A Negative Trifecta

Three proven picks for poor health and well-being

A trifecta bet is a horse racing wager in which you pick which three horses will finish first, second, and third in a race, in that order. In the healthy living department, a negative trifecta might be the three worst lifestyle choices you could embrace. Here are my “top” three picks.

Number 1 – Live a sedentary lifestyle

A recent review and meta-analysis of 34 studies extended the adverse effects to sedentary behavior to death arising from all-causes or cardiovascular disease, as well as incident type 2 diabetes. Even after accounting for varying levels of physical activity, all-cause mortality and cardiovascular mortality increased non-linearly as the amount of total sedentary behavior increased. That is, the curve of risk turned upward as total sedentary behavior increased. The risk of all-cause and cardiovascular mortality increased even more as the amount of TV viewing increased. The risk of developing type 2 diabetes increased linearly as either total sedentary behavior or amount of TV viewing increased. The risk of all-cause and cardiovascular mortality increased above a threshold of 6-8 hours per day of total sitting and 3-4 hours per day of TV viewing, respectively. To help you win the negative trifecta, sit for at least 10 hours a day, preferably watching TV. In addition, move as little as possible and do not elevate your heart rate.

Number 2 – Eat lots of junk food

Researchers at Harvard used data from 120,877 men and women participants in three large, long-term studies from 1986 to 2006 to determine which foods led to the greatest weight gain. Increased consumption of potato chips, French fried potatoes, processed or unprocessed meats, and sugar-sweetened drinks had the greatest impact. Interestingly, increased intake of other foods, namely yogurt, nuts, fruits, whole grains, and vegetables, predicted significant weight loss. Thus, one straightforward strategy to promote weight gain is to load up on ultra-processed food-like materials that have lots of added sugar, processed red meat, refined grains, and other highly processed foods. Stay away from nuts, fruits, and vegetables.

Other researchers found exercising frequently seemed to offset the weight-gaining effects of eating lots of sugar. Larger intakes of sugar result in some of the fructose being metabolized in the liver. In sedentary people, large intakes of fructose over several days lead to unhealthy results: the liver producing fats and triglycerides as well as increased fat in liver cells. However, the result does not occur in physically active people. Just one more reason to avoid physical activity at all costs to win the negative trifecta, live poorly and die young.

And speaking of ultra-processed foods, a recent study showed that they account for 58 percent of calories and 90 percent of added sugar consumed by Americans. Consumption of ultra-processed foods predicts elevated risk of chronic diseases including type 2 diabetes, cardiovascular disease, obesity, and hypertension, among others. Following the NOVA classification of ultra-processed foods, participants were grouped into quartiles based on daily frequency of ultra-processed food intake. Interestingly, less than 1 percent of the participants reported eating no ultra-processed foods. Participants in the highest quartile of ultra-processed food consumption ate significantly more calories, less protein and had lower healthy diet scores. Compared to participants in the lowest quartile of ultra-processed food intake (0-2.5 times per day), participants in the highest quartile (5.2-29.7 times per day) had a 31 percent greater risk of all-cause mortality during 19 years of follow-up. This result did not change substantially following statistical adjustment for demographic and socio-economic confounding factors, as well as processed meat consumption and diet quality. While the underlying mechanisms remain murky, current science suggests boosting intake of ultra-processed foods will harm your health and increase your chances of a negative trifecta.

Number 3 – Minimize enjoyable contact with other people

Social isolation is widely believed to be undesirable for most people but not for those seeking the negative trifecta. Social isolation might shorten your life. The English Longitudinal Study of Aging followed 6,500 men and women over age 52 to evaluate the association of social isolation with mortality. Researchers compared the risk of dying during the seven-year follow-up period for persons who displayed the highest and lowest levels of social isolation. The risk of dying for the most socially isolated people, compared to the least socially isolated, ranged from 20-56 percent higher, depending on which confounding factors (such as age, sex, demographic factors) were included in the analyses.

Loneliness researchers Louise Hawkley and John Cacioppo proposed that loneliness (defined as perceived social isolation) accelerates the rate of age-related declines in physiological regulation and resilience. Several possible pathways include making fewer healthy choices, exposure to stressors, perceived stress, stress response, and the reduced ability to recuperate from stress.

The Kungsholmen Project, a Swedish study, recruited 1,203 non-demented, community-dwelling residents of Stockholm, aged 75 or older, with good mental faculties. After three years, researchers found that, compared to married people living with someone, those who were single and lived alone had a 90 percent higher risk of developing dementia. Compared to those with daily to weekly satisfying contacts, those who had no friends or relatives had a 60 percent higher risk of dementia. Compared to people who had daily to weekly satisfying contacts with children, those who had daily to weekly unsatisfying contacts with children showed a 100 percent higher risk of dementia. A composite index of social network factors showed a graded, increasing risk of dementia as the social network diminished from extensive to moderate to limited to poor. The risk of dementia was 8.26 (!) times higher for people in the poor category compared to those in the extensive category. Thus, you’ll likely increase your risk of dementia and boost your negative trifecta chances if you don’t Cultivate Social Connections.

Putting it all together

Here’s how to win the negative trifecta: Watch lots of TV (alone as much as possible), while eating plenty of junk food, especially potato chips. Stay in your easy chair except to make trips to the refrigerator for another extra-large soda. Live alone, don’t make friends, and don’t answer the phone. Don’t answer the door, either.

Of course, I am NOT really recommending that you follow the path to the negative trifecta. I hope that presenting the three components of the negative trifecta will motivate you move in the other direction and embrace the healthy lifestyle choices of Keep Moving, Eat Better, and Cultivate Social Connections. You’ll likely live better and longer that way.

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