first author Tiia Kekäläinen, PhD, of Laurea University of Applied Sciences in Vantaa, Finland.

Kekäläinen said that smoking, for example, was associated with worsened mental well-being, in the analysis, while physical inactivity was associated with negetive health outcomes, and heavy alcohol consumption with both aspects.

Kanwar Kelley, MD, JD, is a board-certified otolaryngologist (ENT) and Co-founder & CEO of Side Health, who was also not involved in the study. He pointed out that of the three, “the research on smoking and tobacco use is the most robust.”

“However, tobacco and lack of physical activity rank consistently at the top for preventable causes of death by a relatively large margin,” said Kelley.

The study notes that there may also be a circular effect in which these habits lead to poor mental health and vice versa, making cause and effect difficult to unravel.

”Ultimately, these are all avoidable risk factors, and counseling and education should be provided on the possible risks for poor health outcomes,” Kelley affirmed.

The study makes clear that smoking, drinking, and inactivity begin to take their toll on health at a younger age than one might think. The challenge now is getting that message across to an audience at a time of life when they may feel at their most invulnerable.

Still, the need is clear, Kekäläinen said: “The longer the exposure, the more risks for health and mental well-being it causes. It is also harder to change the behaviors later when they have become habits.”

“Since we do not know the threshold at which these behaviors become harmful, the message we should be sending young people is that any amount of these behaviors can be harmful. Deciding where to draw the battle line will be more difficult.”
— David Cutler, MD

“Counseling should be used at every possible interaction with individuals with these health behaviors,” said Kelley.

However, “Lecturing young people on the harms will often alienate them and make them less likely to follow our well-intended advice,” cautioned Cutler. “By maintaining positive, supportive relationships with those engaging in these harmful activities, we are more likely to influence them to alter their behavior.”

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