Combined Impact of Health Behaviours and Mortality in Men and Women: The EPIC-Norfolk Prospective Population Study

Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom.
PLoS Medicine (Impact Factor: 14). 03/2008; 5(1):e12. DOI: 10.1371/journal.pmed.0050012
Source: PubMed

ABSTRACT There is overwhelming evidence that behavioural factors influence health, but their combined impact on the general population is less well documented. We aimed to quantify the potential combined impact of four health behaviours on mortality in men and women living in the general community.
We examined the prospective relationship between lifestyle and mortality in a prospective population study of 20,244 men and women aged 45-79 y with no known cardiovascular disease or cancer at baseline survey in 1993-1997, living in the general community in the United Kingdom, and followed up to 2006. Participants scored one point for each health behaviour: current non-smoking, not physically inactive, moderate alcohol intake (1-14 units a week) and plasma vitamin C >50 mmol/l indicating fruit and vegetable intake of at least five servings a day, for a total score ranging from zero to four. After an average 11 y follow-up, the age-, sex-, body mass-, and social class-adjusted relative risks (95% confidence intervals) for all-cause mortality(1,987 deaths) for men and women who had three, two, one, and zero compared to four health behaviours were respectively, 1.39 (1.21-1.60), 1.95 (1.70--2.25), 2.52 (2.13-3.00), and 4.04 (2.95-5.54) p < 0.001 trend. The relationships were consistent in subgroups stratified by sex, age, body mass index, and social class, and after excluding deaths within 2 y. The trends were strongest for cardiovascular causes. The mortality risk for those with four compared to zero health behaviours was equivalent to being 14 y younger in chronological age.
Four health behaviours combined predict a 4-fold difference in total mortality in men and women, with an estimated impact equivalent to 14 y in chronological age.

Download full-text


Available from: Ailsa A Welch, Jul 06, 2015
  • Source
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Identifying healthy lifestyle behaviours that promote psychological wellbeing is crucial to preventing mental disorders. The aim of the current study was to evaluate the individual and combined associations between different aspects of everyday life and mental health within a representative community sample in Germany. The study was conducted in 2012/2013 and included 7,937 participants representative of the German population. Lifestyle factors were assessed via self-report and included frequency of physical and mental activity, alcohol consumption, smoking, body mass index as well as circadian and social regularity. Outcome variables were depression, anxiety, stress and satisfaction with life. All lifestyle factors were associated with the mental health outcomes. Better mental health was linked to higher frequency of physical and mental activity, moderate alcohol consumption (i.e. not increased or no alcohol consumption), non-smoking, a body mass index within the range of normal to overweight (i.e. not underweight or obese) and a regular life rhythm. The more healthy lifestyle choices an individual makes, the higher life satisfaction and lower psychological distress he or she tends to have. The current study underlines the importance of healthy lifestyle choices in respect to psychological wellbeing.
    12/2014; 2(1):58. DOI:10.1186/s40359-014-0055-y
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective. To describe the design and present the baseline findings of the evaluation study of 'Paesaggi di Prevenzione', a school-based prevention program tackling smoking, alcohol misuse, dietary risks, and physical inactivity in 12- to 14-year-olds. Methods. The program was implemented from January 2011 to April 2012 in Emilia-Romagna, Italy, and comprised classroom activities and school-wide policies. A two-arm cluster randomized controlled trial was designed. Schools were the units of randomization and were matched by socioeconomic status, size, and type. Results. Data from 4700 middle school students and 2952 high school students were collected anonymously from October to December 2010. Past-30-day smoking prevalence was 1.9% among middle school students and 20.8% among high school students. Past-30-day prevalence of alcohol intoxication was 22% among middle school students and 11.4% among high school students. A total of 39.7% of middle school students and 48.0% of high school students drank sugar-sweetened beverages four or more times per week; 7.5% of middle school students and 7.1% of high school students had intense physical activity every day. Conclusions. This study seems adequately powered and baseline variables appear evenly distributed between study groups. Findings are in line with those of the WHO Health Behaviour in School-Aged Children study. (C) 2014 Elsevier Inc. All rights reserved,
    Preventive Medicine 12/2014; 71:20-26. DOI:10.1016/j.ypmed.2014.12.002. · 2.93 Impact Factor