Heart-Healthy Habits: Enhancing Longevity in Cancer Survivors

The Moli-sani study found that cancer survivors with heart-healthy behaviors had a 38% lower overall mortality than survivors with poorer cardiovascular health — reframing survivorship care to include routine cardiovascular risk management.

In a population-based cohort of 779 adults with prior cancer followed for roughly 15 years, investigators used the Life's Simple 7 index to quantify cardiovascular health and measured overall mortality as the primary endpoint. Higher LS7 scores were associated with a graded, stepwise reduction in long-term mortality, establishing cardiovascular health metrics as independent predictors of survival after cancer in this sample.

A secondary analysis substituted the LS7 diet component with adherence to a Mediterranean-style dietary pattern and observed larger survival gains, strengthening the nutritional signal. That finding supports counseling survivors toward feasible Mediterranean-style patterns — emphasizing fruits, vegetables, whole grains, legumes, fish, and extra-virgin olive oil — rather than isolated nutrient targets or unsupported supplements.

The investigators identified plausible shared biological pathways linking cardiometabolic and cancer outcomes, including low-grade systemic inflammation, resting heart rate, and circulating vitamin D. Physical activity (one LS7 domain) emerged as an independent and consistently strong predictor of lower mortality, underscoring fitness as a modifiable risk factor distinct from other cardiometabolic measures. These mechanistic and behavioral targets offer actionable touchpoints for integrated survivorship care.

Collectively, heart-healthy behaviors — diet, activity, and control of conventional risk factors — produced a substantial mortality reduction among long-term cancer survivors, supporting integration of cardiometabolic assessment into routine survivorship follow-up. Embedding Life's Simple 7 metrics into survivorship visits creates a practical pathway to identify and treat modifiable risks and to translate improved profiles into tangible longevity and quality-of-life gains.

Key Takeaways:

• Screening and assessment: Incorporate routine cardio-metabolic profiling for long-term survivors using Life's Simple 7 metrics during survivorship visits to identify modifiable risks such as smoking, blood pressure, glucose, and activity level.
• Interventions: Prioritize structured physical activity programs and promotion of a Mediterranean-style diet as central survivorship interventions to convert improved LS7 profiles into longevity gains.
• Systems and operations: Coordinate cardio-oncology pathways and consider monitoring low-grade inflammation and vitamin D status as part of risk stratification; these steps can strengthen program-level outcomes and support downstream survivorship benefits.