Health risk factors and the risk of death

The Introductionheart-angiogram

At the tender age of 55 years, I am increasingly starting to see more chronic disease and people dying – both at my parents generation and my own. How much of this is related to lifestyle I often ask myself. Physical inactivity, diets low in fruit and vegetables, smoking, and alcohol consumption (all modifiable risk factors) have been shown to be related to higher risks of cardiovascular disease, cancer and increased death rates. This recently published study examined the individual and combined influence of these risk factors on total and cause-specific death rates. The more risk factors you have, the greater your chance of dying early!

The Research

This United Kingdom Health and Lifestyle Survey included 4886 individuals at least 18 years old from a United Kingdom-wide population in 1984 to 1985. A health behaviour score was calculated, allocating 1 point for each poor behaviour: smoking; fruits and vegetables consumed less than 3 times daily; less than 2 hours physical activity per week; and weekly consumption of more than 14 units of alcohol (in women) and more than 21 units (in men) (range of points, 0-4). Twenty years later, the researchers examined the statistical relationship between health behaviours and death and compared it with the death risk associated with aging.

The Results

During a follow-up period of 20 years, 1080 participants died – 431 from cardiovascular diseases, 318 from cancer, and 331 from other causes. The relative risk (chances of dying) for total mortality associated with 1, 2, 3, and 4 of the above poor health behaviours compared with those with none were 1.85 (one risk factor), 2.23 (two risk factors), 2.76 (three risk factors), and 3.49 (four risk factors), respectively with the differences all being significantly different. That is, the more risk factors you have, the greater your chances of dying. Those with all four risk factors compared with those with no poor health behaviours had an all-cause mortality risk equivalent to being 12 years older than their actual age.

The So What?

The combined effect of poor health behaviours on mortality was substantial, indicating that modest, but sustained, improvements to diet and lifestyle could have significant health benefits.


Kvaavik, E., Batty, G.D., Ursin, G., Huxley, R. and Gale, C.R. (2010) Influence of individual and combined health behaviors on total and cause-specific mortality in men and women: the United Kingdom health and lifestyle survey. Archives of Internal Medicine. 170(8): 711-718.

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