Abstract
Impact of combined lifestyles on risk of mortality needs to be explored quantitatively. We aimed to evaluate the associations of combined lifestyle factors with total and cause-specific mortality in Chinese men. We used data from the Shanghai Men’s Health Study (2002–2013), an on-going population-based prospective cohort study of men (aged 40 to 74 years). Four traditional unfavorable lifestyle factors were included: smoking, heavy alcohol use, unhealthy diet and physical inactivity. Cox proportional hazards models were used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs). Among about 61,480 men in the cohort, a total of 4,952 men died, of which 1,637 men died from cardiovascular diseases (CVD), 2,122 from cancer during a median of 9.29 years’ follow-up. The HRs of men with four risk practices comparing to those with zero were 2.92 (95%CI: 2.53, 3.38) for all-cause mortality, 3.15 (95%CI: 2.44, 4.05) for CVD mortality, and 3.18 (95%CI: 2.55, 3.97) for cancer mortality. The population attributable risks (PARs) were 0.41, 0.40 and 0.38 for total, CVD and cancer mortality, accordingly. As combined unhealthy lifestyle behaviors had substantial impact on total and cause-specific mortality, promotion of healthy lifestyle should be a public health priority.
Highlights
Population in the Shanghai Men’s Health Study (SMHS) has its unique lifestyle pattern compared with their counterparts in western countries such as high percentage of smoking and low participation rate of physical activity[23,24,25]
Based on data from the SMHS, a prospective cohort in China, the present study aimed to investigate associations of lifestyle index with all-cause and cause-specific mortality risks and further quantify population attributable risks of these lifestyle factors
66% participants were current smokers or smoking cessation less than 10 years; 13% of participants consumed alcohol more than 14 drinks a week; 40% of participants were categorized as having unhealthy diet; and up to 83% of participants involved moderate-to-vigorous-intensity physical activity less than 150 minutes per week
Summary
Population in the Shanghai Men’s Health Study (SMHS) has its unique lifestyle pattern compared with their counterparts in western countries such as high percentage of smoking and low participation rate of physical activity[23,24,25]. Results from the SMHS would be of great significance for men in other cities of China and for men in other Asian countries with similar ethnicity, cultural factors and life style. Based on data from the SMHS, a prospective cohort in China, the present study aimed to investigate associations of lifestyle index with all-cause and cause-specific mortality risks and further quantify population attributable risks of these lifestyle factors. We evaluated the mortality risk for commonly occurring combinations of these lifestyle factors
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