Among 108,299 Korean adults aged 40-69 followed for a mean 13.9 years (5,045 deaths), women in the top tertile of the standardized WCRF/AICR score, which captures body fatness, physical activity, diet, alcohol and breastfeeding, had 22% lower all-cause mortality (HR 0.78) and 19% lower cancer mortality (HR 0.81). Adding smoking to create an expanded score strengthened the associations: all-cause HR 0.71, cancer HR 0.75, and CVD mortality HR 0.67 in women. Men showed similar patterns with the expanded score.
The finding fits a consistent body of Western cohort work showing that the WCRF/AICR score tracks with mortality from cancer and cardiovascular disease alike, and it extends that evidence to an East Asian population with different dietary patterns and baseline risks. The key practical lesson lies in the gap between the two scores: once smoking enters the model, protection rises and CVD mortality becomes significant. That suggests tobacco is a major driver of the benefit, and that cancer-prevention advice doubles as heart-health advice only when smoking is part of the package. Limitations matter. Adherence was self-reported at baseline, with no tracking of habit change, and the observational design cannot rule out residual confounding or healthy-adherer effects. The abstract also reports the standardized score only for women, so the male results rest on the expanded score. Overall this is a confirmatory, well-powered study: it adds no new mechanism, but it reinforces that weight control, activity, diet quality, limited alcohol and not smoking together carry a substantial longevity payoff.