Abstract
BackgroundLifestyle factors were associated with an increased risk of cardiovascular disease (CVD) occurrence. We explored the associations between lifestyle factors and CVD risk factors, and assessed the interactive effects of lifestyle factors on CVD risk factors.MethodsA cross-sectional data of 114,082 (57,680 men and 56,402 women) middle-aged adults and elderly in Taiwan were collected from 2001 to 2010. Logistic regression analysis was used to assess the associations between lifestyle factors and CVD risk factors. The relative excess risk due to interaction (RERI) and the attributable proportion due to interaction were used to explore the interactive effect of lifestyle factors on CVD risk factors.ResultsThe interaction between alcohol consumption and smoking exhibited an excess risk of high triglycerides (RERI = 0.21; 95% CI: 0.14–0.29), and that of alcohol consumption and physical activity had an excess risk of high LDL-cholesterol (RERI = 0.11; 95% CI: 0.06–0.16) and high blood glucose (RERI = 0.05; 95% CI: 0.01–0.11). Alcohol consumption and vegetable-rich diet (intake of high vegetables with no or low meat) had an excess risk of high LDL-cholesterol and low HDL-cholesterol, but a reduced risk of high triglycerides (RERI = − 0.10; 95% CI: − 0.17 – -0.04). Smoking and physical activity had an increased risk of high blood glucose and a reduced risk of low HDL-cholesterol. Smoking and vegetable-rich diet reduced the risk of high triglycerides (RERI = − 0.11; 95% CI: − 0.18 – − 0.04), high blood glucose (RERI = − 0.14; 95% CI: − 0.21 – − 0.07) and low HDL-cholesterol (RERI = − 0.10; 95% CI: − 0.19 – -0.01).ConclusionsThe interaction between smoking, alcohol consumption, physical activity and diet were associated with lipid profile and blood glucose, hence there was an interaction between these lifestyle factors in an additive scale. Public health promotion should therefore consider multifaceted promotional activities that are likely to make a positive impact on the health status of the Taiwanese population.
Highlights
Lifestyle factors were associated with an increased risk of cardiovascular disease (CVD) occurrence
The adjusted model revealed that smoking significantly increased the development of high TG (OR = 1.44; 95% confidence interval (CI): 1.38–1.50; p ≤ 0.001), total cholesterol (TC) (OR = 1.08; 95% CI: 1.04–1.12; p ≤ 0.001), C-reactive protein (CRP) (OR = 1.33; 95% CI: 1.19– 1.47; p ≤ 0.001), blood glucose (OR = 1.49; 95% CI: 1.43– 1.55; p ≤ 0.001) and low high-density lipoprotein-cholesterol (HDL-C) levels (OR = 1.60; 95% CI: 1.52–1.68; p ≤ 0.001) compared with non-smoking
Our study explored the associations between lifestyle factors and CVD risk factors, and further assessed the interactive effects of lifestyle factors on CVD risk factors
Summary
Lifestyle factors were associated with an increased risk of cardiovascular disease (CVD) occurrence. The prevalence of overweight and obesity among adults in Taiwan increased obviously from 33.2% during 1993–1996 to 43.0% during 2013– 2014 [2] Unhealthy lifestyle habits such as smoking, alcohol consumption, physical inactivity and poor dietary habits have been considered to be associated with an increased risk of overweight and cardiovascular disease (CVD) [3, 4]. Good lifestyle habits such as regular exercise and healthy dietary habits have been known as protective factors against hyperlipidemia as well as CVD occurrence and mortality [10,11,12,13,14], while cigarette smoking is known to have a negative effect on blood lipids [15,16,17]. The interactive effects of these lifestyle factors on blood lipids and inflammation are not clear in literature
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