This study examined combinations of lifestyle factors in relation to cancer, cardiovascular, and all-cause mortality during 24 years of follow-up among 77,782 middle-aged women from the Nurses’ Health Study. During the 24 years of follow-up, the authors documented 8,882 deaths, including 1,790 from cardiovascular disease and 4,527 from cancer. Population-attributable risks of cardiovascular mortality were 33% for cigarette smoking, 31% for overweight, 28% for lack of physical activity, 18% for low diet quality, and 11% for absence of light to moderate alcohol consumption. The authors also evaluated the combinations of these four lifestyle risk factors in relation to mortality. They found that the population-attributable risks for having these risk factors were 72% for cardiovascular mortality, 44% for cancer mortality, and 55% for all-cause mortality. Van Dam et al. concluded that adhering to lifestyle guidelines involving a healthy diet, regular physical activity, and weight management as well as avoiding cigarette smoking are associated with markedly lower mortality.
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