Major Lifestyle Risk Factors Research Articles

1. The fraction of cancer attributable to lifestyle and environmental factors in the UK in 2010

The overall objective of the study is to estimate the percentage of cancers (excluding non-melanoma skin cancer) in the UK in 2010 that were the result of exposure to 14 major lifestyle, dietary and environmental risk factors: tobacco, alcohol, four elements of diet (consumption of meat, fruit and vegetables, fibre and salt), overweight, lack of physical exercise, occupation, infections, radiation (ionising and solar), use of hormones and reproductive history (breast feeding). The number of new cases attributable to suboptimal exposure levels in the past, relative to a theoretical optimum exposure distribution, is evaluated. For most of the exposures, the attributable fraction was calculated based on the distribution of exposure prevalence (around 2000), the difference from the theoretical optimum (by age group and sex) and the relative risk per unit difference. For tobacco smoking, the method developed by Peto et al (1992) was used, which relies on the ratio between observed incidence of lung cancer in smokers and that in non-smokers, to calibrate the risk. This article outlines the structure of the supplement – a section for each of the 14 exposures, followed by a Summary chapter, which considers the relative contributions of each factor to the total number of cancers diagnosed in the UK in 2010 that were, in theory, avoidable.

Does family history of cancer modify the effects of lifestyle risk factors on esophageal cancer? a population‐based case–control study in China

A population-based case-control study on esophageal cancer has been conducted since 2003 in Jiangsu Province, China. The aim of this analysis is to provide further evidence on the relationship between family history of cancer in first-degree relatives (FH-FDRs) and the risk of esophageal cancer, and to explore the joint effects for FH-FDR with major lifestyle risk factors. A total of 1,520 cases and 3,879 controls were recruited. Unconditional logistic regression was applied for evaluating independent association as well as potential interactions between FH-FDR and lifestyle risk factors on the risk of esophageal cancer. Population attributable fraction (PAF) was calculated to quantify the proportion of cases attributable to risk factors. Results showed that with a FH-FDR of any malignant tumor or esophageal cancer, there is a 1.64- and 2.22-fold risk of esophageal cancer, respectively. Association was increased when there was more than one affected FDR (OR = 3.14) and younger age at diagnosis of relatives. Exposure of both FH-FDR and lifestyle risk factors strongly associated with esophageal cancer. Significant superadditivity interaction was found for FH-FDR with fast eating speed and diets low in fruits and vegetables. The estimation of PAF indicated that the majority of cases were attributed to lifestyle risk factors. In conclusion, it was found that FH-FDR significantly increases the risk of esophageal cancer and could modify the effect of certain lifestyle risk factors. If comprehensive lifestyle interventions are carried out within high-risk populations, there is a high probability of curbing occurrences of esophageal cancer.

The Polypill in the Prevention of Cardiovascular Diseases

Cardiovascular disease (CVD) is the major cause of death and disability globally1 and affects approximately half of all individuals over their lifetimes.2 The CVD burden has decreased in developed countries as effective prevention and treatment strategies were implemented,3,–,5 although these gains are threatened by increasing obesity, sedentary lifestyles, and diabetes mellitus.3 By contrast, CVD has increased in developing countries, and by the year 2020, 80% of the global CVD mortality is predicted to occur in low- and middle-income countries.1 The major risk factors for CVD are known. Nine to 10 potentially modifiable risk factors account for 90% of the population attributable risk for myocardial infarction and stroke, with similar estimates in all major regions of the world (Figure 1).6,7 These risk factors are ubiquitous in populations. For example, in the Framingham Study, <5% of middle-aged individuals had optimal levels of risk factors,2 in INTERHEART, 99% of control subjects had at least 1 cardiovascular risk factor,6 and in the US National Health and Nutrition Examination Surveys I, II, and III, the prevalence of low risk factor burden was only 4.4% during 1971–1975, 10.5% during 1988–1994, and 7.5% during 1999–2004.8 Figure 1. Population attributable risk for myocardial infarction associated with 7 major modifiable risk factors overall and by region in the INTERHEART study. The black bars indicate the population attributable risk associated with major biological and lifestyle risk factors combined; the blue bars indicate the population attributable risk associated with major modifiable biological risk factors (abnormal apolipoproteins, hypertension, and diabetes mellitus); and the red bars indicate the population attributable risk associated with major lifestyle modifiable risk factors (smoking, diet poor in fruits and vegetables, and lack of exercise). The 2 additional risk factors shown to significantly affect risk …

