From the journals

Four small lifestyle changes can mean an extra 14 years

If your New Year's resolve to eat better and be more active is wearing thin, here's some news that may help bolster your efforts: scientists have reported that people who engage in just four healthy behaviors — eating five or more servings of fruits and vegetables a day, drinking moderately, not smoking, and getting some kind of physical activity daily — live 14 years longer, on average, than people who don't have these habits. This finding, published in the January 2008 issue of the journal Public Library of Science Medicine, held true even among people who were overweight.

Many studies have examined the benefits of individual healthy behaviors, such as getting regular exercise or adhering to a particular diet, but this study focused on the combined effect of a few modest — and realistically achievable — lifestyle choices.

British researchers with the European Prospective Investigation into Cancer and Nutrition (EPIC) kept track of 20,244 healthy men and women, ages 45 to 79, who filled out health behavior questionnaires between 1993 and 1997. Participants were given one point for each of the following healthy habits: not smoking, taking one to 14 drinks per week, having some level of physical activity (at the very least, a job that required standing or up to one-half hour of daily recreational activity), and having a blood level of vitamin C that was consistent with eating five or more servings of fruits and vegetables a day.

All of the subjects were given medical examinations before enrolling in the study to make sure they didn't have heart disease, cancer, circulatory problems, or other health problems that would put them at risk for premature death.

For 11 years, the researchers recorded deaths from all causes among the participants. After taking age, sex, body mass, and social class into account, the investigators found that those who had a health behavior score of four were four times less likely to die prematurely than people who had a score of zero — an advantage equivalent to being 14 years younger. Those with a score of two were two times less likely to have died. The greatest effect was seen in deaths attributed to heart disease and stroke. Interestingly, vitamin supplements were not associated with greater longevity.

Although these findings will need to be confirmed in other populations and evaluated for their effect on quality of life, they suggest that a handful of behaviors that don't require extreme changes can substantially reduce our risk for premature death — particularly from cardiovascular disease, the biggest killer of men and women in the United States.

In this study, higher vitamin C levels in the blood were associated with extra years, but that doesn't mean that vitamin C supplements would have the same effect. It's not "vitamin C by itself that's related to mortality," explains Dr. Kay-Tee Khaw, one of EPIC's principal investigators, "but rather that vitamin C is a good marker for dietary intake of plant foods, [which] have many more bioactive nutrients than vitamin C alone that may be related to health."

For more information about the health benefits of fruits and vegetables, visit www.hsph.harvard.edu/nutritionsource/fruits.html. To learn more about fruits and vegetables and the amounts you need for your age and activity level, go to www.fruitsandveggiesmatter.gov.