Healthy lifestyle change and all-cause and cancer mortality in the European Prospective Investigation into Cancer and Nutrition cohort

被引：1

作者：

Matta, Komodo ^{[1
]}

Viallon, Vivian ^{[1
]}

Botteri, Edoardo ^{[2
]}

Peveri, Giulia ^{[3
,4
]}

Dahm, Christina ^{[5
]}

Nannsen, Anne ostergaard ^{[5
]}

Olsen, Anja ^{[5
,6
]}

Tjonneland, Anne ^{[6
,7
]}

Elbaz, Alexis ^{[8
]}

Artaud, Fanny ^{[8
]}

Marques, Chloe ^{[8
]}

Kaaks, Rudolf ^{[9
]}

Katzke, Verena ^{[9
]}

Schulze, Matthias B. ^{[10
,11
]}

Llanaj, Erand ^{[10
,12
]}

Masala, Giovanna ^{[13
]}

Pala, Valeria ^{[14
]}

Panico, Salvatore ^{[15
]}

Tumino, Rosario ^{[16
]}

Ricceri, Fulvio ^{[17
]}

Derksen, Jeroen W. G. ^{[18
]}

Nost, Therese Haugdahl ^{[19
,20
]}

Sandanger, Torkjel M. ^{[20
]}

Borch, Kristin Benjaminsen ^{[20
]}

Quiros, J. Ramon ^{[21
]}

Castro-Espin, Carlota ^{[1
,22
,23
]}

Sanchez, Maria-Jose ^{[24
,25
,26
,27
]}

Atxega, Amaia Aizpurua ^{[28
,29
]}

Cirera, Lluis ^{[26
,30
,31
]}

Guevara, Marcela ^{[26
,32
,33
]}

Manjer, Jonas ^{[34
]}

Tin Tin, Sandar ^{[35
]}

Heath, Alicia ^{[36
]}

Touvier, Mathilde ^{[37
]}

Goldberg, Marcel ^{[38
]}

Weiderpass, Elisabete ^{[1
]}

Gunter, Marc J. ^{[1
,36
]}

Freisling, Heinz ^{[1
]}

Riboli, Elio ^{[36
]}

Ferrari, Pietro ^{[1
]}

机构：

[1] Int Agcy Res Canc IARC WHO, Lyon, France

[2] Canc Registry Norway Kreftregisteret, Oslo, Norway

[3] Univ Milan, Dept Clin Sci & Community Hlth, Milan, Italy

[4] Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden

[5] Aarhus Univ, Dept Publ Hlth, Aarhus, Denmark

[6] Danish Canc Soc Res Ctr, Copenhagen, Denmark

[7] Univ Copenhagen, Dept Publ Hlth, Copenhagen, Denmark

[8] Univ Paris Saclay, Inst Gustave Roussy, Team Exposome Hered Canc & Hlth, Inserm,CESP UMR 1018, F-94807 Villejuif, France

[9] German Canc Res Ctr, Div Canc Epidemiol, Heidelberg, Germany

[10] German Inst Human Nutr Potsdam Rehbrucke, Dept Mol Epidemiol, Nuthetal, Germany

[11] Univ Potsdam, Inst Nutr Sci, Nuthetal, Germany

[12] German Ctr Diabet Res DZD, Neuherberg, Germany

[13] Inst Canc Res Prevent & Clin Network ISPRO, Florence, Italy

[14] Fdn IRCCS Ist Nazl Tumori Milano, Epidemiol & Prevent Unit, Milan, Italy

[15] Univ Naples Federico II, Dipartimento Med Clin, Naples, Italy

[16] AIRE ONLUS, Hyblean Assoc Epidemiol Res, Ragusa, Italy

[17] Univ Turin, Ctr Biostat Epidemiol, Dept Clin & Biol Sci & Publ Hlth C BEPH, Turin, Italy

[18] Univ Utrecht, Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands

[19] NTNU Norwegian Univ Sci & Technol, KG Jebsen Ctr Genet Epidemiol, Dept Publ Hlth & Nursing, Trondheim, Norway

