Lifestyle changes at middle age and mortality: a population-based prospective cohort study

Paula Berstad; Edoardo Botteri; Inger Kristin Larsen; Magnus Løberg; Mette Kalager; Øyvind Holme; Michael Bretthauer; Geir Hoff

doi:10.1136/jech-2015-206760

Lifestyle changes at middle age and mortality: a population-based prospective cohort study

Paula Berstad, Edoardo Botteri, Inger Kristin Larsen, Magnus Løberg, Mette Kalager, Øyvind Holme, Michael Bretthauer, Geir Hoff

Istituto Europeo di Oncologia

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND: The effect of modifying lifestyle at middle age on mortality has been sparsely examined.

METHODS: Men and women aged 50-54 years randomised to the control group (no intervention) in the population-based Norwegian Colorectal Cancer Prevention trial were asked to fill in lifestyle questionnaires in 2001 and 2004. Lifestyle scores were estimated ranging from 0 (poorest) to 4 (best) based on health recommendations (non-smoking, daily physical activity, body mass index <25.0 kg/m2and healthy diet). Outcomes were all-cause, cancer and cardiovascular mortality before 31 December 2013.

RESULTS: Of the 6886 attainable individuals included in the study, 4211 (61%) responded to the baseline questionnaire in 2001. After a median follow-up of 12.3 years, 226 (5.4%) of the baseline questionnaire responders died; 110 (49%) from cancer and 32 (14%) from cardiovascular disease. For each increment in lifestyle score in 2001, a 21% lower all-cause mortality was observed (HR 0.79, 95% CI 0.67 to 0.94, adjusted for age, sex, occupational working hours and chronic disease or pain during 3 years before enrolment). A one-point increase in lifestyle score from 2001 to 2004 was associated with a 38% reduction in all-cause mortality (adjusted HR 0.62, CI 0.45 to 0.84). The group reporting lifestyle change from score 0-1 (unfavourable) in 2001 to score 2-4 (favourable) in 2004 had 4.8 fewer deaths per 1000 person years, compared with the group maintaining an 'unfavourable' lifestyle (adjusted HR 0.31, CI 0.13 to 0.70 for all-cause mortality).

CONCLUSIONS: Favourable lifestyle changes at age 50-60 years may prevent early death.

TRIAL REGISTRATION: NCT00119912; pre-results.

Original language	English
Pages (from-to)	59-66
Number of pages	8
Journal	Journal of Epidemiology and Community Health
Volume	71
Issue number	1
DOIs	https://doi.org/10.1136/jech-2015-206760
Publication status	Published - Jan 2017

Keywords

Cardiovascular Diseases/mortality
Cause of Death
Colonoscopy
Colorectal Neoplasms/diagnosis
Female
Follow-Up Studies
Healthy Lifestyle
Humans
Male
Middle Aged
Neoplasms/mortality
Norway
Prospective Studies
Risk Factors
Surveys and Questionnaires
Survival Analysis

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10.1136/jech-2015-206760

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Lifestyle changes at middle age and mortality : a population-based prospective cohort study. / Berstad, Paula; Botteri, Edoardo; Larsen, Inger Kristin; Løberg, Magnus; Kalager, Mette; Holme, Øyvind; Bretthauer, Michael; Hoff, Geir.

In: Journal of Epidemiology and Community Health, Vol. 71, No. 1, 01.2017, p. 59-66.

Research output: Contribution to journal › Article › peer-review

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title = "Lifestyle changes at middle age and mortality: a population-based prospective cohort study",

abstract = "BACKGROUND: The effect of modifying lifestyle at middle age on mortality has been sparsely examined.METHODS: Men and women aged 50-54 years randomised to the control group (no intervention) in the population-based Norwegian Colorectal Cancer Prevention trial were asked to fill in lifestyle questionnaires in 2001 and 2004. Lifestyle scores were estimated ranging from 0 (poorest) to 4 (best) based on health recommendations (non-smoking, daily physical activity, body mass index <25.0 kg/m2and healthy diet). Outcomes were all-cause, cancer and cardiovascular mortality before 31 December 2013.RESULTS: Of the 6886 attainable individuals included in the study, 4211 (61%) responded to the baseline questionnaire in 2001. After a median follow-up of 12.3 years, 226 (5.4%) of the baseline questionnaire responders died; 110 (49%) from cancer and 32 (14%) from cardiovascular disease. For each increment in lifestyle score in 2001, a 21% lower all-cause mortality was observed (HR 0.79, 95% CI 0.67 to 0.94, adjusted for age, sex, occupational working hours and chronic disease or pain during 3 years before enrolment). A one-point increase in lifestyle score from 2001 to 2004 was associated with a 38% reduction in all-cause mortality (adjusted HR 0.62, CI 0.45 to 0.84). The group reporting lifestyle change from score 0-1 (unfavourable) in 2001 to score 2-4 (favourable) in 2004 had 4.8 fewer deaths per 1000 person years, compared with the group maintaining an 'unfavourable' lifestyle (adjusted HR 0.31, CI 0.13 to 0.70 for all-cause mortality).CONCLUSIONS: Favourable lifestyle changes at age 50-60 years may prevent early death.TRIAL REGISTRATION: NCT00119912; pre-results.",

