Four behaviours which can add an average of 14 years life expectancy have been identified in a study led by Cambridge University.

The research, spearheaded by Dr. Kay-Tee Khaw at Cambridge's Institute of Public Health, found that those who exercised regularly, ate five portions of fruit and vegetables a day, didn't smoke, and had a moderate alcohol consumption lived an average of 14 years longer than those who adopted none of these behaviours.

The study's results are particularly important given the ageing population of many European nations, including the UK. All four factors are achievable lifestyle changes which can improve quality of life for middle-aged and older people.

20,000 men and women aged 45-79 took part in the study. Between 1993 and 1997 they completed a questionnaire, which awarded them a score between 0 and 4.

A point was awarded for not smoking, an alcohol intake of between 1 and 14 units per week, a level of Vitamin C in the blood consistent with eating five portions of fruit and vegetables a day, and not being physically inactive. Physical inactivity was defined as having a sedentary job and not taking any form of exercise in leisure time. Deaths were then recorded in the subject group till 2006.

After taking account of the influence of age, the researchers found that, over the course of 11 years, those who had a score of zero were four times more likely to die than those with a score of four.

They also found that those scoring zero had the same risk of dying as those who were 14 years older than them but scored four in the questionnaire. Both of these findings were independent of social class or Body Mass Index.

The Cambridge study, which is part of the European Prospective Investigation into Cancer and Nutrition, is unusual in focusing on the combined impact of these activities. Whilst there is a great deal of evidence about the impact on health and life expectancy of these factors singly, very little research has been conducted on their combined effect.

The study, titled Combined Impact of Health Behaviours and Mortality in Men and Women: The EPIC-Norfolk Prospective Population Study, has been published by the Public Library of Science's journal PLoS Medicine (see sidebar).

An accompanying editorial addresses the issues involved for individuals trying to make these lifestyle changes, and the complex processes by which research becomes public policy.


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