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Lifestyle in perspective

Bottom line

Not smoking, drinking alcohol in moderation, eating fruit and vegetables, and being physically active have a huge effect on your chance of dying. For a 58 year old over the next 11 years, with all four healthy behaviours your chance of dying is 1 in 20. With no healthy behaviours it is 1 in 4.

Data sources

KT Khaw et al. Combined impact of health behaviours and mortality in men and women: the EPIC-Norfolk prospective population study. PLoS Medicine 2008 5:e12.

What the sources tell us

This was a prospective study looking at the relationship between lifestyle and mortality in a large group of over 20,000 men and women aged 45 to 79 years at baseline (average age 58 years). The participants had no known cardiovascular or cancer at the beginning of the study, and were followed up for an average of 11 years.

The four health behaviours looked at were:

There were just under 2,000 deaths. Compared with those people who had four good health behaviours, the relative risk of dying increased as the number of health behaviours fell, so that those with none of the healthy living behaviours were four times more likely to die over the 11 years of follow up (Figure 1). The trends were biggest for cardiovascular disease.

Figure 1: Relative risk according to number of healthy behaviours (four health behaviours is referent)

Give us the odds

The figure below calculates the chance of dying for those with no healthy behaviours and four healthy behaviours, and puts them onto the perspective scale. For someone with no healthy behaviours the 11 year risk of dying is 1 in 4. For someone with four healthy behaviours it is 1 in 20 (Figure 2).

Figure 2:Risk of dying over 11 years at starting age 58 years according to the number of healthy behaviours

Risk Communication Tool (c) John Paling 2000 (



It is time people woke up to the fact that healthy behaviour is simple. Not only does it give you a longer life, but a better longer life. There is a huge additional risk with not living healthily, which completely dwarfs the risk that we see in other areas.

Healthy living gives benefits that are far in excess anything that any doctor can do for you, and is much more pleasant. It is a way of avoiding seeing your doctor, except socially.