Maintaining a healthy lifestyle, including eating a healthy diet, regular exercise and not smoking, could prolong life expectancy at age 50 by 14 years for women and just over 12 years for men, according to new research in the American Heart Association’s journal Circulation.

America is one of the wealthiest countries worldwide, yet Americans have a shorter life expectancy compared with other high-income countries, including Japan, Canada, and Norway. Heart disease and stroke are major contributors to premature death in this country, with 2,300 Americans dying of cardiovascular disease each day, or one death every 38 seconds. Researchers point out that the US health-care system focuses heavily on drug discovery and disease management; however, a greater emphasis on prevention could change this life expectancy trend.

To quantify the effects of prevention, researchers analyzed data from two major ongoing cohort studies that includes dietary, lifestyle, and medical information on thousands of adults in the Nurses’ Health Study and the Health Professionals Follow-up Study. These data were combined with National Health and Nutrition Examination Survey (NHANES) data, as well as mortality data from the Centers for Disease Control and Prevention (CDC), to estimate the impact of lifestyle factors on life expectancy in the US population. Specifically, they looked at how the following five behaviors affected a person’s longevity: not smoking, eating a healthy diet (diet score in the top 40% of each cohort), regularly exercising (30+ minutes a day of moderate to vigorous activity), keeping a healthy body weight (18.5-24.9 kg/m), and moderate alcohol consumption (5-15 g/day for women, 5-30 g/day for men).

Over the course of nearly 34 and 27 years of follow-up of women and men, respectively, a total of 42,167 deaths were recorded, of which 13,953 were due to cancer and another 10,689 were due to cardiovascular disease. Following all five lifestyle behaviors significantly improved longevity for both men and women. Other noteworthy findings from the study include:

•Compared with people who didn’t follow any of the five lifestyle habits, those who followed all five were 74% less likely to die during the follow-up period; 82% less likely to die from cardiovascular disease; and 65% less likely to die from cancer.
•There was a direct association between each individual behavior and a reduced risk of premature death, with the combination of following all five lifestyle behaviors showing the most protection.

Between 1940 and 2014, Americans’ life expectancy at birth rose from around 63 years to nearly 79 years. However, researchers believe the improvement of life expectancy would be even larger without the widespread prevalence of obesity—a known risk factor for heart disease, stroke, and premature death.

“Quantifying the association between healthy lifestyle factors and longer life expectancy is important not only for individual behavioral changes but also for health communicators and policy makers,” said study author Frank B. Hu, MD, PhD, who chairs the Department of Nutrition at the Harvard T.H. Chan School of Public Health in Boston. “It is critical to put prevention first. Prevention, through diet and lifestyle modifications, has enormous benefits in terms of reducing occurrence of chronic diseases, improving life expectancy as shown in this study, and reducing health-care costs.”