Healthy lifestyle and life expectancy free of cancer, cardiovascular disease, and type 2 diabetes: prospective cohort study.
Level 3 - non-randomized controlled study
Prospective cohort study with long-term follow-up
PubMed 31915124 · doi:10.1136/bmj.l6669
What was done
Data from two prospective cohort studies—the Nurses' Health Study (1980–2014, n=73,196) and the Health Professionals Follow-Up Study (1986–2014, n=38,366)—were analyzed to estimate life expectancy free of diabetes, cardiovascular disease, and cancer. Five low-risk lifestyle factors were assessed: never smoking, normal body mass index (18.5–24.9), moderate-to-vigorous physical activity (≥30 minutes/day), moderate alcohol intake (5–15 g/day for women, 5–30 g/day for men), and high diet quality score (top 40%).
What was found
At age 50, estimated life expectancy free of diabetes, cardiovascular diseases, and cancer was 23.7 years (95% CI 22.6 to 24.7) for women with zero low-risk lifestyle factors versus 34.4 years (95% CI 33.1 to 35.5) for women with four or five low-risk factors. For men at age 50, disease-free life expectancy was 23.5 years (95% CI 22.3 to 24.7) with zero factors versus 31.1 years (95% CI 29.5 to 32.5) with four or five factors. Male heavy smokers (≥15 cigarettes/day) and obese participants (BMI ≥30) had the lowest proportion of disease-free life expectancy (≤75% of total life expectancy at age 50).
Why it matters
This study provides quantitative estimates of how combining basic lifestyle modifications at midlife extends disease-free longevity by approximately 7 to 11 years, shifting the focus from total life extension to healthspan.
Limits
The study is observational and cannot prove direct causality. The population consists entirely of health professionals, potentially limiting generalizability across other socioeconomic and racial demographics. Lifestyle factors and health outcomes were assessed via self-report.
Cited by
- supports Adhering to comprehensive healthy lifestyle practices provides 7 to 10 additional years of life free from major age-related chronic diseases.