Multiple lifestyle behaviours and mortality, findings from a large population-based Norwegian cohort study - The HUNT Study
Krokstad, Steinar, Ding, Ding, Grunseit, Anne C., Sund, Erik R., Holmen, Turid Lingaas, Rangul, Vegar, and Bauman, Adrian (2017) Multiple lifestyle behaviours and mortality, findings from a large population-based Norwegian cohort study - The HUNT Study. BMC Public Health, 17 (58).
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Abstract
Background: Lifestyle risk behaviours are responsible for a large proportion of disease burden and premature mortality worldwide. Risk behaviours tend to cluster in populations. We developed a new lifestyle risk index by including emerging risk factors (sleep, sitting time, and social participation) and examine unique risk combinations and their associations with all-cause and cardio-metabolic mortality. Methods: Data are from a large population-based cohort study in a Norway, the Nord-Trøndelag Health Study (HUNT), with an average follow-up time of 14.1 years. Baseline data from 1995-97 were linked to the Norwegian Causes of Death Registry. The analytic sample comprised 36 911 adults aged 20-69 years. Cox regression models were first fitted for seven risk factors (poor diet, excessive alcohol consumption, current smoking, physical inactivity, excessive sitting, too much/too little sleep, and poor social participation) separately and then adjusted for socio-demographic covariates. Based on these results, a lifestyle risk index was developed. Finally, we explored common combinations of the risk factors in relation to all-cause and cardio-metabolic mortality outcomes.
Results: All single risk factors, except for diet, were significantly associated with both mortality outcomes, and were therefore selected to form a lifestyle risk index. Risk of mortality increased as the index score increased. The hazard ratio for all-cause mortality increased from 1.37 (1.15-1.62) to 6.15 (3.56-10.63) as the number of index risk factors increased from one to six respectively. Among the most common risk factor combinations the association with mortality was particularly strong when smoking and/or social participation were included.
Conclusions: This study adds to previous research on multiple risk behaviours by incorporating emerging risk factors. Findings regarding social participation and prolonged sitting suggest new components of healthy lifestyles and potential new directions for population health interventions.
| Item ID: | 53997 |
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| Item Type: | Article (Research - C1) |
| ISSN: | 1471-2458 |
| Keywords: | all-cause mortality, cardiovascular disease, cohort study, lifestyle behaviour, metabolic disease, risk factors |
| Additional Information: | The Author(s). 2017. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
| Funders: | National Health and Medical Research Council of Australia (NHMRC) |
| Projects and Grants: | NHMRC APP1072223 |
| Date Deposited: | 12 Jun 2018 03:55 |
| FoR Codes: | 42 HEALTH SCIENCES > 4202 Epidemiology > 420201 Behavioural epidemiology @ 50% 42 HEALTH SCIENCES > 4206 Public health > 420699 Public health not elsewhere classified @ 50% |
| SEO Codes: | 92 HEALTH > 9202 Health and Support Services > 920204 Evaluation of Health Outcomes @ 50% 92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920408 Health Status (e.g. Indicators of Well-Being) @ 50% |
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