Department of Public Health, Aarhus University, Aarhus, Denmark.
Department of Public Health, Aarhus University, Aarhus, Denmark; Danish Cancer Society Research Center, Copenhagen, Denmark.
Am J Prev Med. 2021 Jun;60(6):792-801. doi: 10.1016/j.amepre.2021.01.003. Epub 2021 Mar 26.
Modifiable lifestyle behaviors represent a central target for public health interventions. This study investigates the association between adherence to 4 modifiable lifestyle recommendations and all-cause, cancer, or cardiovascular disease mortality.
Investigators used data from the Danish Diet, Cancer and Health cohort (1993-2013; N=54,276). Lifestyle recommendations included smoking (never smoking), diet (adherence to 6 national food-based dietary guidelines), alcohol consumption (≤7 units per week for women and ≤14 units per week for men), and physical activity (≥30 minutes per day of moderate-to-vigorous leisure-time physical activity). Pseudo-values were used to estimate the adjusted risk differences and 95% CIs for all-cause, cancer, or cardiovascular disease mortality. Data were analyzed in 2019-2020.
A total of 8,860 participants died during a median follow-up of 17.0 years. Adherence to all modifiable lifestyle recommendations was associated with an 18.46% (95% CI= -20.52%, -16.41%) lower absolute risk of all-cause mortality than no adherence. Never smokers had a 13.19% (95% CI= -13.95%, -12.44%) lower risk, those adhering to dietary guidelines (diet score ≥5) had a 7.52% (95% CI= -8.89%, -6.14%) lower risk, and those adhering to recommended levels of alcohol (2.11%, 95% CI= -2.75%, -1.48%) and physical activity (1.58%, 95% CI= -2.20%, -1.00%) had a lower risk than those who did not adhere. Stronger associations were observed in men than in women and in older than in middle-aged participants.
Findings suggest that adherence to modifiable lifestyle recommendations is associated with a lower risk of mortality from all causes, cancer, and cardiovascular disease, underlining the importance of supporting adherence to national guidelines for lifestyle recommendations.
可改变的生活方式行为是公共卫生干预的一个核心目标。本研究调查了遵守 4 项可改变的生活方式建议与全因、癌症或心血管疾病死亡率之间的关联。
研究人员使用了丹麦饮食、癌症和健康队列（1993-2013 年；N=54276）的数据。生活方式建议包括吸烟（从不吸烟）、饮食（遵守 6 项国家基于食物的饮食指南）、饮酒（女性每周不超过 7 单位，男性每周不超过 14 单位）和身体活动（每天至少 30 分钟的中等到剧烈强度的休闲时间身体活动）。使用伪值来估计全因、癌症或心血管疾病死亡率的调整风险差异和 95%置信区间。数据于 2019-2020 年进行分析。
在中位随访 17.0 年期间，共有 8860 名参与者死亡。与不遵守所有可改变的生活方式建议相比，遵守所有可改变的生活方式建议与全因死亡率绝对风险降低 18.46%（95%CI=-20.52%，-16.41%）相关。从不吸烟者的风险降低 13.19%（95%CI=-13.95%，-12.44%），饮食指南遵守者（饮食评分≥5 分）的风险降低 7.52%（95%CI=-8.89%，-6.14%），酒精和身体活动推荐水平的遵守者（2.11%，95%CI=-2.75%，-1.48%）和（1.58%，95%CI=-2.20%，-1.00%）的风险低于不遵守者。在男性中观察到的关联强于女性，在老年参与者中观察到的关联强于中年参与者。
研究结果表明，遵守可改变的生活方式建议与全因、癌症和心血管疾病死亡率降低相关，这突显了支持遵守国家生活方式建议指南的重要性。
