The combined effects of healthy lifestyle behaviors on all cause mortality: A systematic review and meta-analysis

• Published in: Preventive medicine Vol. 55; no. 3; pp. 163 - 170
• Main Authors: Loef, Martin, Walach, Harald
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2012
• Subjects: Adult; Aged; Aged, 80 and over; All-cause mortality; Cause of Death; Cohort studies; Female; Humans; Indexing in process; Internal Medicine; Life Style; Lifestyle; Male; Middle Aged; Mortality; Physical activity; Relative risks; Risk factors; Risk Reduction Behavior; Robustness; Sensitivity analysis; Young Adult; Lifestyle; All-cause mortality; Risk factors; Cohort studies
• ISSN: 0091-7435; 1096-0260
• DOI: 10.1016/j.ypmed.2012.06.017

Abstract Objective Lifestyle factors are related to mortality. Although much is known about the impact of single factors, the current evidence about the combined effects of lifestyle behaviors on mortality has not yet been systematically compiled. Method We searched Medline, Embase, Global Health, and Somed up to February 2012. Prospective studies were selected if they reported the combined effects of at least three of five lifestyle factors (obesity, alcohol consumption, smoking, diet, and physical activity). The mean effect sizes that certain numbers of combined lifestyle factors have on mortality were compared to the group with the least number of healthy lifestyle factors by meta-analysis. Sensitivity analyses were conducted to explore the robustness of the results. Results 21 studies (18 cohorts) met the inclusion criteria of which 15 were included in the meta-analysis that comprised 531,804 people with a mean follow-up of 13.24 years. The relative risks decreased proportionate to a higher number of healthy lifestyle factors for all cause mortality. A combination of at least four healthy lifestyle factors is associated with a reduction of the all cause mortality risk by 66% (95% confidence interval 58%–73%). Conclusion Adherence to a healthy lifestyle is associated with a lower risk of mortality.