Lifestyle factors and risk of multimorbidity of cancer and cardiometabolic diseases : a multinational cohort study
(2020) In BMC Medicine 18(1).- Abstract
BACKGROUND: Although lifestyle factors have been studied in relation to individual non-communicable diseases (NCDs), their association with development of a subsequent NCD, defined as multimorbidity, has been scarcely investigated. The aim of this study was to investigate associations between five lifestyle factors and incident multimorbidity of cancer and cardiometabolic diseases. METHODS: In this prospective cohort study, 291,778 participants (64% women) from seven European countries, mostly aged 43 to 58 years and free of cancer, cardiovascular disease (CVD), and type 2 diabetes (T2D) at recruitment, were included. Incident multimorbidity of cancer and cardiometabolic diseases was defined as developing subsequently two diseases... (More)
BACKGROUND: Although lifestyle factors have been studied in relation to individual non-communicable diseases (NCDs), their association with development of a subsequent NCD, defined as multimorbidity, has been scarcely investigated. The aim of this study was to investigate associations between five lifestyle factors and incident multimorbidity of cancer and cardiometabolic diseases. METHODS: In this prospective cohort study, 291,778 participants (64% women) from seven European countries, mostly aged 43 to 58 years and free of cancer, cardiovascular disease (CVD), and type 2 diabetes (T2D) at recruitment, were included. Incident multimorbidity of cancer and cardiometabolic diseases was defined as developing subsequently two diseases including first cancer at any site, CVD, and T2D in an individual. Multi-state modelling based on Cox regression was used to compute hazard ratios (HR) and 95% confidence intervals (95% CI) of developing cancer, CVD, or T2D, and subsequent transitions to multimorbidity, in relation to body mass index (BMI), smoking status, alcohol intake, physical activity, adherence to the Mediterranean diet, and their combination as a healthy lifestyle index (HLI) score. Cumulative incidence functions (CIFs) were estimated to compute 10-year absolute risks for transitions from healthy to cancer at any site, CVD (both fatal and non-fatal), or T2D, and to subsequent multimorbidity after each of the three NCDs. RESULTS: During a median follow-up of 11 years, 1910 men and 1334 women developed multimorbidity of cancer and cardiometabolic diseases. A higher HLI, reflecting healthy lifestyles, was strongly inversely associated with multimorbidity, with hazard ratios per 3-unit increment of 0.75 (95% CI, 0.71 to 0.81), 0.84 (0.79 to 0.90), and 0.82 (0.77 to 0.88) after cancer, CVD, and T2D, respectively. After T2D, the 10-year absolute risks of multimorbidity were 40% and 25% for men and women, respectively, with unhealthy lifestyle, and 30% and 18% for men and women with healthy lifestyles. CONCLUSION: Pre-diagnostic healthy lifestyle behaviours were strongly inversely associated with the risk of cancer and cardiometabolic diseases, and with the prognosis of these diseases by reducing risk of multimorbidity.
(Less)
- author
- organization
- publishing date
- 2020-01-10
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Cancer, Cancer and cardiometabolic multimorbidity, Cardiovascular disease, Diabetes, Healthy lifestyle, Obesity, Prevention
- in
- BMC Medicine
- volume
- 18
- issue
- 1
- article number
- 5
- publisher
- BioMed Central (BMC)
- external identifiers
-
- scopus:85077697686
- pmid:31918762
- ISSN
- 1741-7015
- DOI
- 10.1186/s12916-019-1474-7
- language
- English
- LU publication?
