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

Research output: Contribution to journalArticle

4 Citations (Scopus)

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 languageEnglish
Pages (from-to)59-66
Number of pages8
JournalJournal of Epidemiology and Community Health
Volume71
Issue number1
DOIs
Publication statusPublished - Jan 2017

Fingerprint

Life Style
Cohort Studies
Prospective Studies
Mortality
Population
Chronic Pain
Colorectal Neoplasms
Neoplasms
Body Mass Index
Chronic Disease
Cardiovascular Diseases
Exercise
Control Groups
Health
Surveys and Questionnaires

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

Cite this

Berstad, P., Botteri, E., Larsen, I. K., Løberg, M., Kalager, M., Holme, Ø., ... Hoff, G. (2017). Lifestyle changes at middle age and mortality: a population-based prospective cohort study. Journal of Epidemiology and Community Health, 71(1), 59-66. https://doi.org/10.1136/jech-2015-206760

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 journalArticle

Berstad, P, Botteri, E, Larsen, IK, Løberg, M, Kalager, M, Holme, Ø, Bretthauer, M & Hoff, G 2017, 'Lifestyle changes at middle age and mortality: a population-based prospective cohort study', Journal of Epidemiology and Community Health, vol. 71, no. 1, pp. 59-66. https://doi.org/10.1136/jech-2015-206760
Berstad, Paula ; Botteri, Edoardo ; Larsen, Inger Kristin ; Løberg, Magnus ; Kalager, Mette ; Holme, Øyvind ; Bretthauer, Michael ; Hoff, Geir. / Lifestyle changes at middle age and mortality : a population-based prospective cohort study. In: Journal of Epidemiology and Community Health. 2017 ; Vol. 71, No. 1. pp. 59-66.
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AU - Berstad, Paula

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AU - Løberg, Magnus

AU - Kalager, Mette

AU - Holme, Øyvind

AU - Bretthauer, Michael

AU - Hoff, Geir

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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.

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KW - Healthy Lifestyle

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KW - Male

KW - Middle Aged

KW - Neoplasms/mortality

KW - Norway

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