Healthy Lifestyle And All-cause Mortality Risk In Adults And Older Adults

A healthy lifestyle is important in maintaining and promoting overall health and well-being. Physical activity, nutrition, tobacco and alcohol consumption and sleep are health-related behaviors considered key components of a healthy lifestyle. PURPOSE: To analyze the individual and clustered associations between key health-related behaviors forming the healthy lifestyle composite score and mortality risk in adults and older adults. METHODS: We used data from 95,142 adults (60,903 women) aged 35 to 112 years from the Mexican Health and Aging Study (MHAS). Information on health behaviors (physical activity, fruit and vegetable intake, sleep, alcohol intake, and smoking) were self-reported. All-cause mortality was monitored during a 22-year follow-up (up to 31 December 2020), according to the International Classification of Diseases version 10 (ICD-10). The proportional hazards Cox regression was used to estimate the mortality risk ratio (RR) according to the individual and clustered health-related behaviors. RESULTS: Individual level analysis revealed that physical activity (RR = 0.88, 95%CI: 0.84, 0.92), fruit and vegetable intake (RR = 0.94, 95%CI: 0.91, 0.98), alcohol intake (RR = 0.86, 95%CI: 0.81, 0.92), and smoking (RR = 0.93, 95%CI: 0.89, 0.97) decreased the risk of mortality, but not sleep. All-cause mortality risk progressively decreased with each additional health behavior (from RR = 0.92 [0.86-0.99] to RR = 0.71 [0.63, 0.81]). CONCLUSION: Clustering health behaviors provides additional benefits, potentiating their effects on all-cause mortality. Our findings can assist current policy efforts to prevent behavioral risk factors and create effective strategies to promote the health of the adult population.