The Prevalence and Clustering of Four Major Lifestyle Risk Factors in Hong Kong Chinese Older Adults

This study investigated the prevalence and clustering of four common lifestyle risk factors--cigarette smoking, heavy alcohol drinking, physical inactivity, and low consumption of vegetables and fruits--among older Chinese women and men in Hong Kong. The author examined 4,812 community-dwelling older persons aged 60 and older in a cross-sectional representative study, collecting data on lifestyle risk factors and sociodemographics by in-person interviews during household visits. About 5% of older persons had at least three lifestyle risk factors, and more than 90% of them were men. Clustering was found at both ends of the lifestyle spectrum, especially in older men. Prevalence of multiple risk factors was higher among men, older age groups, and those with higher levels of education but lower for those who were employed. Findings suggest that common lifestyle risk factors cluster among older men, and the clustering of risk factors provides support for multiple-behavior interventions.

The prevalence and clustering of four major lifestyle risk factors in an English adult population

Background The aim of this study was to examine the clustering of four major lifestyle risk factors (smoking, heavy drinking, lack of fruit and vegetables consumption, and lack of physical activity), and to examine the variation across different socio-demographic groups in the English adult population. Methods The study population was derived from the 2003 Health Survey for England ( n = 11,492). Clustering was examined by comparing the observed and expected prevalence of the different possible combinations. A multinomial multilevel regression model was conducted to examine the socio-demographic variation in the clustering of the four risk factors. Results The study found that, when using British health recommendations, a majority of the English population have multiple lifestyle risk factors at the same time. Clustering was found at both ends of the lifestyle spectrum and was more pronounced for women than for men. Overall, multiple risk factors were more prevalent among men, lower social class households, singles, and people who are economically inactive, but less prevalent among homeowners and older age groups. Conclusions The clustering of multiple risk factors provides support for multiple-behavior interventions as opposed to single-behavior interventions.

Prevalence of Health Behaviors Related to Hypertension in 3 Blood Pressure Treatment Groups: The Minnesota Heart Health Program

Background. Lifestyle modifications have the potential to bring blood pressure under control or reduce the need for potentially harmful medications and, most importantly, to prevent high blood pressure from developing. Evaluation of the contribution of primary and secondary prevention efforts requires monitoring risk factors for hypertension among those with and without a history of the condition. Methods. This study in the Minnesota Heart Health Program describes the prevalence of the major lifestyle risk factors for hypertension and other cardiovascular disease. Data are from men and women age 25-74 over a period of about 10 years (1980-1990). The study involved six communities, three received an education intervention, and three were used as comparison groups. Irrespective of observed blood pressure values, risk factor levels and time trends are compared among persons taking antihypertensive medication, persons with a history of hypertension but not currently medicated, and a general population, nonhypertensive group who report they were never told they were hypertensive. Analysis was done at the level of the city rather than the individual and involved a subset of the cross-sectional survey data. Results . Significant differences were found between groups for knowledge about and control of high blood pressure, for body mass index, intent to lose weight, physical activity, sodium and fat intake, and total serum cholesterol level. No differences were found in intent to increase physical activity, in alcohol intake, or smoking prevalence. A group by time interaction was found only for frequent use of table salt and percentage of total kilocalories from fat. Most time trends were significant and in a favorable direction for prevention. Means for all groups indicated failure to meet national recommendations for dietary sodium, percentage of calories from fat, total cholesterol level, smoking, and possibly exercise. Conclusions. Efforts to prevent, treat, and control hypertension will require more intensive intervention. Continued monitoring of the knowledge and behaviors of hypertensives and the general population is needed to inform primary and secondary prevention efforts, especially in more diverse populations than this study represents.