Introduction
Although numerous studies have suggested that lifestyle-related factors are associated
with chronic diseases and preventable deaths, limited evidence is available for the
Chinese population.
Methods
This study established a prospective cohort of >360,000 residents on the basis of
the Yinzhou Health Information System in China during 2004–2017 and calculated the
combined effects of lifestyle-related factors, including BMI, smoking, alcohol consumption,
and physical activity, using a points system. A Cox regression model estimated the
combined effects of lifestyle-related factors on total mortality, and a competing
risk model estimated the combined effects on cancer and cardiovascular disease mortality.
All data analyses were conducted in 2018‒2019.
Results
During 3,755,879 person-years of follow-up, 11,791 deaths were identified, including
4,983 from cancer and 3,143 from cardiovascular disease. Having a standard BMI, never
smoking, never drinking, and engaging in physical activity more than 4 times per week
had protective effects on total mortality. Overall, the risk of total and cause-specific
mortality increased with the increment of risk score. Compared with subjects in the
lowest quartile, the risk of total and cause-specific mortality peaked among individuals
in the fourth quartile (total mortality: hazard ratio=1.87, 95% CI=1.77, 1.98; cancer
mortality: hazard ratio=2.05, 95% CI=1.87, 2.25; cardiovascular disease mortality:
hazard ratio=1.51, 95% CI=1.35, 1.68). Sensitivity analyses excluding individuals
with follow-up <3 years did not materially change the results.
Conclusions
The combined effects of lifestyle-related factors, including BMI, smoking, alcohol
drinking, and physical activity, are associated with total, cancer, and cardiovascular
disease mortality among the Chinese population.
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Article Info
Publication History
Published online: May 14, 2020
Identification
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© 2020 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
