Leading a country comes with extraordinary privileges but also, apparently, a price: new research suggests heads of state age faster, the stress of the job shaving maybe three years off their life expectancy.
Doctors have analysed how long presidents and prime ministers in 17 countries - including Britain, Canada, France, Germany and the US - survived after leaving office, compared to the losing candidates.
They also observed the number of years heads of state lived versus what was expected for someone of the same age and gender.
After considering the fates of 279 heads of state and 261 runner-ups, they concluded former leaders lived almost three fewer years than expected.
The study was published online on Monday in the medical journal, The BMJ.
"To lose a few years is significant," said senior author, Harvard Medical School's Dr Anupam Jena.
"(Leaders) probably felt national priorities were much more pressing than eating right and exercising," he said, saying former US President Bill Clinton's admitted weakness for fast food may have resulted in "stress eating".
"Maybe if there had been world peace, his lifestyle would have been different," Jena said.
After leaving office, Clinton had bypass surgery; he subsequently said he lost weight and became vegan to try to reverse his heart disease.
Other researchers have found US presidents actually live longer than their constituents.
"The stress (of leading a country) could accelerate the greying of hair and wrinkling of skin but that doesn't mean they'll die earlier," said S. Jay Olshansky, a professor at the University of Illinois at Chicago.
His research on former commanders in chief found they had a longer-than-expected life expectancy, partly because they are from the top one per cent of the population who are highly educated, wealthy and have better access to health care than most.
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