Obesity, alcohol consumption, smoking, and mortality
ABSTRACT The goals of this study were to assess prospectively the impact of obesity, alcohol use, and smoking on total mortality and to test the etiologic hypothesis that subjects with two or more of these risk factors may experience an elevated risk of overall mortality.
Information on body mass index (BMI), alcohol intake, cigarette smoking, and other life-style factors was obtained from a cohort of 8006 Japanese-American men living in Hawaii. They were between 45 and 68 years of age at the initial examination (1965-1968). After 22 years of follow-up that included nearly 159,000 person-years of observation, 2667 deaths from all causes were identified.
There was a significant quadratic (J-shaped) relation between BMI and overall mortality. A weaker J-shaped pattern in risk was also present for the intake of alcohol. A strong positive association was observed with pack-years of cigarette smoking. A synergistic interaction between BMI and alcohol was statistically significant (P = 0.0017). Specifically, men who had the lowest body mass (BMI < 21.21 kg/m2) and drank moderately to heavily (> or = 25 oz/mo) experienced a 63% excess risk (relative risk, 1.63; 95% confidence interval; 1.33 - 1.99) compared to a reference group composed of men who had intermediate body mass (BMI, 21.21 - 26.30 kg/m2) and drank occasionally to lightly (0.01 - 24.99 oz/mo). The increase in risk due to the interactive effect of low BMI and high alcohol intake was stronger (and statistically significant) than when each of these risk factors was considered separately (excess risk, 28% and 2%, respectively). There was no significant interaction for BMI and cigarette smoking, for alcohol and cigarette smoking, or for the three factors combined.
The most important finding of this study was that, in addition to confirming that cigarette smoking could shorten life, extreme (high or low) BMI values and high alcohol consumption are each potentially harmful to health, but even more so if moderate or heavy drinking is concomitant with low body mass, a possible indicator for low intake of nutrients.
- SourceAvailable from: Hillary J Mull
[Show abstract] [Hide abstract]
- "(Anonymous, 2001; McNeil, 1997; LaPlante, 1996) Certain modifiable health behaviors have been linked to many of these chronic conditions, specifically smoking, a sedentary lifestyle, and obesity. (Anonymous, 1994; Chyou et al., 1997; Knowler et al., 2002; Manson et al., 1999; Pan et al., 1997; Petrella & Bartha, 2000; Rao, Donahue, Pi- Sunyer, & Fuster, 2001; Rimm, Chan, Stampfer, Colditz, & Willett, 1995; Sahyoun, Hochberg, Helmick, Harris, & Pamuk, 1999; Tuomilehto et al., 2001; US Department of Health and Human Services, Public Health Service, Centers for Disease Control, Center for Chronic Disease Prevention and Health Promotion, & Office on Smoking and Health, 1989; Williams, 2001) Using a large nationally representative longitudinal cohort study, we sought to quantify the extent to which cigarette smoking; a sedentary lifestyle and obesity are independent modifiable risk factors for WFD. "
ABSTRACT: The effects of poor health habits on mortality have been studied extensively. However, few studies have examined the impact of these health behaviors on workforce disability. In the Health and Retirement Study, a nationally representative cohort of 6044 Americans who were between the ages of 51 and 61 and who were working in 1992, we found that both baseline smoking status and a sedentary lifestyle predict workforce disability six years later. If this relationship is causal, cost-benefit analyses of health behavior intervention that neglect workforce disability may substantially underestimate the benefits of such interventions.SSRN Electronic Journal 06/2003; DOI:10.2139/ssrn.1092134
- [Show abstract] [Hide abstract]
ABSTRACT: To describe the clustering of behavior-related risk factors in the adult population of the Autonomous Community of Madrid (Spain) and evaluate the association between the level of aggregation of these factors and suboptimal subjective health. Data were drawn from the Non-communicable Disease Risk-Factor Surveillance System (Sistema de Vigilancia de Factores de Riesgo asociados a Enfermedades No Transmisibles [SIVFRENT]). We studied the associations between smoking, high-risk alcohol consumption, leisure-time sedentariness and unbalanced diet in 16,043 persons aged 18-64 years and compared the observed against the expected proportions. Logistic regression was used to estimate the association between clustering of risk factors and suboptimal health (fair, poor and very poor). Almost 20% of subjects had 3 or 4 risk factors simultaneously. Most combinations of 3 risk factors exceeded expectations and, in particular, 4 factor clustering yielded observed/expected quotients of 2.15 (95% confidence interval [CI]: 1.93-2.38) in men and 2.96 (95% CI, 2.46-3.46) in women. In both sexes, the individual factor most closely associated with the remaining risk factors was smoking. Aggregation of risk factors was more frequent among men, younger age groups and subjects with low educational level. Compared with persons with none of the 4 risk factors, those that simultaneously had 3 or 4 more frequently reported suboptimal subjective health (OR = 2.49; 95% CI, 1.59-3.90 in men and OR = 1.96; 95% CI, 1.29-2.97 in women). Behavior-related risk factors tend to aggregate, and this accumulation is higher among men, younger age groups, and subjects with a low educational level. A greater level of clustering is associated with a higher frequency of suboptimal perceived health.Gaceta Sanitaria 11/2004; 19(5):370-8. · 1.19 Impact Factor