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Single lifestyle or multiple break-ups could increase risk of inflammation and early death in middle-aged men

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A large population study published online in the Journal of Epidemiology & Community Health indicates that living alone for several years and/or facing repeated relationship break-ups are closely linked to elevated levels of inflammatory markers in the blood–but only in men.

Although the inflammation was considered low-grade, it persisted, indicating a higher risk of age-related illness and death, according to the researchers.

Divorce and serious relationship break-ups, which are frequently followed by a potentially protracted period of living alone, have been linked to an increased risk of poor physical and mental health, reduced immunity, and death.

However, most previous research has only looked at the effects of one partnership dissolution, and then only on marital breakups.

In this study, the researchers wanted to know if the number of partnership break-ups or years lived alone had an effect on the immune system response in middle age, and if gender and educational achievement were factors.

They used data from 4835 people in the Copenhagen Aging and Midlife Biobank (CAMB) project, all of whom were between the ages of 48 and 62.

4612 (3170 men and 1442 women) provided information on serial breakups, including 83 deaths of the spouse, and 4835 (3336 men and 1499 women) provided information on years spent alone from 1986 to 2011.

Years spent alone were divided into three categories: under one year, which was used as the reference group since it is highly common and deemed normal; 2–6 years; and 7 years or more. 

Age, educational attainment, early major life events (loss of a parent, financial worries, family conflict, foster care); weight (BMI); long-term conditions; medicines likely to affect inflammation (statins, steroids, non-steroidal anti-inflammatory drugs, immunosuppressants); recent bouts of inflammation; and personality trait scores were also obtained as potential influencing factors (neuroticism, agreeableness, and conscientiousness).

In blood samples, the inflammatory markers interleukin 6 (IL-6) and C-reactive protein (CRP) were analyzed. 

In this study, approximately half of the participants had gone through a relationship break-up, and a comparable amount had spent more than a year living by themselves (54 percent of women, 49 percent of men).

An estimated 1 in 5 people had less than 10 years of education, and around 6 in 10 people had at least one long-term health issue. Half of the women and almost two-thirds of the males had been through early major life events, and half of the women and nearly two-thirds of the men were overweight or obese.

The highest levels of inflammatory markers were detected in men who had suffered the most breakups in their relationships. Inflammatory indicators were 17 percent higher in this group than in the control group. Inflammatory indicators were also up to 12 percent higher in the group that had spent the most time alone (7 or more).

Men with high educational attainment and 2–6 years living alone (CRP) and 7 or more years living alone (CRP) had the highest values of both inflammatory markers for years lived alone (IL-6).

However, these findings were only seen in men; no similar connections were seen in women.

Following a breakup, men tend to externalize their behavior, such as by drinking, but women tend to internalize, manifesting in depressed symptoms, which may alter inflammatory levels differently, according to the study.

They also point out that the study only covered a limited number of women (1499), which could explain the disparity.

As this is an observational study, it cannot demonstrate cause and effect. The researchers also note that the participants’ average age was 54, a time when the full effects of inflammatory chemical exposure may not have yet manifested. They also point out that men had higher inflammatory reactions than women of the same age.

They explain that immune system competence declines with age, resulting to systemic low-grade inflammation, which is thought to play a role in a number of age-related illnesses, including cancer, cardiovascular disease, and type 2 diabetes.

“Small numbers of breakups or years lived alone is not in itself a risk of poor health, but the combination of (many) years lived alone and several break-ups is in our study shown to affect both CRP and IL-6 levels significantly,” according to the authors. 

“The levels of inflammation in our study are low, but they are also significant, clinically relevant, and most likely a risk factor for increased mortality,” they point out, adding that there are “notable numbers of people living with low level inflammation.”

They continue: “Since the number of one-person households has been increasing throughout the past 50–60 years in most high-income countries, this group of people going through relationship break-ups, or who are living on their own for different reasons, are part of at-risk groups.”

Source: 10.1136/jech-2021-217422

Image Credit: Getty

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