Engaging in a combination of healthy behaviours, such as not smoking, moderate alcohol consumption, exercise, and eating fruits and vegetables daily makes it significantly more likely people will stay healthy as they age, according to a study published in CMAJ (Canadian Medical Association Journal).

"Our study shows the cumulative impact of healthy behaviours on successful aging -- the greater the number of healthy behaviours, the greater the benefit," writes Dr. Séverine Sabia, Department of Epidemiology and Public Health, UCL (University College London), UK, with coauthors.

Successful aging was defined as maintaining the ability to function well with good mobility, cognitive skills, respiratory function, mental health and no chronic diseases such as diabetes, cancer, heart disease, stroke or disability at age 60 years or older. Normal aging included people who were alive at the end of the 16-year study but who had chronic disease and/or lower scores on functioning and mental health.

"Among members of a large cohort of British men and women 42-63 years of age at baseline, all 4 healthy behaviours examined during midlife…were associated with greater odds of successfully aging during a 16-year follow-up," write the authors. "Compared with participants who engaged in no healthy behaviours, those who engaged in all 4 healthy behaviours had greater odds of aging successfully."

The study, by researchers in the UK and France, involved 5100 men and women from the Whitehall II study who did not have cancer, heart disease or stroke in the assessment phase during 1991-1994 and were followed to 2007-2009. Of the total participants, 549 died during follow-up, and 953 were classified as successfully aging while the remaining people aged normally. People in the successfully aging group were younger than the normally aging group (mean age 49.7 v. 51.3 yr), and 81% were married compared with 78% in the second group and 71% in the deceased group. Successful agers were more likely to have higher education than the normally aging group (32% v. 24%) and 18% in the deceased group. In the study population, 5% of people did not engage in any of the 4 healthy behaviours.

"Although individual healthy behaviours are moderately associated with successful aging, their combined impact is quite substantial. Multiple healthy behaviours appear to increase the chance of reaching old age disease-free and fully functional in an additive manner," conclude the authors.