New research published by the American Heart Association (AHA) suggests that adults in the US who follow 5 healthy lifestyle habits may live more than a decade longer compared with people who follow none of the 5 habits. These 5 habits are:

• eating a healthy diet
• getting regular exercise
• not smoking
• staying at a healthy weight
• limiting alcohol

Starting at age 50, men in the study were estimated to have an average life expectancy of 14 years and women were estimated to have an average life expectancy of 12 years when they followed all 5 habits. The study was published April 30, 2018 in the AHA journal Circulation.

The study authors point out that the US ranks 31^st in the world for life expectancy among those born in 2015, even though it’s one of the richest countries in the world and spends more on health care per person as a percent of gross domestic product than any other country. According to the authors, the US healthcare system focuses mainly on drug discovery and disease management, even though a greater emphasis on prevention could go a long way toward controlling the most common and most expensive diseases, including cancer and cardiovascular disease.

The researchers looked at data of 123,219 people enrolled in the Nurses’ Health Study from 1980 to 2014 and the Health Professionals Follow-up Study from 1986 to 2014. They used information on death rates from the Centers for Disease Control and Prevention to estimate the impact of the 5 healthy lifestyle habits on how long people lived. Among the findings:

• During a follow-up period of up to 34 years, 42,167 people in the study died.
• Of the reported deaths, 13,953 were due to cancer and 10,689 were due to cardiovascular disease.
• In men and women who reported following all 5 healthy lifestyle habits, life expectancy was found to be lengthened. At age 50 years, women who adopted none of the healthy lifestyle habits had an average remaining life expectancy of another 29 years compared with 43.1 years for women who adopted all 5 healthy lifestyle behaviors. Men aged 50 who adopted none of the healthy lifestyle habits had an average remaining life expectancy of another 25.5 years compared with 37.6 years for men who adopted all 5 healthy lifestyle habits.
• Those who followed all 5 healthy habits were found to be 74% less likely to die during the follow-up period than those who followed none of the habits. They were 82% less likely to die from cardiovascular disease and 65% less likely to die from cancer.
• Each individual healthy habit was directly linked to a reduced risk of premature death in this study, with the combination of all 5 habits showing the lowest risk.

How healthy is ‘healthy?’

To compare diets among the study participants, researchers created a scoring system that gave higher scores to people who reported eating more foods considered healthy and fewer foods considered unhealthy. Healthy foods included vegetables, fruits, nuts, and whole grains. Unhealthy foods included red and processed meats, sugar-sweetened beverages, trans fat, and sodium. The American Cancer Society recommends:

• Eating at least 2 ½ cups of vegetables and fruits each day
• Choosing whole-grain breads, pasta, and cereals (such as barley and oats) instead of breads, cereals, and pasta made from refined grains, and brown rice instead of white rice.
• Choosing fish, poultry, or beans instead of red meat (beef, pork, and lamb) and instead of processed meat (bacon, sausage, lunch meats, and hot dogs).
• Drinking more water and less of sugar-sweetened beverages such as soft drinks, sports drinks, and fruit-flavored drinks.
• Limiting refined carbohydrate foods, including pastries, candy, sugar-sweetened breakfast cereals, and other high-sugar foods.
• Avoiding calorie-dense foods such as French fries, potato and other chips, ice cream, doughnuts, and other sweets.

Participants also received the highest health scores if they never smoked, if they got more than 30 minutes per day of moderate or vigorous activity (including brisk walking), if they kept their body weight within a body mass index (BMI) range of 18.5 – 24.9, and if they limited alcohol to less than 15 grams a day for women and less than 30 grams a day for men. That calculates to about 1 drink a day for women and 2 for men.