Effect of healthy lifestyle index and lifestyle patterns on the risk of mortality: A community-based cohort study

Hu，Peng1,2; Zheng，Murui3; Huang，Jun4; Fan，Huan Ying5; Fan，Chun Jiang6; Ruan，Hui Hong7; Yuan，Yue Shuang5; Zhao，Wenjing8; Wang，Harry H.X.2,9; Deng，Hai10; Liu，Xudong1

2022-08-30

10.3389/fmed.2022.920760

Frontiers in Medicine   影响因子和分区

2296-858X

Background: Limited evidence was available on the association of the integrated effect of multidimensional lifestyle factors with mortality among Chinese populations. This cohort study was to examine the effect of combined lifestyle factors on the risk of mortality by highlighting the number of healthy lifestyles and their overall effects. Methods: A total of 11,395 participants from the Guangzhou Heart Study (GZHS) were followed up until 1 January 2020. Individual causes of death were obtained from the platform of the National Death Registry of China. The healthy lifestyle index (HLI) was established from seven dimensions of lifestyle, and lifestyle patterns were extracted from eight dimensions of lifestyle using principal component analysis (PCA). Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were estimated using the Cox proportional hazard regression model. Results: During 35,837 person-years of follow-up, 184 deaths (1.61%) were observed, including 64 from cardiovascular disease. After adjustment for confounders, HLI was associated with a 50% (HR: 0.50, 95% CI: 0.25–0.99) reduced risk of all-cause mortality when comparing the high (6–7 lifestyle factors) with low (0–2 lifestyle factors) categories. Three lifestyle patterns were defined and labeled as pattern I, II, and III. Lifestyle pattern II with higher factor loadings of non-smoking and low-level alcohol drinking was associated with a decreased risk of all-cause mortality (HR: 0.63, 95% CI: 0.43–0.92, P = 0.023) when comparing the high with low tertiles of pattern score, after adjustment for confounders. Every 1-unit increment of pattern II score was associated with a decreased risk (HR: 0.97, 95% CI: 0.95–0.99) of all-cause mortality. The other two patterns were not associated with all-cause mortality, and the association of cardiovascular mortality risk was observed with neither HLI nor any lifestyle pattern. Conclusion: The results suggest that the more dimensions of the healthy lifestyle the lower the risk of death, and adherence to the lifestyle pattern characterized with heavier loading of non-smoking and low-level alcohol drinking reduces the risk of all-cause mortality. The findings highlight the need to consider multi-dimensional lifestyles rather than one when developing health promotion strategies.

cohort study healthy lifestyle index lifestyle lifestyle pattern mortality

SCI

英语

通讯

Science and Technology Program of Guangzhou City[202102080404] ; Guangdong Basic and Applied Basic Research Foundation[2022A1515010686] ; Guangdong Provincial Key RD Program[2019B020230004] ; National Key R&D Program of China[2018YFC1312502] ; Medical Science and Technology Research Fund of Guangdong Province[202011269127579]

General & Internal Medicine

Medicine, General & Internal

WOS:000891736700001

FRONTIERS MEDIA SA

2-s2.0-85138252611

Scopus

1.School of Public Health,Guangdong Pharmaceutical University,Guangzhou,China
2.Department of Epidemiology,School of Public Health,Sun Yat-sen University,Guangzhou,China
3.Guangzhou Center for Disease Control and Prevention,Guangzhou,China
4.Department of Geriatrics,Guangdong Provincial People’s Hospital,Institute of Geriatrics,Guangdong Academy of Medical Science,Guangzhou,China
5.Xinzao Hospital of Guangzhou Panyu District,Guangzhou,China
6.Community Health Service Center of Nancun Town,Guangzhou,China
7.Community Health Service Center of Hualong Town,Guangzhou,China
8.School of Public Health and Emergency Management,Southern University of Science and Technology,Shenzhen,China
9.JC School of Public Health and Primary Care,The Chinese University of Hong Kong,Hong Kong
10.Department of Cardiology,Guangdong Provincial People’s Hospital,Guangdong Cardiovascular Institute,Guangdong Academy of Medical Science,Guangzhou,China

Hu，Peng,Zheng，Murui,Huang，Jun,et al. Effect of healthy lifestyle index and lifestyle patterns on the risk of mortality: A community-based cohort study[J]. Frontiers in Medicine,2022,9.

Hu，Peng.,Zheng，Murui.,Huang，Jun.,Fan，Huan Ying.,Fan，Chun Jiang.,...&Liu，Xudong.(2022).Effect of healthy lifestyle index and lifestyle patterns on the risk of mortality: A community-based cohort study.Frontiers in Medicine,9.

Hu，Peng,et al."Effect of healthy lifestyle index and lifestyle patterns on the risk of mortality: A community-based cohort study".Frontiers in Medicine 9(2022).