Khaw Kay-Tee, Wareham Nicholas, Bingham Sheila, Welch Ailsa, Luben Robert, Day Nicholas
Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom.
PLoS Med. 2008 Jan 8;5(1):e12. doi: 10.1371/journal.pmed.0050012.
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.
有大量证据表明行为因素会影响健康，但它们对普通人群的综合影响记录较少。我们旨在量化四种健康行为对普通社区中男性和女性死亡率的潜在综合影响。
在一项前瞻性人群研究中，我们调查了生活方式与死亡率之间的前瞻性关系，该研究纳入了20244名年龄在45 - 79岁之间的男性和女性，他们在1993 - 1997年的基线调查中无已知心血管疾病或癌症，居住在英国普通社区，随访至2006年。参与者每具备一种健康行为得一分：当前不吸烟、非身体不活动、适度饮酒（每周1 - 14单位）以及血浆维生素C > 50 mmol/l（表明每天摄入至少五份水果和蔬菜），总分范围为零至四分。经过平均11年的随访，与具备四种健康行为相比，具备三种、两种、一种和零种健康行为的男性和女性全因死亡率（1987例死亡）在年龄、性别、体重和社会阶层调整后的相对风险（95%置信区间）分别为1.39（1.21 - 1.60）、1.95（1.70 - 2.25）、2.52（2.13 - 3.00）和4.04（2.95 - 5.54），p < 0.001，呈趋势性变化。在按性别、年龄、体重指数和社会阶层分层的亚组中以及排除2年内死亡病例后，这些关系是一致的。心血管病因导致的趋势最为明显。具备四种健康行为与零种健康行为相比的死亡风险相当于实际年龄年轻14岁。
四种健康行为综合起来可预测男性和女性总死亡率有4倍的差异，估计影响相当于实际年龄相差14岁。
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