Journal Article

DKFZ-2024-01517

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png On the use of the healthy lifestyle index to investigate specific disease outcomes.

Viallon, V. ; Freisling, H. ; Matta, K. ; Nannsen, A. Ø. ; Dahm, C. C. ; Tjønneland, A. ; Eriksen, A. K. ; Kaaks, R.DKFZ* ; Katzke, V. A.DKFZ* ; Schulze, M. B. ; Masala, G. ; Tagliabue, G. ; Simeon, V. ; Tumino, R. ; Milani, L. ; Derksen, J. W. G. ; van der Schouw, Y. T. ; Nøst, T. H. ; Borch, K. B. ; Sandanger, T. M. ; Quirós, J. R. ; Rodriguez-Barranco, M. ; Bonet, C. ; Aizpurua-Atxega, A. ; Cirera, L. ; Guevara, M. ; Sundström, B. ; Winkvist, A. ; Heath, A. K. ; Gunter, M. J. ; Weiderpass, E. ; Johansson, M. ; Ferrari, P.

2024
Macmillan Publishers Limited, part of Springer Nature [London]

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Please use a persistent id in citations: doi:10.1038/s41598-024-66772-w

Abstract: The healthy lifestyle index (HLI), defined as the unweighted sum of individual lifestyle components, was used to investigate the combined role of lifestyle factors on health-related outcomes. We introduced weighted outcome-specific versions of the HLI, where individual lifestyle components were weighted according to their associations with disease outcomes. Within the European Prospective Investigation into Cancer and Nutrition (EPIC), we examined the association between the standard and the outcome-specific HLIs and the risk of T2D, CVD, cancer, and all-cause premature mortality. Estimates of the hazard ratios (HRs), the Harrell's C-index and the population attributable fractions (PAFs) were compared. For T2D, the HR for 1-SD increase of the standard and T2D-specific HLI were 0.66 (95% CI: 0.64, 0.67) and 0.43 (0.42, 0.44), respectively, and the C-index were 0.63 (0.62, 0.64) and 0.72 (0.72, 0.73). Similar, yet less pronounced differences in HR and C-index were observed for standard and outcome-specific estimates for cancer, CVD and all-cause mortality. PAF estimates for mortality before age 80 were 57% (55%, 58%) and 33% (32%, 34%) for standard and mortality-specific HLI, respectively. The use of outcome-specific HLI could improve the assessment of the role of lifestyle factors on disease outcomes, thus enhancing the definition of public health recommendations.

Keyword(s): Humans (MeSH) ; Healthy Lifestyle (MeSH) ; Male (MeSH) ; Female (MeSH) ; Middle Aged (MeSH) ; Neoplasms: mortality (MeSH) ; Neoplasms: epidemiology (MeSH) ; Cardiovascular Diseases: mortality (MeSH) ; Cardiovascular Diseases: epidemiology (MeSH) ; Prospective Studies (MeSH) ; Aged (MeSH) ; Adult (MeSH) ; Diabetes Mellitus, Type 2: mortality (MeSH) ; Diabetes Mellitus, Type 2: epidemiology (MeSH) ; Risk Factors (MeSH) ; Proportional Hazards Models (MeSH) ; Europe: epidemiology (MeSH) ; Mortality, Premature (MeSH) ; Life Style (MeSH) ; Cancer ; Cardiovascular diseases ; Composite score ; Healthy lifestyle index ; Lifestyle factors ; Mortality ; Type 2 diabetes

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Contributing Institute(s):

1. C020 Epidemiologie von Krebs (C020)

Research Program(s):

1. 313 - Krebsrisikofaktoren und Prävention (POF4-313) (POF4-313)

Appears in the scientific report 2024

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