Key result
Higher Healthy Lifestyle Index adherence is linked to ~52% lower all-cause and reduced cardiovascular mortality.
Why the study?
While higher adherence to the Healthy Lifestyle Index is linked to lower disease and mortality risk, its long-term trajectory association remains understudied.
Does higher adherence to the Healthy Lifestyle Index (HLI) reduce the risk of all-cause, CVD, and cancer mortality?
Meta-Analysis (n=13,700,000)
Does higher adherence to the Healthy Lifestyle Index (HLI) reduce the risk of all-cause, CVD, and cancer mortality?
Higher adherence to the Healthy Lifestyle Index and improving lifestyle trajectories are associated with significantly lower risks of all-cause, cardiovascular, and cancer mortality.
Answers are grounded in this paper and cite their sources.
May support lifestyle counseling in practice; hypothesis-generating for causality pending randomized confirmation.
Background The Healthy Lifestyle Index (HLI) integrates key behaviours to assess their cumulative impact on health. While higher HLI adherence is linked to lower disease and mortality risk, its long-term trajectory association remains understudied. This study aims to examine the dose-response relationship and long-term association of HLI on mortality risks. Design Systematic review and dose-response meta-analysis using the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) approach. Data sources PubMed, Scopus and Web of Science were searched until June 2024. Eligibility criteria for selecting studies We included observational cohort studies that assessed the relationship of HLI or its trajectories with all-cause, cardiovascular disease (CVD)-cause or cancer-cause of mortality. Result Analysis of 13.7 million participants demonstrated that higher adherence to the HLI is linked to lower risk of all-cause (HR: 0.48; 95% CI 0.46 to 0.53; GRADE: moderate), CVD-cause (HR: 0.49; 95% CI 0.44 to 0.51; GRADE: moderate) and cancer-cause mortality (HR: 0.55; 95% CI 0.49 to 0.61; GRADE: low). These associations were further confirmed in a dose-response manner. Moreover, compared with maintaining an unhealthy lifestyle, a decline in HLI adherence was associated with a 14% higher risk of all-cause and a 19% higher risk of cancer-related mortality. In contrast, an improvement in HLI adherence was linked to a 20% lower risk of all-cause and a 13% lower risk of cancer-related mortality. Conclusion Adherence to HLI and its long-term patterns are associated with lower mortality risk. These findings emphasise the importance of lifestyle-based prevention and intervention strategies in reducing mortality. PROSPERO registration number CRD42024500538.
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HasanRashedi et al. (2026) conducted a meta-analysis in Mortality risk (n=13,700,000). Higher adherence to the Healthy Lifestyle Index (HLI) vs. Lower adherence or maintaining an unhealthy lifestyle was evaluated on All-cause mortality (HR 0.48, 95% CI 0.46 to 0.53). Higher adherence to the Healthy Lifestyle Index was associated with a lower risk of all-cause mortality, alongside reduced cardiovascular and cancer mortality.
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