Researchers followed over 111,000 Korean adults for 18 years to see how healthy lifestyle choices affected their chances of living longer. People who did five healthy things—didn’t smoke, exercised regularly, drank moderately, maintained a healthy weight, and ate well—had dramatically lower risks of dying from any cause, cancer, or heart disease. Women who followed all five habits cut their overall death risk by 62%, while men reduced theirs by 35%. The study shows that combining multiple healthy behaviors is more powerful than doing just one thing right.
The Quick Take
- What they studied: Whether following five healthy lifestyle habits together could help people live longer and reduce their chances of dying from major diseases
- Who participated: Over 111,000 Korean men and women, average age 55, who answered health questions between 2004 and 2013 and were tracked for up to 19 years
- Key finding: People who followed all five healthy habits—no smoking, regular exercise, moderate drinking, healthy weight, and good diet—had 35-62% lower chances of dying during the study period compared to those who followed none of these habits
- What it means for you: Making multiple healthy lifestyle changes together appears to be much more protective than making just one change. The benefits were especially strong for people over 55. However, this study shows association, not proof that these habits directly cause longer life.
The Research Details
This was a long-term follow-up study where researchers tracked the same group of people over nearly two decades. Participants answered detailed questions about their lifestyle when they joined the study between 2004 and 2013, including what they ate, whether they smoked, how much they exercised, and how much alcohol they drank. Researchers then followed their health records until the end of 2023 to see who got sick or died and from what causes.
The researchers created a ‘healthy lifestyle score’ by counting how many of five healthy behaviors each person did: never smoking or having quit smoking, exercising at least 30 minutes on 5 or more days per week, drinking alcohol in moderation (less than 40 grams daily for men, 20 for women), keeping body weight in a healthy range, and eating a diet low in unhealthy plant-based foods (like refined grains and sugary drinks). People got points for each habit they followed.
The researchers used statistical methods to compare death rates between people with high scores and low scores, while accounting for other factors that might affect health like age and education.
This research approach is valuable because it follows real people over a very long time, which helps show what actually happens in everyday life rather than in a controlled lab setting. The large number of participants and long follow-up period make the results more reliable. By looking at multiple lifestyle factors together rather than one at a time, the study shows how combinations of healthy habits work together.
The study’s strengths include its large size (over 111,000 people), long follow-up period (up to 19 years), and careful tracking of actual deaths from medical records. The researchers also adjusted their analysis for other factors that could affect results. However, the study only included Korean adults, so results may not apply equally to other populations. Also, people self-reported their lifestyle habits, which can sometimes be inaccurate. The study shows association between healthy habits and longer life, but cannot prove that the habits directly cause longer life.
What the Results Show
The results were striking: women who followed all five healthy habits had a 62% lower risk of dying from any cause compared to women who followed none of these habits. Men who followed all five habits had a 35% lower risk. For cancer deaths specifically, women in the highest healthy lifestyle group had a 48% lower risk, and men had a 38% lower risk. For heart disease deaths, the protection was even stronger: women had a 70% lower risk and men had a 66% lower risk.
When researchers looked at each healthy habit separately, all five were important. Not smoking was especially critical—when researchers removed smoking from the healthy lifestyle score, the protective benefits dropped significantly, particularly for men. This suggests that quitting smoking may be one of the most important single changes someone can make.
The benefits were stronger for older adults (age 55 and up) than for younger adults. A 60-year-old following all five habits saw much greater protection than a 45-year-old following the same habits. This makes sense because older adults have higher baseline risks of serious diseases.
Diet quality also mattered significantly. People who ate the healthiest diets (mostly whole plant foods, not processed foods) had about a 26-33% lower risk of dying compared to those eating the least healthy diets.
The study found that each individual healthy behavior contributed to the overall protection. Exercise, maintaining a healthy weight, moderate alcohol consumption, and good diet quality all independently reduced death risk. However, the combination of all five habits was much more powerful than any single habit alone. This suggests that healthy behaviors work together synergistically—they’re stronger together than separate.
These findings align with previous research showing that multiple healthy lifestyle factors reduce disease risk. However, this study is notable for examining a comprehensive score combining all factors together in a large Asian population, where dietary patterns differ from Western populations. Previous studies have often looked at individual factors separately, so this comprehensive approach adds new evidence about how combined habits work.
The study only included Korean adults, so results may not apply equally to people of other ethnicities or from other countries with different food cultures and healthcare systems. People reported their own lifestyle habits at the start of the study, and memory or honesty can affect these reports. The study shows that healthy habits are associated with longer life, but cannot prove the habits directly cause longer life—other unmeasured factors could be involved. Additionally, lifestyle habits were measured mainly at the beginning of the study, so changes over 19 years weren’t fully captured.
The Bottom Line
If you want to live longer and reduce your disease risk, focus on these five habits: (1) Don’t smoke—if you do, quitting is the single most important change; (2) Exercise at least 30 minutes on most days of the week; (3) Keep your weight in a healthy range; (4) Drink alcohol only in moderation if at all; (5) Eat a diet rich in whole plant foods like vegetables, fruits, and whole grains while limiting processed foods. The evidence is strong that doing all five together is much more protective than doing just one or two. Start with whichever habit feels most achievable for you, then gradually add others.
Everyone should care about these findings, but they’re especially important for people over 55, people with family histories of cancer or heart disease, and current smokers. If you’re younger and healthy, these habits still matter for long-term prevention. People with existing health conditions should talk to their doctor before making major lifestyle changes, especially regarding exercise intensity.
You may notice some benefits quickly—better energy and mood from exercise can appear within weeks. However, the major protective benefits against serious diseases develop over years and decades. Don’t expect to see dramatic health changes in a few months; think of these habits as long-term investments in your health.
Want to Apply This Research?
- Track your ‘healthy lifestyle score’ weekly by logging: (1) smoking status, (2) minutes of moderate-to-vigorous exercise per day, (3) alcoholic drinks consumed, (4) weight, and (5) diet quality rating (1-10 based on how much whole food vs. processed food you ate). Aim to improve your score each week.
- Start a ‘Five Habits Challenge’: Pick one habit to focus on each week for five weeks. Week 1: Commit to one form of exercise you enjoy. Week 2: Add a daily vegetable or fruit serving. Week 3: Reduce alcohol or set a drinking limit. Week 4: Track your weight weekly. Week 5: If applicable, plan smoking cessation. Use the app to log progress and celebrate small wins.
- Set up monthly check-ins where you review your healthy lifestyle score trend. Create a dashboard showing your progress on each of the five habits. Set reminders for exercise days, weekly weigh-ins, and diet logging. Track not just the behaviors but also how you feel—energy levels, mood, sleep quality—to reinforce the connection between habits and wellbeing.
This study shows an association between healthy lifestyle habits and longer life in a Korean population, but cannot prove these habits directly cause longer life. Individual results vary based on genetics, existing health conditions, and other factors. Before making significant lifestyle changes, especially regarding exercise intensity or if you have existing health conditions, consult with your healthcare provider. This information is for educational purposes and should not replace professional medical advice. If you’re considering smoking cessation, talk to your doctor about available support and medications.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.