Lifestyle changes at middle age and mortality: a population-based prospective cohort study

被引:13
作者
Berstad, Paula [1 ,2 ]
Botteri, Edoardo [1 ,3 ]
Larsen, Inger Kristin [1 ]
Loberg, Magnus [4 ,5 ]
Kalager, Mette [4 ,6 ]
Holme, Oyvind [4 ,7 ]
Bretthauer, Michael [4 ,5 ,6 ]
Hoff, Geir [1 ,2 ,4 ,5 ]
机构
[1] Canc Registry Norway, Dept Colorectal Canc Screening, POB 5313 Majorstuen, N-0304 Oslo, Norway
[2] Telemark Hosp, Skien, Norway
[3] European Inst Oncol, Div Epidemiol & Biostat, Milan, Italy
[4] Univ Oslo, Inst Hlth & Soc, Dept Hlth Management & Hlth Econ, Oslo, Norway
[5] Oslo Univ Hosp, Dept Transplantat Med, KG Jebsen Ctr Colorectal Canc Res, Oslo, Norway
[6] Harvard Sch Publ Hlth, Dept Epidemiol, Boston, MA USA
[7] Sorlandet Hosp, Kristiansand, Norway
关键词
CORONARY-HEART-DISEASE; RANDOMIZED CONTROLLED-TRIAL; ALL-CAUSE MORTALITY; SMOKING-CESSATION; PHYSICAL-ACTIVITY; COMBINED IMPACT; CLINICAL-TRIAL; LUNG-CANCER; FOLLOW-UP; WOMEN;
D O I
10.1136/jech-2015-206760
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background The effect of modifying lifestyle at middle age on mortality has been sparsely examined. Methods Men and women aged 50-54 years randomised to the control group (no intervention) in the population-based Norwegian Colorectal Cancer Prevention trial were asked to fill in lifestyle questionnaires in 2001 and 2004. Lifestyle scores were estimated ranging from 0 (poorest) to 4 (best) based on health recommendations (non-smoking, daily physical activity, body mass index < 25.0 kg/m(2) and healthy diet). Outcomes were all-cause, cancer and cardiovascular mortality before 31 December 2013. Results Of the 6886 attainable individuals included in the study, 4211 (61%) responded to the baseline questionnaire in 2001. After a median follow-up of 12.3 years, 226 (5.4%) of the baseline questionnaire responders died; 110 (49%) from cancer and 32 (14%) from cardiovascular disease. For each increment in lifestyle score in 2001, a 21% lower all-cause mortality was observed (HR 0.79, 95% CI 0.67 to 0.94, adjusted for age, sex, occupational working hours and chronic disease or pain during 3 years before enrolment). A one-point increase in lifestyle score from 2001 to 2004 was associated with a 38% reduction in all-cause mortality (adjusted HR 0.62, CI 0.45 to 0.84). The group reporting lifestyle change from score 0-1 (unfavourable) in 2001 to score 2-4 (favourable) in 2004 had 4.8 fewer deaths per 1000 person years, compared with the group maintaining an 'unfavourable' lifestyle (adjusted HR 0.31, CI 0.13 to 0.70 for all-cause mortality). Conclusions Favourable lifestyle changes at age 50-60 years may prevent early death.
引用
收藏
页码:59 / 66
页数:8
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