Distinct Life's Essential 8 health profiles identified via latent profile analysis showed heterogeneous associations with neuropsychiatric disease risk, with healthier profiles linked to lower anxiety and bipolar disorder risk, while schizophrenia findings remained inconclusive.
Key Findings
Methods
Latent profile analysis of LE8 components identified five distinct health profiles among UK Biobank participants.
The five profiles were: Low LE8 score; Elevated adiposity, blood pressure, and glucose group; Low physical activity with poor sleep group; Elevated blood pressure and dyslipidaemia group; and High LE8 score group.
The sample comprised 242,947 UK Biobank participants without prevalent neuropsychiatric diseases at baseline.
LE8 comprises eight components: healthy diet, physical activity, nicotine exposure, sleep health, glucose, blood lipid, blood pressure, and body mass index.
LPA was applied rather than treating LE8 as a composite score, to avoid assumptions of equal weighting and to capture heterogeneity in health behaviour patterns.
Results
All four comparison LE8 profiles showed significant protective associations for anxiety compared to the Low LE8 score group.
Over a median follow-up of 13.8 years, 11,419 cases of incident anxiety were identified.
Hazard ratios for anxiety ranged from 0.65 to 0.78 across the four comparison profiles (all p < 0.001).
Risk reductions for anxiety were up to 35% relative to the Low LE8 score reference group.
Cox proportional hazards models were used to examine associations between LE8 profiles and disease incidence.
Results
All four comparison LE8 profiles showed significant protective associations for bipolar disorder compared to the Low LE8 score group.
Over a median follow-up of 13.8 years, 341 cases of incident bipolar disorder were identified.
Hazard ratios for bipolar disorder ranged from 0.37 to 0.51 across the four comparison profiles (all p < 0.001).
Risk reductions for bipolar disorder were up to 63% relative to the Low LE8 score reference group.
The magnitude of protective association was substantially greater for bipolar disorder than for anxiety.
Results
No significant associations were observed between LE8 profiles and schizophrenia incidence.
Only 40 incident cases of schizophrenia were identified over the follow-up period.
The authors attributed the lack of significant findings to the small number of incident cases.
Schizophrenia findings were explicitly characterized as 'exploratory' and 'inconclusive'.
The small case count limits statistical power to detect associations for this outcome.
Discussion
The study found heterogeneous associations between distinct LE8 profiles and neuropsychiatric disease risk, supporting pattern-based over composite-score approaches.
The authors concluded that results 'support person-centred, pattern-based approaches over composite scoring for neuropsychiatric risk stratification and hypothesis generation.'
Using a composite LE8 score assumes equal weighting of components and may obscure heterogeneity in health behaviour patterns.
Different profiles with varying combinations of health behaviours and metabolic factors showed differing levels of risk reduction.
The Elevated adiposity, blood pressure, and glucose group and the Low physical activity with poor sleep group both showed protective associations despite having specific risk factors elevated, illustrating the value of profile-based analysis.
What This Means
This research suggests that people's overall cardiovascular and lifestyle health patterns — as measured by the American Heart Association's 'Life's Essential 8' framework covering diet, physical activity, smoking, sleep, blood sugar, cholesterol, blood pressure, and body weight — are meaningfully linked to their risk of developing anxiety and bipolar disorder. Rather than simply adding up a single health score, the researchers used a statistical technique called latent profile analysis to group nearly 243,000 UK adults into five distinct health pattern categories. Over an average follow-up of nearly 14 years, they found that people in healthier profile groups had substantially lower rates of new anxiety diagnoses (up to 35% lower risk) and bipolar disorder diagnoses (up to 63% lower risk) compared to those in the lowest-scoring health profile group.
A particularly notable aspect of this study is its methodological approach: by identifying distinct health profiles rather than using a single composite score, the researchers were able to show that different combinations of health factors carry different levels of neuropsychiatric risk. For example, groups with specific metabolic problems (like elevated blood pressure or poor sleep combined with low physical activity) still showed lower risk than the overall low-health group. The findings for schizophrenia were inconclusive because only 40 new cases occurred during follow-up, which was too few to draw reliable conclusions.
This research suggests that a person's overall pattern of cardiovascular and lifestyle health factors may matter for brain and mental health, not just heart disease. The findings point toward the potential value of personalized, pattern-based health assessments rather than single summary scores when thinking about mental health risk. However, as an observational study, it cannot prove that improving these health factors directly causes reductions in anxiety or bipolar disorder — other factors not measured in this study could help explain the associations.
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Huangfu H, Jia H, Chen C, Xu Y, Zhou X, Tang Y, et al.. (2026). Life's essential 8 health profiles and risk of incident neuropsychiatric diseases: a nationwide prospective cohort study.. BMC psychiatry. https://doi.org/10.1186/s12888-026-08341-1