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. 2008 Jan 8;5(1):e12.
doi: 10.1371/journal.pmed.0050012.

Combined impact of health behaviours and mortality in men and women: the EPIC-Norfolk prospective population study

Kay-Tee Khaw  1 , Nicholas Wareham, Sheila Bingham, Ailsa Welch, Robert Luben, Nicholas Day
Affiliations

Combined impact of health behaviours and mortality in men and women: the EPIC-Norfolk prospective population study

Kay-Tee Khaw et al. PLoS Med. .

Erratum in

  • PLoS Med. 2008 Mar 18;5(3):e70

Abstract

Background: 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.

Methods and findings: 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.

Conclusions: 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.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Survival Function According to Number of Health Behaviours in Men and Women Aged 45–79 Years without Known Cardiovascular Disease or Cancer, Adjusted for Age, Sex, Body Mass Index and Social Class, EPIC-Norfolk 1993–2006
See this image and copyright information in PMC

Comment in

References

    1. [No authors listed] Diet, nutrition and the prevention of chronic diseases. World Health Organ Tech Rep Ser. 2003;916:1–149. - PubMed
    1. Chiuve SE, McCullough ML, Sacks FM, Rimm EB. Healthy lifestyle factors in the primary prevention of coronary heart disease among men: benefits among users and nonusers of lipid-lowering and antihypertensive medications. Circulation. 2006;114:160–167. - PubMed
    1. Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to smoking: 50 years' observations on male British doctors. BMJ. 2004;328:1519. - PMC - PubMed
    1. Hu FB, Rimm EB, Stampfer MJ, Ascherio A, Spiegelman D, et al. Prospective study of major dietary patterns and risk of coronary heart disease in men. Am J Clin Nutr. 2000;72:912–921. - PubMed
    1. Joshipura KJ, Hu FB, Manson JE, Stampfer MJ, Rimm EB, et al. The effect of fruit and vegetable intake on risk for coronary heart disease. Ann Intern Med. 2001;134:1106–1114. - PubMed

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