The combined impact of adherence to five lifestyle factors on all-cause, cancer and cardiovascular mortality: a prospective cohort study among Danish men and women

• Published in: British journal of nutrition Vol. 113; no. 5; pp. 849 - 858
• Main Authors: Petersen, Kristina E. N., Johnsen, Nina F., Olsen, Anja, Albieri, Vanna, Olsen, Lise K. H., Dragsted, Lars O., Overvad, Kim, Tjønneland, Anne, Egeberg, Rikke
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 14.03.2015
• Subjects: Alcohol Abstinence; alcohol drinking; Alcohol Drinking - adverse effects; Cancer; Cardiovascular disease; Cardiovascular Diseases - etiology; Cardiovascular Diseases - mortality; Cardiovascular Diseases - prevention & control; Cardiovascular Diseases - therapy; Cohort Studies; Combined Modality Therapy; Denmark - epidemiology; diet; Female; Follow-Up Studies; guidelines; Health Promotion; Health risks; Human and Clinical Nutrition; Humans; Life Style; lifestyle; Lifestyles; Male; men; Middle Aged; Mortality; Mortality risk; Motor Activity; neoplasms; Neoplasms - etiology; Neoplasms - mortality; Neoplasms - prevention & control; Neoplasms - therapy; Nutrition Policy; Overweight - physiopathology; Overweight - prevention & control; Overweight - therapy; Patient Compliance; physical activity; Prospective Studies; protective effect; risk; Risk factors; Smoking Cessation; Waist Circumference; Weight Loss; women; Denmark; Recommendations; Mortality; Public health; Lifestyle factors
• ISSN: 0007-1145; 1475-2662; 1475-2662
• DOI: 10.1017/S0007114515000070

Individual lifestyle factors have been associated with lifestyle diseases and premature mortality by an accumulating body of evidence. The impact of a combination of lifestyle factors on mortality has been investigated in several studies, but few have applied a simple index taking national guidelines into account. The objective of the present prospective cohort study was to investigate the combined impact of adherence to five lifestyle factors (smoking, alcohol intake, physical activity, waist circumference and diet) on all-cause, cancer and cardiovascular mortality based on international and national health recommendations. A Cox proportional hazards model was used to estimate hazard ratios (HR) with 95 % CI. During a median follow-up of 14 years, 3941 men and 2827 women died. Among men, adherence to one additional health recommendation was associated with an adjusted HR of 0·73 (95 % CI 0·71, 0·75) for all-cause mortality, 0·74 (95 % CI 0·71, 0·78) for cancer mortality and 0·70 (95 % CI 0·65, 0·75) for cardiovascular mortality. Among women, the corresponding HR was 0·72 (95 % CI 0·70, 0·75) for all-cause mortality, 0·76 (95 % CI 0·73, 0·80) for cancer mortality and 0·63 (95 % CI 0·57, 0·70) for cardiovascular mortality. In the present study, adherence to merely one additional health recommendation had a protective effect on mortality risk, indicating a huge potential in enhancing healthy lifestyle behaviours of the population.