Outside the index, and inside it

More markers

Organized the way the calculator itself is organized: by body area. Everything here is outside the score, and reading this page does not change your calculator score.

Fiber, steps and sleep are scored, so they live with the 8 metrics: Dietary fiber, Daily steps, Sleep duration.

Lifestyle

Nut intake

People who ate more nuts had a lower risk of dying, with most of the association already present at a fairly modest amount.

Add a small daily handful of nuts — whole nuts, not peanut butter.

Not in the integer Overlap with fiber. No separate dose in the integer.

Diet quality

Closer adherence to a Mediterranean-style diet score was associated with a lower risk of dying.

Score the whole eating pattern, not one "good" or "bad" food.

Not in the integer Overlap with fiber. No separate dose in the integer.

Sleep regularity

How consistent sleep and wake times are from night to night may matter independently of how long you sleep.

Go to bed and wake at the same time.

Not in the integer Overlap. Sleep duration already holds the scored sleep window.

Tooth loss

Losing natural teeth to disease or decay was associated with a higher risk of dying in women.

See a dentist. Keep the natural teeth you still have.

Not in the integer No dose the integer can weight.

Social connection

Weaker contact with other people is associated with a higher risk of dying. Isolation and loneliness are two different pools.

Spend time with people you care about.

Not in the integer Wrong endpoint. Isolation is not one of the eight.

Purpose & optimism

People who scored higher on purpose or optimism had a lower risk of dying in pooled cohorts. Neither has been tested in a trial that tries to raise it.

Find what gives your day meaning, and notice what is going well.

Not in the integer Wrong endpoint. No mortality dose the integer can weight.

Cardiometabolic

Waist circumference

Context · not scored

Higher hazard in the study bins. Not your risk, and not a point on the score.

Cerhan 2014, 650,386 adults, PMID 24582192. Women: 95 cm or more versus under 70 cm, HR 1.80 (1.70–1.89). Men: 110 cm or more versus under 90 cm, HR 1.52 (1.45–1.59). Those are the study bins, not a guideline.

Not in the integer No defensible relative weight inside this index. Waist-to-height is not this card.

Measure the same way each time: level tape, mid-point between the lowest rib and the top of the hip bone, end of a normal exhale. Reading this card does not change the calculator.

ApoB

ApoB counts the particles that can lodge in artery walls. The evidence here is heart disease, not death from all causes.

An optional heart lab. The evidence here is heart disease, not death from all causes.

Not in the integer Wrong endpoint. Heart disease, not death from all causes.

Waist-to-height ratio

Most people watch the scale. The scale can’t see where fat sits. This ratio can, and a higher one was linked to a higher risk of dying, even after accounting for BMI.

Not this version of the waist card.

Not in the integer Not in this version. The card below is Cerhan circumference bins, not a ratio.

Physical Capacity

MVPA

You don’t need to be an athlete to get most of the benefit. The biggest drop in risk came from simply leaving the least-active group.

Add minutes at a pace that raises your breathing — a brisk walk counts.

Not in the integer Overlap. Steps already hold the movement volume.

Sitting time

Sitting is the quiet one. Each daily hour added a little risk, and past about 8 hours it climbed faster, even for people who exercise.

Spend more of your day moving: stand, walk or pace for a few minutes each hour.

Not in the integer Overlap. Steps and strength already hold that ground.

Grip strength

A weaker grip is associated with a higher risk of dying. That is a marker of whole-body strength, not a training result that has been shown to lower the risk of death.

Squeeze a hand dynamometer. Enter the stronger hand.

Not in the integer Overlap. It is a strength readout, not a habit, and strength training already holds that ground.

Balance

Failing a 10-second one-leg stand was associated with a higher risk of dying in one clinic cohort.

Hold a 10-second single-leg stand.

Not in the integer Older-adult clinic cohort only. No dose the integer can weight.

Gait speed

A faster usual walking speed is associated with a lower risk of dying in older adults.

Walk at a steady usual pace.

Not in the integer Older-adult only.

Hearing

The comparison is any hearing loss versus normal. Whether hearing aids lower the risk of death is unproven.

Get a hearing check. Whether hearing aids lower the risk of death is unproven.

Not in the integer Wrong endpoint for this index. Aids have not been shown to lower the risk of death.

Muscle mass

Liu 2017 (6 cohorts, 7,367 community-dwelling older adults; PMID 28778327): sarcopenia was linked to 60% higher mortality than no sarcopenia. Low muscle plus reduced function, not muscle mass alone.

Ask a clinician about a muscle-mass or sarcopenia screen if you are over 60.

Not in the integer Older-adult only. No dose in the integer.

Back to the calculator — the 8-metric score.