Purpose: Although several health-related factors are independently associated with diverse health outcomes, their combined affect on mortality has not been fully described.
Methods: We examined the combined effect of several positive health factors, including having normal weight (body mass index = 18.5-24.9 kg.m), not smoking (not current smoker), consuming a moderate alcohol intake (1-14 drinks per week), being physically active (moderate to high level), and having a higher cardiorespiratory fitness (top two-thirds), on all-cause mortality in 38,110 men aged 20-84 yr from the Aerobics Center Longitudinal Study.
Results: There were 2642 deaths during an average of 16 yr of follow-up. Compared with men with zero positive health factors, the multivariable-adjusted hazard ratios (HR) of all-cause mortality with one, two, three, four, and five positive health factors were 0.78 (95% confidence interval (CI) = 0.64-0.95), 0.61 (95% CI = 0.50-0.73), 0.54 (95% CI = 0.44-0.65), 0.43 (95% CI = 0.35-0.52), and 0.39 (95% CI = 0.31-0.48), respectively (P for trend <0.001). The combination of five positive health factors accounted for 29% (95% CI = 14%-40%) of population-attributable risk for all-cause mortality.
Conclusions: Our findings suggest that targeting more of these modifiable health factors may provide substantial health benefits in middle-aged men.