A new study involving over 700,000 US veterans reports that people who adopt eight healthy lifestyle habits, including having good sleep hygiene, by middle age can expect to live substantially longer than those with few or none of these habits. 

In addition to good sleep hygiene, the other seven habits are: being physically active, being free from opioid addiction, not smoking, managing stress, having a good diet, not regularly binge drinking, and having positive social relationships.

According to the results, men who have all eight habits at age 40 would be predicted to live an average of 24 years longer than men with none of these habits. For women, having all eight healthy lifestyle factors in middle age was associated with a predicted 21 additional years of life compared to women with none of these habits.

“We were really surprised by just how much could be gained with the adoption of one, two, three, or all eight lifestyle factors,” says Xuan-Mai T. Nguyen, health science specialist at the Department of Veterans Affairs and rising fourth-year medical student at Carle Illinois College of Medicine, in a release. “Our research findings suggest that adopting a healthy lifestyle is important for both public health and personal wellness. The earlier the better, but even if you only make a small change in your 40s, 50s, or 60s, it still is beneficial.”

Nguyen will present the findings at Nutrition 2023, the flagship annual meeting of the American Society for Nutrition, held July 22–25 in Boston.

For the study, scientists used data from medical records and questionnaires collected between 2011 and 2019 from 719,147 people enrolled in the Veterans Affairs Million Veteran Program, a large, nationally representative study of US veterans. The analysis included data from adults aged 40 to 99 and included 33,375 deaths during follow-up.

Overall, the results showed that low physical activity, opioid use, and smoking had the biggest impact on lifespan; these factors were associated with around a 30-45% higher risk of death during the study period. Poor sleep hygiene, stress, binge drinking, and poor diet were each associated with around a 20% increase in the risk of death, and a lack of positive social relationships was associated with a 5% increased risk of death.

According to researchers, the findings underscore the role of lifestyle factors in contributing to chronic diseases, such as type 2 diabetes and heart disease, that lead to premature disability and death. The results also help to quantify the degree to which making healthy lifestyle choices can help people reduce their risk of such diseases and live longer.

“Lifestyle medicine is aimed at treating the underlying causes of chronic diseases rather than their symptoms,” says Nguyen in a release. “It provides a potential avenue for altering the course of ever-increasing health care costs resulting from prescription medicine and surgical procedures.”

The estimated gain in life expectancy from adopting the eight healthy lifestyle factors grew slightly smaller with age but remained significant, meaning that adopting healthier habits at an older age can still help you live longer. “It is never too late to adopt a healthy lifestyle,” says Nguyen in the release.

As an observational study, the research does not definitively prove causality, Nguyen notes in the release. However, the findings align with a growing body of research supporting the role of lifestyle factors in preventing chronic diseases and promoting healthy aging.

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