Don’t smoke, eat healthily, exercise regularly, and go easy on the alcohol, and you are likely not only to have fewer chronic health problems, but also to live longer, according to a new study from the US Centers for Disease Control and Prevention (CDC) that concludes neglecting to follow these four healthy behaviors is responsible for much of the illness and death linked to chronic diseases.

A report on the study is published in the 18 August issue of the American Journal of Public Health and finds that even practising one of these health behaviors can make a difference to length of life, although not smoking has the biggest impact.

7 out of 10 deaths in the US every year is as a result of a chronic disease like heart disease, cancer, or stroke: just these three account for more than 50% of annual deaths among Americans.

For the study, CDC researchers used data on 16,958 people who took part in the National Health and Nutrition Examination Survey III Mortality Study from 1988 to 2006. All of them were aged 17 years and above and were considered to be a representative sample of people living in the United States.

An analysis of links between four low-risk behaviors – never smoked, healthy diet, adequate physical activity, and moderate alcohol consumption (no more than two drinks a day for men, one per day for women) – and mortality, found the following results:

  • The number of low-risk behaviors was inversely related to the risk of death: the more behaviors, the lower the risk.
  • Compared with participants who had no low-risk behaviors (ie people who smoked, did not exercise enough, did not follow a healthy diet and drank more than a moderate amount of alcohol), those who practised all 4 were 66% less likely to die early from cancer, 65% less likely to die early from a major cardiovascular disease, and 57% less likely to die early from other causes.
  • 40 to 50% of the participants already practised at least one of the four healthy behaviors.

The researchers conclude that:

“Low-risk lifestyle factors exert a powerful and beneficial effect on mortality.”

They suggest the goal should be for more people to practise more of the 4 healthy behaviors. They acknowledge this is a tough public health challenge, because while smoking rates have come down, and it appears that more people are now exercising, it does not look like many Americans are eating more healthily than before.

The CDC suggests you:

  1. Avoid Tobacco: if you don’t smoke, don’t start, and if you do, quit now. Get in touch with 1-800-Quit-Now and they will help you (for resources in other countries, contact your local health authority, or look for useful resources on the internet, such as
  2. Limit Alcohol: men should have no more than two drinks a day, women no more than one.
  3. Improve Your Diet: eat more fruits, vegetables, whole grains, switch to fat-free and low-fat dairy and seafoods. Cut down on salt and foods high in sodium, saturated fats, trans fats, cholesterol, added sugar, and refined grains.
  4. Exercise: do at least 150 minutes of moderate exercise such as brisk walking spread over at least five days each week, or on three days a week or more, do a total of 75 minutes of vigorous exercise such as jogging or race walking (this raises heart rate more than brisk walking).

Written by Catharine Paddock PhD