[20] UiT Arctic Univ Norway, Dept Community Med, Tromso, Norway

[21] Publ Hlth Directorate, Asturias, Spain

[22] Catalan Inst Oncol ICO, Unit Nutr & Canc, Barcelona, Spain

[23] Bellvitge Biomed Res Inst IDIBELL, Epidemiol Publ Hlth Canc Prevent & Palliat Care Pr, Nutr & Canc Grp, Barcelona, Spain

[24] Escuela Andaluza Salud Publ EASP, Granada 18011, Spain

[25] Inst Invest Biosanit ibs GRANADA, Granada 18012, Spain

[26] Ctr Invest Biomed Red Epidemiol & Salud Publ CIBER, Madrid 28029, Spain

[27] Univ Granada, Dept Prevent Med & Publ Hlth, Granada 18071, Spain

[28] Minist Hlth Basque Govt, Sub Directorate Publ Hlth & Addict Gipuzkoa, San Sebastian, Spain

[29] Biodonostia Hlth Res Inst, Epidemiol Chron & Commun Dis Grp, San Sebastian, Spain

[30] IMIB Arrixaca, Murcia Reg Hlth Council, Dept Epidemiol, Murcia, Spain

[31] Univ Murcia, Dept Hlth & Social Sci, Murcia, Spain

[32] Inst Salud Publ & Laboral Navarra, Pamplona 31003, Spain

[33] Navarra Inst Hlth Res IdiSNA, Pamplona 31008, Spain

[34] Lund Univ, Skane Univ Hosp Malmo, Dept Surg, Malmo, Sweden

[35] Univ Oxford, Nuffield Dept Populat Hlth NDPH, Oxford, England

[36] Imperial Coll London, Sch Publ Hlth, London, England

[37] Inst Natl Sante & Rech Med INSERM, Paris, France

[38] Univ Paris 05, Paris, France

来源：

BMC MEDICINE | 2024年 / 22卷 / 01期

关键词：

Healthy lifestyle index; Composite score; Change score; Mortality; Cancer; Longitudinal; Prospective study; RISK; BEHAVIORS; EDUCATION;

D O I：

10.1186/s12916-024-03362-7

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background Healthy lifestyles are inversely associated with the risk of noncommunicable diseases, which are leading causes of death. However, few studies have used longitudinal data to assess the impact of changing lifestyle behaviours on all-cause and cancer mortality.Methods Within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, lifestyle profiles of 308,497 cancer-free adults (71% female) aged 35-70 years at recruitment across nine countries were assessed with baseline and follow-up questionnaires administered on average of 7 years apart. A healthy lifestyle index (HLI), assessed at two time points, combined information on smoking status, alcohol intake, body mass index, and physical activity, and ranged from 0 to 16 units. A change score was calculated as the difference between HLI at baseline and follow-up. Associations between HLI change and all-cause and cancer mortality were modelled with Cox regression, and the impact of changing HLI on accelerating mortality rate was estimated by rate advancement periods (RAP, in years).Results After the follow-up questionnaire, participants were followed for an average of 9.9 years, with 21,696 deaths (8407 cancer deaths) documented. Compared to participants whose HLIs remained stable (within one unit), improving HLI by more than one unit was inversely associated with all-cause and cancer mortality (hazard ratio [HR]: 0.84; 95% confidence interval [CI]: 0.81, 0.88; and HR: 0.87; 95% CI: 0.82, 0.92; respectively), while worsening HLI by more than one unit was associated with an increase in mortality (all-cause mortality HR: 1.26; 95% CI: 1.20, 1.33; cancer mortality HR: 1.19; 95% CI: 1.09, 1.29). Participants who worsened HLI by more than one advanced their risk of death by 1.62 (1.44, 1.96) years, while participants who improved HLI by the same amount delayed their risk of death by 1.19 (0.65, 2.32) years, compared to those with stable HLI.Conclusions Making healthier lifestyle changes during adulthood was inversely associated with all-cause and cancer mortality and delayed risk of death. Conversely, making unhealthier lifestyle changes was positively associated with mortality and an accelerated risk of death.

引用

页数：12

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