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A research team led by Dr. Nicholas Koemel, a research fellow and registered dietitian at the University of Sydney, published a large-scale cardiovascular study on March 23, 2026, in the European Journal of Preventive Cardiology. The paper examined how three specific lifestyle behaviors, taken together, affect the risk of major cardiovascular events – meaning heart attacks, strokes, and heart failure. What the data showed is that the bar for meaningful protection is far lower than most people assume. Getting 11 more minutes of sleep per night, adding roughly 4.5 to 5 minutes of moderate-to-vigorous physical activity each day, and eating an extra quarter cup of vegetables was tied to a 10% reduction in cardiovascular risk over eight years.
The study introduced a framework the researchers called SPAN – an acronym for Sleep, Physical Activity, and Nutrition. SPAN was designed to measure how these three behaviors work together rather than independently, because in real life they overlap and influence each other in ways that isolated studies miss.
The term “major adverse cardiovascular events,” or MACE, refers to a cluster of serious heart-related outcomes that doctors track in large studies: heart attack (also called myocardial infarction, which is when blood flow to part of the heart muscle is blocked), stroke (when blood supply to part of the brain is cut off or interrupted), and heart failure (when the heart can no longer pump enough blood to meet the body’s needs). These are among the leading causes of death and disability worldwide, and the ability to reduce their likelihood through achievable daily changes is exactly what this research set out to measure.
What the Study Found
The study enrolled 53,242 participants from the UK Biobank, a large health database of adults, with a median age of 63 years. Sleep duration and physical activity levels were tracked objectively using wearable devices – the kind of smartwatches many people already wear. Diet quality was assessed using a food frequency questionnaire, which allowed researchers to calculate a numerical diet quality score. Over an eight-year follow-up period, 2,034 major cardiovascular events were recorded among participants, including 932 incidents of myocardial infarction, 584 strokes, and 518 heart failure events.
The headline finding: sleeping 11 minutes more, doing an additional 4.5 minutes of moderate-to-vigorous physical activity, and eating an extra quarter cup of vegetables each day were associated with a 10% reduction in major cardiovascular events. These are not dramatic lifestyle overhauls. Eleven minutes of sleep is roughly the difference between going to bed at 10:49 p.m. versus 11:00 p.m. Four and a half minutes of brisk activity is a short walk to the coffee shop. A quarter cup of vegetables fits in a small handful. The point the researchers are making is deliberate: modest, combined changes carry real weight.
This study is the first to examine the minimum and optimal combinations of sleep, physical activity, and nutrition necessary for meaningful reductions in the risk of a major cardiovascular event, including heart attack, heart failure, and stroke. Previous research had looked at these behaviors separately or in pairs, but the SPAN framework is unique in measuring them as a single, integrated score. That distinction matters for how we interpret the results.