• Phyo K Myint, Richard D Smith, Robert N Luben, Paul G Surtees, Nicholas W J Wainwright, Nicholas J Wareham, and Kay-Tee Khaw.
• Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, Norfolk NR4 7TJ, UK. phyo.k.myint@uea.ac.uk
• Age Ageing. 2011 Sep 1; 40 (5): 589-95.

Objectiveto examine the relationship between combined lifestyle behaviours and quality-adjusted life years (QALYs) in a general population.Methodsa population-based study was conducted in 13,358 men and women who participated in the European Prospective Investigation into Cancer (EPIC)-Norfolk (baseline 1993-97). A score of 1 was given to each of non-smoking, physically not inactive, moderate alcohol consumption (1-14 units) and consumption of at least five portions of fruit and vegetables (vitamin C level ≥50 µmol/l). Short-Form Six-Dimension (SF-6D) health utility index scores were derived from the SF-36. QALYs were estimated up to follow-up (July 2007).Resultsa total of 13,358 men and women were eligible to be included in the study (aged 40-79 years at baseline). A total of 12,921 people were alive at follow-up (117, 784 person-years). Mean follow-up period was ∼11.5 years. 437 (4.4% of men and 2.4% of women) died. The death rate was 6.5 times higher in people with health behaviour score 0 compared with those who scored 4 (8.4 versus 1.3%). People with higher scores had significantly higher QALYs.Conclusionour findings support the view that modifiable lifestyle factors are an important component in health improvement.

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