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dc.contributor.authorMatta, Komodo
dc.contributor.authorViallon, Vivian
dc.contributor.authorBotteri, Edoardo
dc.contributor.authorPeveri, Giulia
dc.contributor.authorDahm, Christina
dc.contributor.authorNannsen, Anne Østergaard
dc.contributor.authorOlsen, Anja
dc.contributor.authorTjønneland, Anne
dc.contributor.authorElbaz, Alexis
dc.contributor.authorArtaud, Fanny
dc.contributor.authorMarques, Chloé
dc.contributor.authorKaaks, Rudolf
dc.contributor.authorKatzke, Verena
dc.contributor.authorSchulze, Matthias B.
dc.contributor.authorLlanaj, Erand
dc.contributor.authorMasala, Giovanna
dc.contributor.authorPala, Valeria
dc.contributor.authorPanico, Salvatore
dc.contributor.authorTumino, Rosario
dc.contributor.authorRicceri, Fulvio
dc.contributor.authorDerksen, Jeroen W. G.
dc.contributor.authorNøst, Therese Haugdahl
dc.contributor.authorSandanger, Torkjel Manning
dc.contributor.authorBorch, Kristin Benjaminsen
dc.contributor.authorQuirós, J. Ramón
dc.contributor.authorCastro-Espin, Carlota
dc.contributor.authorSánchez, Maria-José
dc.contributor.authorAtxega, Amaia Aizpurua
dc.contributor.authorCirera, Lluís
dc.contributor.authorGuevara, Marcela
dc.contributor.authorManjer, Jonas
dc.contributor.authorTin Tin, Sandar
dc.contributor.authorHeath, Alicia
dc.contributor.authorTouvier, Mathilde
dc.contributor.authorGoldberg, Marcel
dc.contributor.authorWeiderpass Vainio, Elisabete
dc.contributor.authorGunter, Marc J.
dc.contributor.authorFreisling, Heinz
dc.contributor.authorRiboli, Elio
dc.contributor.authorFerrari, Pietro
dc.date.accessioned2024-09-24T12:17:31Z
dc.date.available2024-09-24T12:17:31Z
dc.date.issued2024-05-29
dc.description.abstractBackground Healthy lifestyles are inversely associated with the risk of noncommunicable diseases, which are leading causes of death. However, few studies have used longitudinal data to assess the impact of changing lifestyle behaviours on all-cause and cancer mortality.<p> <p>Methods Within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, lifestyle profiles of 308,497 cancer-free adults (71% female) aged 35–70 years at recruitment across nine countries were assessed with baseline and follow-up questionnaires administered on average of 7 years apart. A healthy lifestyle index (HLI), assessed at two time points, combined information on smoking status, alcohol intake, body mass index, and physical activity, and ranged from 0 to 16 units. A change score was calculated as the difference between HLI at baseline and follow-up. Associations between HLI change and all-cause and cancer mortality were modelled with Cox regression, and the impact of changing HLI on accelerating mortality rate was estimated by rate advancement periods (RAP, in years). <p>Results After the follow-up questionnaire, participants were followed for an average of 9.9 years, with 21,696 deaths (8407 cancer deaths) documented. Compared to participants whose HLIs remained stable (within one unit), improving HLI by more than one unit was inversely associated with all-cause and cancer mortality (hazard ratio [HR]: 0.84; 95% confidence interval [CI]: 0.81, 0.88; and HR: 0.87; 95% CI: 0.82, 0.92; respectively), while worsening HLI by more than one unit was associated with an increase in mortality (all-cause mortality HR: 1.26; 95% CI: 1.20, 1.33; cancer mortality HR: 1.19; 95% CI: 1.09, 1.29). Participants who worsened HLI by more than one advanced their risk of death by 1.62 (1.44, 1.96) years, while participants who improved HLI by the same amount delayed their risk of death by 1.19 (0.65, 2.32) years, compared to those with stable HLI. <p>Conclusions Making healthier lifestyle changes during adulthood was inversely associated with all-cause and cancer mortality and delayed risk of death. Conversely, making unhealthier lifestyle changes was positively associated with mortality and an accelerated risk of death.en_US
dc.identifier.citationMatta, Viallon, Botteri, Peveri, Dahm, Nannsen, Olsen, Tjønneland, Elbaz, Artaud, Marques, Kaaks, Katzke, Schulze, Llanaj, Masala, Pala, Panico, Tumino, Ricceri, Derksen, Nøst, Sandanger, Borch, Quirós, Castro-Espin, Sánchez, Atxega, Cirera, Guevara, Manjer, Tin Tin, Heath, Touvier, Goldberg, Weiderpass Vainio, Gunter, Freisling, Riboli, Ferrari. Healthy lifestyle change and all-cause and cancer mortality in the European Prospective Investigation into Cancer and Nutrition cohort. BMC Medicine. 2024;22(1)en_US
dc.identifier.cristinIDFRIDAID 2277204
dc.identifier.doi10.1186/s12916-024-03362-7
dc.identifier.issn1741-7015
dc.identifier.urihttps://hdl.handle.net/10037/34844
dc.language.isoengen_US
dc.publisherBMCen_US
dc.relation.journalBMC Medicine
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2024 World Health Organizationen_US
dc.rights.urihttps://creativecommons.org/licenses/by/4.0en_US
dc.rightsAttribution 4.0 International (CC BY 4.0)en_US
dc.titleHealthy lifestyle change and all-cause and cancer mortality in the European Prospective Investigation into Cancer and Nutrition cohorten_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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Attribution 4.0 International (CC BY 4.0)
Except where otherwise noted, this item's license is described as Attribution 4.0 International (CC BY 4.0)