ArticleEpidemiology (Cambridge, Mass.)2021
Is Cohort Representativeness Passé? Poststratified Associations of Lifestyle Risk Factors with Mortality in the UK Biobank.
Article in Epidemiology (Cambridge, Mass.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 89 papers, 1 of them a synthesis that pooled it.
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Who cites it
89 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Association Between Daily Alcohol Intake and Risk of All-Cause Mortality: A Systematic Review and Meta-analyses.JAMA network open · 2023Pooled it
- Wine consumption, Mediterranean diet, and cardiovascular risk in two Spanish cohorts.European heart journal · 2026Trial
- Design and model choices shape inference of age-varying genetic effects on complex traits.Nature aging · 2026Article
- Accelerometer-derived real-world sleep stages and risk of incident diseases: A UK Biobank cohort study and phenome-wide association analysis.PLoS medicine · 2026Article
- Device-measured movement behaviours and cancer incidence in a population sample of UK adults: Dual 24-hour analyses of postural and intensity compositions.BMC medicine · 2026Article
- Deficit accumulation frailty and risk of incident chronic kidney disease: a prospective analysis of the UK biobank and CHARLS cohorts.International urology and nephrology · 2026Article
- Inclusion bias affects common variant discovery and replication in a health-system linked biobank.American journal of human genetics · 2026Article
- Data from the UK Biobank demonstrates that increased brief, sporadic moderate-to-vigorous physical activity reduces mortality.Communications medicine · 2026Article
- An evaluation of age-varying genetic effects underlying body-mass index and blood pressure in the UK Biobank.PLoS genetics · 2026Article
- Education, Employment, Income, and Urban-Rural Differences as Drivers of Social Inequalities in Environmental Exposures: Evidence from the UK Biobank.Environmental science & technology · 2026Article
- Impact of patient phenotype on the relationship between accelerometer-derived physical activity and cardiovascular events in atrial fibrillation.American journal of preventive cardiology · 2026Article
- Exploring the Relationship Between Caffeine Consumption, Caffeine Metabolism, and Sleep Behaviours: A Mendelian Randomisation Study.Journal of sleep research · 2026Article
- Minimum combined sleep, physical activity, and nutrition variations associated with lifeSPAN and healthSPAN improvements: a population cohort study.EClinicalMedicine · 2026Article
- Using large biobanks for psychiatric genomic research: Consistency of clinical and genetic aspects of recorded depression across US states in the All of Us Research Program.Psychological medicine · 2026Article
- The European Health Data Space and biobanking in Europe: synergies, tensions and the future governance of data-driven health research.Frontiers in genetics · 2026Review
- Effects of Rare Coding Variants in Severe Early-Onset Obesity Genes in the Population-Based UK Biobank Study.The Journal of clinical endocrinology and metabolism · 2025Article
- Wearable device-based health equivalence of different physical activity intensities against mortality, cardiometabolic disease, and cancer.Nature communications · 2025Article
- Data Donation as a Method to Measure Physical Activity in Older Adults: Cross-Sectional Web Survey Assessing Consent Rates, Donation Success, and Bias.Journal of medical Internet research · 2025Article
- Refining the evidence linking dietary diversity, genetic susceptibility, and dementia.The journal of prevention of Alzheimer's disease · 2025Article
- Replicated blood-based biomarkers for myalgic encephalomyelitis not explicable by inactivity.EMBO molecular medicine · 2025Article
29 more citing papers are in PubMed but not listed here.
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6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe UK Biobank (UKB) has been used widely to examine associations between lifestyle risk factors and mortality outcomes. It is unknown whether the extremely low UKB response rate (5.5%) and lack of representativeness materially affects the magnitude and direction of effect estimates.
methodsWe used poststratification to match the UKB sample to the target population in terms of sociodemographic characteristics and prevalence of lifestyle risk factors (physical inactivity, alcohol intake, smoking, and poor diet). We compared unweighted and poststratified associations between each lifestyle risk factor and a lifestyle index score with all-cause, cardiovascular disease (CVD), and cancer mortality. We also calculated the unweighted to poststratified ratio of HR (RHR) and 95% confidence interval as a marker of effect-size difference.
resultsOf 371,974 UKB participants with no missing data, 302,009 had no history of CVD or cancer, corresponding to 3,298,958 person years of follow-up. Protective associations between alcohol use and CVD mortality observed in the unweighted UKB were substantially altered after poststratification, for example, from a hazard ratio (HR) of 0.63 (0.45-0.87) unweighted to 0.99 (0.65-1.50) poststratified for drinking ≥5 times/week versus never drinking. The magnitude of the poststratified all-cause mortality hazard ratio comparing least healthy with healthiest tertile of lifestyle risk factor index was 9% higher (95% confidence interval: 4%, 14%) than the unweighted estimates.
conclusionsLack of representativeness may distort the associations of alcohol with CVD mortality, and may underestimate health hazards among those with cumulatively the least healthy lifestyles.
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