ArticleBMJ public health2026
Estimating differences in life satisfaction as a function of health-related behaviours: cross-sectional evidence from the Health Survey for England.
Article in BMJ public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Stopping tobacco smoking, reducing alcohol consumption from high-risk levels, increasing physical activity and improving diet can improve mental well-being. To gain a preliminary estimate of the potential benefits of healthy lifestyle changes at a population level, this study estimated differences in life satisfaction among middle-aged adults in England as a function of whether they met recommended guidelines for smoking, alcohol consumption, physical activity and diet. Methods: Using the Health Survey for England, a cross-sectional nationally representative household survey conducted in 2017 and 2018 (6978 adults aged 35-64 years), linear and logistic models were conducted predicting life satisfaction scores (0-10 scale) or odds of 'high life satisfaction' (score ≥7), from smoking status (current vs ex-), alcohol intake, physical activity and fruit and vegetable consumption categorised according to whether participants met recommended guidelines. Results: After adjusting for other health behaviours and socio-demographic characteristics, the odds of high life satisfaction were 1.23 (95% CI 1.04 to 1.45) times higher for those eating ≥5 versus <5 portions/day, 1.47 (95% CI 1.20 to 1.79) times higher for people who have quit smoking versus people who smoke currently and 2.13 (95% CI 1.86 to 2.44) times higher for those with high versus low physical activity. These effects were additive: meeting all three of these guidelines was associated with the greatest increase in the likelihood of high life satisfaction (+32%; 89% vs 67% not meeting any guidelines). No significant difference was observed as a function of meeting alcohol consumption guidelines (OR=0.88 (95% CI 0.74 to 1.04)). Meeting all three of these behavioural guidelines was associated with an 18% increase in predicted life satisfaction (an average life satisfaction score of 8.0 vs 6.8). Conclusions: Meeting English government guidelines for physical activity, smoking cessation and fruit and vegetable intake is associated with a 32 percentage point higher likelihood of reporting high life satisfaction than meeting none of them. People drinking above the English government recommended level have similar life satisfaction to those drinking below it.
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