The association between adult attained height and sitting height with mortality in the European Prospective Investigation into Cancer and Nutrition (EPIC).

Norie Sawada,Kim Overvad,Marc J Gunter,Laureen Dartois,Elisabete Weiderpass,Melissa A Merritt,Anne Tjønneland,Petra A Wark,Miren Dorronsoro,Elio Riboli,Antonia Trichopoulou,Giovanna Masala,Rudolf Kaaks,Yvonne T Van Der Schouw,Sabina Rinaldi,Jonas Manjer,Shoichiro Tsugane,Marisa Da Silva,Valeria Pala,Eva Ardanaz,Amanda J Cross,Anja Olsen,Guri Skeie,Olle Melander,Mathilde His,Petra H.m Peeters ,Elisavet Valanou ,Elena Molina‐Portillo ,Lluís Cirera ,Aurora Perez‐Cornago ,Παγώνα Λάγιου ,Noémie Travier ,Maria Luísa Redondo ,Heather Ward ,Marie Christine Boutron-Ruault ,Renée T Fortner

doi:10.1371/journal.pone.0173117

Abstract

Adult height and sitting height may reflect genetic and environmental factors, including early life nutrition, physical and social environments. Previous studies have reported divergent associations for height and chronic disease mortality, with positive associations observed for cancer mortality but inverse associations for circulatory disease mortality. Sitting height might be more strongly associated with insulin resistance; however, data on sitting height and mortality is sparse. Using the European Prospective Investigation into Cancer and Nutrition study, a prospective cohort of 409,748 individuals, we examined adult height and sitting height in relation to all-cause and cause-specific mortality. Height was measured in the majority of participants; sitting height was measured in ~253,000 participants. During an average of 12.5 years of follow-up, 29,810 deaths (11,931 from cancer and 7,346 from circulatory disease) were identified. Hazard ratios (HR) with 95% confidence intervals (CI) for death were calculated using multivariable Cox regression within quintiles of height. Height was positively associated with cancer mortality (men: HRQ5 vs. Q1 = 1.11, 95%CI = 1.00–1.24; women: HRQ5 vs. Q1 = 1.17, 95%CI = 1.07–1.28). In contrast, height was inversely associated with circulatory disease mortality (men: HRQ5 vs. Q1 = 0.63, 95%CI = 0.56–0.71; women: HRQ5 vs. Q1 = 0.81, 95%CI = 0.70–0.93). Although sitting height was not associated with cancer mortality, it was inversely associated with circulatory disease (men: HRQ5 vs. Q1 = 0.64, 95%CI = 0.55–0.75; women: HRQ5 vs. Q1 = 0.60, 95%CI = 0.49–0.74) and respiratory disease mortality (men: HRQ5 vs. Q1 = 0.45, 95%CI = 0.28–0.71; women: HRQ5 vs. Q1 = 0.60, 95%CI = 0.40–0.89). We observed opposing effects of height on cancer and circulatory disease mortality. Sitting height was inversely associated with circulatory disease and respiratory disease mortality.

Highlights

Poor nutrition, illness and early life exposures may contribute to ill health in later life [1,2,3]; there is a paucity of data to explore such associations in prospective cohorts with extended follow-up of children
Sitting height was not associated with cancer mortality, it was inversely associated with circulatory disease and respiratory disease mortality
Higher sitting height is of interest because compared with adult height, sitting height may be more strongly positively associated with insulin resistance [7], and is positively associated with lung function, independently of height [8]; the effects of sitting height on mortality might be different from those of overall height

Summary

Introduction

Illness and early life exposures may contribute to ill health in later life [1,2,3]; there is a paucity of data to explore such associations in prospective cohorts with extended follow-up of children. The association between height and mortality has been investigated in previous studies. A meta-analysis of 121 cohort studies comprising over 1 million participants reported that height was inversely associated with risk of death from circulatory diseases such as coronary disease, stroke and heart failure [6]. Height was positively associated with risk of death from melanoma and cancers of the pancreas, endocrine and nervous systems, ovary, breast, prostate, colorectum, blood and lung [6]. One cohort study reported that sitting height was positively associated with cancer mortality and inversely associated with death from circulatory disease [9], but others showed no association [7, 10,11,12]

Methods

Results

Conclusion