Research

Mixed

Adherence to a composite healthy lifestyle index (HLI) comprising non-smoking, moderate alcohol intake, physical activity, normal BMI, and Mediterranean diet adherence is strongly inversely associated with the risk of developing cancer-cardiometabolic multimorbidity (subsequent occurrence of cancer, cardiovascular disease, or type 2 diabetes).

Adopt a composite healthy lifestyle to significantly lower your risk of developing multiple chronic diseases (cancer, heart disease, diabetes). This involves maintaining a healthy weight (BMI 22-23.9), not smoking, engaging in regular physical activity, limiting alcohol intake (0-12g/day), and following a Mediterranean-style diet. The study shows that even after developing one of these conditions, maintaining these habits reduces the risk of developing a second one by approximately 15-25% compared to unhealthy lifestyles.

GoodSupportsHIGH confidence
A higher HLI, reflecting healthy lifestyles, was strongly inversely associated with multimorbidity, with hazard ratios per 3-unit increment of 0.75 (95% CI, 0.71 to 0.81), 0.84 (0.79 to 0.90), and 0.82 (0.77 to 0.88) after cancer, CVD, and T2D, respectively.
Heinz Freisling et al. · BMC Medicine · 2020

Why this rating

Large prospective cohort (n=291,778), long follow-up (median 11 years), rigorous outcome ascertainment, but observational design limits causal inference compared to RCTs.

Source

Lifestyle factors and risk of multimorbidity of cancer and cardiometabolic diseases: a multinational cohort study

Heinz Freisling et al. · BMC Medicine · 2020

DOI 10.1186/s12916-019-1474-7

cohort · n=291778Cited 397×
Read the paper
DOI resolved against Crossref · corpus check 2026-06-10

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