In this study of 23 153 German participants aged 35 to 65 years of the European Prospective Investigation Into Cancer and Nutrition–Potsdam Study, the impact of 4 healthy lifestyle factors—never smoking, having a body mass index lower than 30 (calculated as weight in kilograms divided by height in meters squared), performing 3.5 h/wk or more of physical activity, and adhering to healthy dietary principles (high intake of fruits, vegetables, and whole-grain bread and low meat consumption)—on the incidence of chronic disease (diabetes, myocardial infarction, stroke, and cancer) was examined. At baseline, approximately 4% of participants had zero healthy factors, most had 1 to 3 healthy factors, and approximately 9% had 4 factors. During a mean follow-up of 7.8 years, 2006 participants developed a chronic disease. Compared with participants with no healthy factor, reductions in chronic disease among participants with 1, 2, 3, and 4 healthy factors were 49% (95% confidence interval [CI], 40%-57%), 63% (95% CI, 57%-69%), 72% (95% CI, 67%-76%), and 78% (95% CI, 72%-83%), respectively. Adhering to 4 simple healthy lifestyle principles can have a strong impact on the prevention of chronic diseases.