Ford Earl S, Bergmann Manuela M, Kröger Janine, Schienkiewitz Anja, Weikert Cornelia, Boeing Heiner
Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
Arch Intern Med. 2009 Aug 10;169(15):1355-62. doi: 10.1001/archinternmed.2009.237.
Our objective was to describe the reduction in relative risk of developing major chronic diseases such as cardiovascular disease, diabetes, and cancer associated with 4 healthy lifestyle factors among German adults.
We used data from 23,153 German participants aged 35 to 65 years from the European Prospective Investigation Into Cancer and Nutrition-Potsdam study. End points included confirmed incident type 2 diabetes mellitus, myocardial infarction, stroke, and cancer. The 4 factors were never smoking, having a body mass index lower than 30 (calculated as weight in kilograms divided by height in meters squared), performing 3.5 h/wk or more of physical activity, and adhering to healthy dietary principles (high intake of fruits, vegetables, and whole-grain bread and low meat consumption). The 4 factors (healthy, 1 point; unhealthy, 0 points) were summed to form an index that ranged from 0 to 4.
During a mean follow-up of 7.8 years, 2006 participants developed new-onset diabetes (3.7%), myocardial infarction (0.9%), stroke (0.8%), or cancer (3.8%). Fewer than 4% of participants had zero healthy factors, most had 1 to 3 healthy factors, and approximately 9% had 4 factors. After adjusting for age, sex, educational status, and occupational status, the hazard ratio for developing a chronic disease decreased progressively as the number of healthy factors increased. Participants with all 4 factors at baseline had a 78% (95% confidence interval [CI], 72% to 83%) lower risk of developing a chronic disease (diabetes, 93% [95% CI, 88% to 95%]; myocardial infarction, 81% [95% CI, 47% to 93%]; stroke, 50% [95% CI, -18% to 79%]; and cancer, 36% [95% CI, 5% to 57%]) than participants without a healthy factor.
Adhering to 4 simple healthy lifestyle factors can have a strong impact on the prevention of chronic diseases.
我们的目标是描述在德国成年人中，与4种健康生活方式因素相关的患主要慢性疾病（如心血管疾病、糖尿病和癌症）的相对风险降低情况。
我们使用了来自欧洲癌症与营养前瞻性调查 - 波茨坦研究中23153名年龄在35至65岁的德国参与者的数据。终点包括确诊的2型糖尿病、心肌梗死、中风和癌症。这4个因素分别是从不吸烟、体重指数低于30（计算方法为体重千克数除以身高米数的平方）、每周进行3.5小时或更多的体育活动以及坚持健康饮食原则（水果、蔬菜和全麦面包摄入量高且肉类消费低）。这4个因素（健康，1分；不健康，0分）相加形成一个范围从0到4的指数。
在平均7.8年的随访期间，2006名参与者出现了新发糖尿病（3.7%）、心肌梗死（0.9%）、中风（0.8%）或癌症（3.8%）。不到4%的参与者没有健康因素，大多数参与者有1至3个健康因素，约9%的参与者有4个健康因素。在调整年龄、性别、教育程度和职业状况后，随着健康因素数量的增加，患慢性病的风险比逐渐降低。基线时具有所有4个因素的参与者患慢性病（糖尿病，93%[95%置信区间，88%至95%]；心肌梗死，81%[95%置信区间，47%至93%]；中风，50%[95%置信区间，-18%至79%]；癌症，36%[95%置信区间，5%至57%]）的风险比没有健康因素的参与者低78%（95%置信区间，72%至83%）。
坚持4种简单的健康生活方式因素对预防慢性病有很大影响。