- yes
- id
- 494de5fe-0a96-4e95-9cb3-0aa5d1ff1f93
- date added to LUP
- 2020-01-27 10:02:29
- date last changed
- 2024-09-18 16:56:10
@article{494de5fe-0a96-4e95-9cb3-0aa5d1ff1f93,
abstract = {{<p>BACKGROUND: Although lifestyle factors have been studied in relation to individual non-communicable diseases (NCDs), their association with development of a subsequent NCD, defined as multimorbidity, has been scarcely investigated. The aim of this study was to investigate associations between five lifestyle factors and incident multimorbidity of cancer and cardiometabolic diseases. METHODS: In this prospective cohort study, 291,778 participants (64% women) from seven European countries, mostly aged 43 to 58 years and free of cancer, cardiovascular disease (CVD), and type 2 diabetes (T2D) at recruitment, were included. Incident multimorbidity of cancer and cardiometabolic diseases was defined as developing subsequently two diseases including first cancer at any site, CVD, and T2D in an individual. Multi-state modelling based on Cox regression was used to compute hazard ratios (HR) and 95% confidence intervals (95% CI) of developing cancer, CVD, or T2D, and subsequent transitions to multimorbidity, in relation to body mass index (BMI), smoking status, alcohol intake, physical activity, adherence to the Mediterranean diet, and their combination as a healthy lifestyle index (HLI) score. Cumulative incidence functions (CIFs) were estimated to compute 10-year absolute risks for transitions from healthy to cancer at any site, CVD (both fatal and non-fatal), or T2D, and to subsequent multimorbidity after each of the three NCDs. RESULTS: During a median follow-up of 11 years, 1910 men and 1334 women developed multimorbidity of cancer and cardiometabolic diseases. A higher HLI, reflecting healthy lifestyles, was strongly inversely associated with multimorbidity, with hazard ratios per 3-unit increment of 0.75 (95% CI, 0.71 to 0.81), 0.84 (0.79 to 0.90), and 0.82 (0.77 to 0.88) after cancer, CVD, and T2D, respectively. After T2D, the 10-year absolute risks of multimorbidity were 40% and 25% for men and women, respectively, with unhealthy lifestyle, and 30% and 18% for men and women with healthy lifestyles. CONCLUSION: Pre-diagnostic healthy lifestyle behaviours were strongly inversely associated with the risk of cancer and cardiometabolic diseases, and with the prognosis of these diseases by reducing risk of multimorbidity.</p>}},
author = {{Freisling, Heinz and Viallon, Vivian and Lennon, Hannah and Bagnardi, Vincenzo and Ricci, Cristian and Butterworth, Adam S. and Sweeting, Michael and Muller, David and Romieu, Isabelle and Bazelle, Pauline and Kvaskoff, Marina and Arveux, Patrick and Severi, Gianluca and Bamia, Christina and Kühn, Tilman and Kaaks, Rudolf and Bergmann, Manuela and Boeing, Heiner and Tjønneland, Anne and Olsen, Anja and Overvad, Kim and Dahm, Christina C. and Menéndez, Virginia and Agudo, Antonio and Sánchez, Maria Jose and Amiano, Pilar and Santiuste, Carmen and Gurrea, Aurelio Barricarte and Tong, Tammy Y.N. and Schmidt, Julie A. and Tzoulaki, Ioanna and Tsilidis, Konstantinos K. and Ward, Heather and Palli, Domenico and Agnoli, Claudia and Tumino, Rosario and Ricceri, Fulvio and Panico, Salvatore and Picavet, H. Susan J. and Bakker, Marije and Monninkhof, Evelyn and Nilsson, Peter and Manjer, Jonas and Rolandsson, Olov and Thysell, Elin and Weiderpass, Elisabete and Jenab, Mazda and Riboli, Elio and Vineis, Paolo and Danesh, John and Wareham, Nick J and Gunter, Marc J. and Ferrari, Pietro}},
issn = {{1741-7015}},
keywords = {{Cancer; Cancer and cardiometabolic multimorbidity; Cardiovascular disease; Diabetes; Healthy lifestyle; Obesity; Prevention}},
language = {{eng}},
month = {{01}},
number = {{1}},
publisher = {{BioMed Central (BMC)}},
series = {{BMC Medicine}},
title = {{Lifestyle factors and risk of multimorbidity of cancer and cardiometabolic diseases : a multinational cohort study}},
url = {{http://dx.doi.org/10.1186/s12916-019-1474-7}},
doi = {{10.1186/s12916-019-1474-7}},
volume = {{18}},
year = {{2020}},
}