Abstract
Lifestyle score approaches combining individual lifestyle factors, e.g. favourable diet, physical activity or normal body weight, showed inverse associations with cardiovascular disease (CVD) risk. However, research mainly focussed on adult behaviour and is scarce for vulnerable time windows for adult health like adolescence. We investigated associations between an adolescent lifestyle score and CVD risk markers in young adulthood. Overall, we analysed 270 participants of the open DONALD cohort study with 1-6 complete measurements of five lifestyle factors (healthy diet, moderate-to-vigorous physical activity, sedentary behaviour, sleep duration and BMI standard deviation score) during adolescence (females: 8⋅5-15⋅5 years and males: 9⋅5-16⋅5 years). Multivariable linear regression models were used to investigate the prospective association between the adolescent lifestyle score (0-5 points) and CVD risk markers in young adulthood (18-30 years). On average, participants obtained a mean adolescent lifestyle score of 2⋅9 (0-5) points. Inverse associations between the adolescent lifestyle score and waist circumference, waist-to-height ratio and percentage of body fat were observed (4⋅1, 4⋅1 and 9⋅2 % decrease per 1 point increase in adolescent lifestyle score, respectively, P < 0⋅05). For the remaining CVD risk markers (glucose, blood lipids, blood pressure and a proinflammatory score), no associations were observed. A healthy adolescent lifestyle is particularly associated with CVD risk-related favourable anthropometric markers in adulthood. A more comprehensive understanding of lifestyle patterns in the life course might enable earlier, targeted preventive measures to assist vulnerable groups in prevention of chronic diseases.
Highlights
Associations between lifestyle factors and cardiovascular disease (CVD) risk are well known in adults
After adjustments of the multivariate adjusted model, inverse associations were observed between adolescence lifestyle score and WC (−4⋅1 % [−5⋅9, −2⋅3 %], P = 0⋅0006), WHtR (−4⋅1 % [−5⋅9, −2⋅3 %], P = 0⋅0004) and %BF (−9⋅2 % [−13⋅1, −5⋅1 %], P = 0⋅0008) in young adulthood
Our findings indicate that a healthy lifestyle consisting of the five factors favourable diet, physical activity, sedentary behaviour, sleep duration and body weight during adolescence was inversely associated with WC, WHtR and %BF in young adulthood
Summary
Associations between lifestyle factors and cardiovascular disease (CVD) risk are well known in adults. Using a multidimensional lifestyle pattern approach, various risk factors are simultaneously considered as well as the interaction between them[10,11,12]. When considering such multidimensional patterns, cut-off values of single score factors can be either based on established references[13,14] or on population-specific cut-offs[15] and summed up to an overall score. In a recent meta-analysis of twenty-two cohort studies, adherence to a healthy lifestyle was associated with a 66 % reduction in total CVD risk[12]
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