ArticleBMC medicine2024
Healthy lifestyle change and all-cause and cancer mortality in the European Prospective Investigation into Cancer and Nutrition cohort.
Article in BMC medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed.
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- Effect of morbidity on the association between lifestyle and mortality in the Health Examinee cohort.Epidemiology and health · 2026Article
- Association between cardiovascular-kidney-metabolic syndrome, lifestyle, and all-cause and cause-specific mortality: a prospective cohort study.EClinicalMedicine · 2025Article
- Mortality attributable to modifiable lifestyle factors in the Spanish cohort of the European prospective investigation into cancer and nutrition (EPIC) study.BMC public health · 2025Article
- Quantifying Health-Related Risk Factors Associated with Breast and Prostate Cancer Burden: The Role of Trends and Disparities in Obesity and Cholesterol.Iranian journal of public health · 2025Article
- Integration of Screening and Referral Tools for Social Determinants of Health and Modifiable Lifestyle Factors in the Epic Electronic Health Record System: Scoping Review.Journal of medical Internet research · 2025Article
- Biomarkers of aging: from molecules and surrogates to physiology and function.Physiological reviews · 2025Review
- Mobile Application Intervention for Prevention of Multiple Risk Behaviors among Thai Female Adolescents: A Quasi-experimental Study.International journal of community based nursing and midwifery · 2025Article
- Joint association of antioxidant intakes from diet and supplements and sedentary behavior with all-cause and cardiovascular disease mortality among US adults.BMC public health · 2025Article
- Digital literacy and its effects on older adults' health: exploring mechanisms and outcomes.Frontiers in public health · 2025Article
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Abstract
backgroundHealthy lifestyles are inversely associated with the risk of noncommunicable diseases, which are leading causes of death. However, few studies have used longitudinal data to assess the impact of changing lifestyle behaviours on all-cause and cancer mortality.
methodsWithin the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, lifestyle profiles of 308,497 cancer-free adults (71% female) aged 35-70 years at recruitment across nine countries were assessed with baseline and follow-up questionnaires administered on average of 7 years apart. A healthy lifestyle index (HLI), assessed at two time points, combined information on smoking status, alcohol intake, body mass index, and physical activity, and ranged from 0 to 16 units. A change score was calculated as the difference between HLI at baseline and follow-up. Associations between HLI change and all-cause and cancer mortality were modelled with Cox regression, and the impact of changing HLI on accelerating mortality rate was estimated by rate advancement periods (RAP, in years).
resultsAfter the follow-up questionnaire, participants were followed for an average of 9.9 years, with 21,696 deaths (8407 cancer deaths) documented. Compared to participants whose HLIs remained stable (within one unit), improving HLI by more than one unit was inversely associated with all-cause and cancer mortality (hazard ratio [HR]: 0.84; 95% confidence interval [CI]: 0.81, 0.88; and HR: 0.87; 95% CI: 0.82, 0.92; respectively), while worsening HLI by more than one unit was associated with an increase in mortality (all-cause mortality HR: 1.26; 95% CI: 1.20, 1.33; cancer mortality HR: 1.19; 95% CI: 1.09, 1.29). Participants who worsened HLI by more than one advanced their risk of death by 1.62 (1.44, 1.96) years, while participants who improved HLI by the same amount delayed their risk of death by 1.19 (0.65, 2.32) years, compared to those with stable HLI.
conclusionsMaking healthier lifestyle changes during adulthood was inversely associated with all-cause and cancer mortality and delayed risk of death. Conversely, making unhealthier lifestyle changes was positively associated with mortality and an accelerated risk of death.
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