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author = "Paula Berstad and Edoardo Botteri and Larsen, {Inger Kristin} and Magnus L{\o}berg and Mette Kalager and {\O}yvind Holme and Michael Bretthauer and Geir Hoff",

note = "Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.",

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doi = "10.1136/jech-2015-206760",

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T1 - Lifestyle changes at middle age and mortality

T2 - a population-based prospective cohort study

AU - Berstad, Paula

AU - Botteri, Edoardo

AU - Larsen, Inger Kristin

AU - Løberg, Magnus

AU - Kalager, Mette

AU - Holme, Øyvind

AU - Bretthauer, Michael

AU - Hoff, Geir

N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

PY - 2017/1

Y1 - 2017/1

N2 - BACKGROUND: The effect of modifying lifestyle at middle age on mortality has been sparsely examined.METHODS: Men and women aged 50-54 years randomised to the control group (no intervention) in the population-based Norwegian Colorectal Cancer Prevention trial were asked to fill in lifestyle questionnaires in 2001 and 2004. Lifestyle scores were estimated ranging from 0 (poorest) to 4 (best) based on health recommendations (non-smoking, daily physical activity, body mass index <25.0 kg/m2and healthy diet). Outcomes were all-cause, cancer and cardiovascular mortality before 31 December 2013.RESULTS: Of the 6886 attainable individuals included in the study, 4211 (61%) responded to the baseline questionnaire in 2001. After a median follow-up of 12.3 years, 226 (5.4%) of the baseline questionnaire responders died; 110 (49%) from cancer and 32 (14%) from cardiovascular disease. For each increment in lifestyle score in 2001, a 21% lower all-cause mortality was observed (HR 0.79, 95% CI 0.67 to 0.94, adjusted for age, sex, occupational working hours and chronic disease or pain during 3 years before enrolment). A one-point increase in lifestyle score from 2001 to 2004 was associated with a 38% reduction in all-cause mortality (adjusted HR 0.62, CI 0.45 to 0.84). The group reporting lifestyle change from score 0-1 (unfavourable) in 2001 to score 2-4 (favourable) in 2004 had 4.8 fewer deaths per 1000 person years, compared with the group maintaining an 'unfavourable' lifestyle (adjusted HR 0.31, CI 0.13 to 0.70 for all-cause mortality).CONCLUSIONS: Favourable lifestyle changes at age 50-60 years may prevent early death.TRIAL REGISTRATION: NCT00119912; pre-results.

AB - BACKGROUND: The effect of modifying lifestyle at middle age on mortality has been sparsely examined.METHODS: Men and women aged 50-54 years randomised to the control group (no intervention) in the population-based Norwegian Colorectal Cancer Prevention trial were asked to fill in lifestyle questionnaires in 2001 and 2004. Lifestyle scores were estimated ranging from 0 (poorest) to 4 (best) based on health recommendations (non-smoking, daily physical activity, body mass index <25.0 kg/m2and healthy diet). Outcomes were all-cause, cancer and cardiovascular mortality before 31 December 2013.RESULTS: Of the 6886 attainable individuals included in the study, 4211 (61%) responded to the baseline questionnaire in 2001. After a median follow-up of 12.3 years, 226 (5.4%) of the baseline questionnaire responders died; 110 (49%) from cancer and 32 (14%) from cardiovascular disease. For each increment in lifestyle score in 2001, a 21% lower all-cause mortality was observed (HR 0.79, 95% CI 0.67 to 0.94, adjusted for age, sex, occupational working hours and chronic disease or pain during 3 years before enrolment). A one-point increase in lifestyle score from 2001 to 2004 was associated with a 38% reduction in all-cause mortality (adjusted HR 0.62, CI 0.45 to 0.84). The group reporting lifestyle change from score 0-1 (unfavourable) in 2001 to score 2-4 (favourable) in 2004 had 4.8 fewer deaths per 1000 person years, compared with the group maintaining an 'unfavourable' lifestyle (adjusted HR 0.31, CI 0.13 to 0.70 for all-cause mortality).CONCLUSIONS: Favourable lifestyle changes at age 50-60 years may prevent early death.TRIAL REGISTRATION: NCT00119912; pre-results.

KW - Cardiovascular Diseases/mortality

KW - Cause of Death

KW - Colonoscopy

KW - Colorectal Neoplasms/diagnosis

KW - Female

KW - Follow-Up Studies

KW - Healthy Lifestyle

KW - Humans

KW - Male

KW - Middle Aged

KW - Neoplasms/mortality

KW - Norway

KW - Prospective Studies

KW - Risk Factors

KW - Surveys and Questionnaires

KW - Survival Analysis

U2 - 10.1136/jech-2015-206760

DO - 10.1136/jech-2015-206760

M3 - Article

C2 - 27312250

VL - 71

SP - 59

EP - 66

JO - Journal of Epidemiology and Community Health

JF - Journal of Epidemiology and Community Health

SN - 0143-005X

IS - 1

ER -

Lifestyle changes at middle age and mortality: a population-based prospective cohort study

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Keywords

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