Two Studies That Support This Claim

The Nurse’s Health Study and the Health Professionals Follow-Up Study collectively assessed over 120,000 participants with regular evaluations every two years for more than 30 years. Those who adhered to five “low-risk lifestyle” factors experienced considerably longer lives compared to those who did not. For instance, a 50-year-old woman could expect an additional 14 years of life (increasing from 29 to 43 extra years), while a man of the same age could gain 12 additional years (from 26 to 38 years).

The five lifestyle factors identified in these long-term studies included: never smoking (versus smoking), maintaining a normal BMI (versus being overweight), engaging in at least 30 minutes of moderate exercise daily (like brisk walking), consuming alcohol in moderation (as opposed to excessive drinking), and following a nutritious diet (compared to poor eating habits). High blood pressure and high cholesterol were excluded from this analysis, as they typically necessitate medical intervention.

Participants received a score based on their adherence to these five lifestyle factors, where a score of 5 indicated full compliance, and 0 indicated none. As shown in the accompanying table, around 7% of participants adhered to none of the five factors, while only 1% followed all five, and 9% adhered to four. Most participants fell within the 1–3 score range.

During the observation period, approximately 42,000 participants passed away. Death certificates were analyzed, revealing that around 14,000 died from cancer, 11,000 from cardiovascular diseases, and the rest from various other causes.

For a 50-year-old woman who followed all five lifestyle factors, her 14 additional years of life expectancy were attributed to a 31% reduction in cardiovascular disease mortality, 21% due to lower cancer rates, and 48% due to a decrease in deaths from other causes. For a 50-year-old man, the additional 12 years were linked to a 34% reduction in heart disease, 23% from cancer, and 43% from other causes.

Each of the five factors contributed positively, with each adding roughly two years to life expectancy. However, moving from a score of 4 to 5 could add nearly four years for women and two years for men.

For older individuals starting at 80, the five factors still hold considerable importance, although the increase in life expectancy diminishes with age. For instance, an 80-year-old woman could gain about five additional years with a score of four and nearly nine years with a perfect score of five. Older men also see benefits, though typically not as pronounced as women's.

You might argue that comparing those with no factors to those with all five isn't entirely fair, as most individuals likely adhere to at least two or three factors. The question remains: is there a significant benefit if someone moves from three to four or five? Absolutely. Each additional healthy lifestyle factor could yield about two extra years for a 50-year-old woman, with the transition from four to five contributing an extra four years.

What about the 80-year-old? The benefits still exist, albeit smaller, but nonetheless meaningful. For me, at 81, gaining even a few additional years of good health is tremendously valuable.

This study is just one among many that highlight the advantages of adopting healthier lifestyles. Numerous other studies have reached similar conclusions, despite variations in definitions, participant demographics, and geographical locations.

Additional Research on Lifestyle and Longevity

A Japanese study involving roughly 62,000 participants over an average of 13 years found that healthy lifestyles could add an estimated 8 years for women and 10 years for men, along with a substantial decrease in mortality—ranging from 40% to nearly 50%—for those adhering to all six evaluated lifestyle factors compared to those who followed 0-2. The six factors included not smoking, avoiding heavy drinking, walking for at least one hour daily, sleeping between 6.5 and 7.5 hours, eating green leafy vegetables regularly, and maintaining a BMI between 18.5 and 25. Note the inclusion of sleep, emphasis on vegetables, and a longer exercise duration.

The authors also noted that individuals with low lifestyle scores tended to be younger, less educated, experience higher mental stress, and were less likely to have a spouse. Although stress wasn’t measured as a lifestyle factor, it emerged as a notable aspect in the demographic analysis.

In another long-term study conducted in Rotterdam with about 6,000 participants over an average of 11 years, five lifestyle factors were examined. Participants were categorized into three groups: least healthy, moderately healthy, and most healthy. Compared to the least healthy group, those who did not smoke, consumed alcohol in moderation, maintained a healthy weight, followed a balanced diet, and exercised reasonably gained 4.5 years for men and 3.4 years for women at age 45, with similar improvements noted for those at ages 65 and 85.

A German study, the EPIC (European Prospective Investigation into Cancer and Nutrition)-Heidelberg cohort, included around 22,000 adults recruited between 1994-98, all over 40 years old and free from diabetes, heart disease, or cancer at the start of the study. They were monitored for an average of 11 years. Lifestyle factors varied slightly from other studies, focusing on heavy smoking, obesity, excessive alcohol consumption, and high intake of processed/red meat, contrasting with non-smokers, optimal BMI (defined as 22.5 to 24.9), low alcohol intake, and limited processed/red meat consumption. Exercise was not assessed.

Comparing those adhering to all lifestyle factors to those with none revealed a significant loss of life expectancy—17 years for men and 14 years for women.

A 2010 Canadian Community Health Survey analyzed 90,000 individuals regarding their alcohol consumption, physical activity, diet, and smoking habits using the Canadian Mortality Population Risk Tool (MPoRT). Those adhering to four health behavior recommendations enjoyed an 18-year increase in life expectancy compared to those with the least favorable risk profile (88 years versus 70 years). Smoking and physical inactivity were identified as primary contributors to reduced lifespan.

While these studies did not address chronic stress, only one included sleep, and none evaluated the importance of intellectual engagement and social interaction, I will explore these aspects in future articles.

Lifestyle Changes Contribute to a Longer Healthspan

While the various studies may yield different estimates of added years, the overarching trend is clear—healthy lifestyles lead to increased years of vitality. Each investigation revealed not only a greater lifespan but also a reduction in chronic illnesses, resulting in an extended healthspan. Initiating healthy habits as early as possible is ideal, yet even those aged 80 or 85 will see benefits. This strongly indicates that it is never too late to make a change.

The evidence is clear: lifestyle choices significantly influence lifespan, the onset of chronic diseases, and overall healthspan.

Key Takeaways

I don't want to overwhelm you with a list of "shoulds." Instead, consider this a gentle nudge.

It's never too late to start, nor is it too early, as investing in your health yields dividends over the years. Begin slowly; attempting too much at once may lead to discouragement if you struggle. Focus on one area, such as exercise. Aim for a 30-minute walk daily. You'll likely feel better and motivated to keep going. Gradually incorporate resistance exercises a few times a week—these can be done at home without equipment, such as planks, crunches, pushups, and squats. As your endorphins rise, you'll feel more energized and eager to continue.

Next, consider your dietary choices, and take it step by step. Don’t be disheartened if you can’t do everything right away; every small change matters. It’s not about what you “should” do, but about what makes you feel better.

Remember: this information serves an educational purpose. Always consult your doctor or nurse practitioner before starting any exercise program.

Stephen C Schimpff, MD, MACP, is the author of *Longevity Decoded — The 7 Keys to Healthy Aging.