Combined Impact of Known Lifestyle Factors on Total and Cause-Specific Mortality among Chinese Men: A Prospective Cohort Study

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.

Lifestyle risk score and mortality in Korean adults: a population-based cohort study

“…A large body of existing evidence shows that being obese, physically inactive, smoking and heavy alcohol use respectively have harmful effects on diverse diseases and overall health [1][2][3][4] . However, relatively fewer studies have examined the combined effects of these major lifestyle factors on health outcomes [9][10][11][12][13][14][15][16][17][18] . Moreover, most of the existing studies have been conducted among Western populations (i.e., Caucasians) and found a strong inverse association between a combined healthy lifestyle habits and overall mortality.…”

Joint trajectories of lifestyle pattern and subsequent psychopathological outcomes in adolescence

“…China is heading towards a ballooning epidemic of mental health problems in teens (1)(2)(3). The preliminary results of a nationwide epidemiological study suggest that 15% of children suffer from mental health problems and the prevalence of some disorders, such as anxiety disorders, are increasing (4). The 12-month prevalence of non-suicidal self-injury (NSSI), suicidal ideation and suicide attempt was 26.1%, 17.5% and 4.4%, respectively, based on a population of 14 820 students aged 10-20 years from three provinces in China (1).…”

“…Such soaring of mental health problem has paralleled a dramatic shift in health-related behaviors and lifestyle from traditional, healthy patterns towards unhealthy patterns. During the transition from childhood to adolescence, children in China gradually develop its unique lifestyle pattern due to high level academic pressure compared with their counterparts in western countries, including prolonged sitting and screen time (5,6), high proportion of regular sugar-sweetened beverages (SSBs) consumption (7) and insu cient sleep (8).…”

Effectiveness of complex multiple-risk lifestyle interventions in reducing symptoms of depression: a study protocol for a systematic review and meta-analysis of randomised controlled trials

“…It is increasingly accepted that poor sleep, dietary habits, smoking and sedentary habits are important modifiable risk factors for depressive disorders 9–12. Nowadays, the most prevalent lifestyle risk factors in many countries include tobacco use, physical inactivity and unhealthy diet 13–16…”