It appears you don't have support to open PDFs in this web browser. To view this file, Open with your PDF reader
Abstract
The healthy lifestyle index (HLI), defined as the unweighted sum of individual lifestyle components, was used to investigate the combined role of lifestyle factors on health-related outcomes. We introduced weighted outcome-specific versions of the HLI, where individual lifestyle components were weighted according to their associations with disease outcomes. Within the European Prospective Investigation into Cancer and Nutrition (EPIC), we examined the association between the standard and the outcome-specific HLIs and the risk of T2D, CVD, cancer, and all-cause premature mortality. Estimates of the hazard ratios (HRs), the Harrell’s C-index and the population attributable fractions (PAFs) were compared. For T2D, the HR for 1-SD increase of the standard and T2D-specific HLI were 0.66 (95% CI: 0.64, 0.67) and 0.43 (0.42, 0.44), respectively, and the C-index were 0.63 (0.62, 0.64) and 0.72 (0.72, 0.73). Similar, yet less pronounced differences in HR and C-index were observed for standard and outcome-specific estimates for cancer, CVD and all-cause mortality. PAF estimates for mortality before age 80 were 57% (55%, 58%) and 33% (32%, 34%) for standard and mortality-specific HLI, respectively. The use of outcome-specific HLI could improve the assessment of the role of lifestyle factors on disease outcomes, thus enhancing the definition of public health recommendations.
You have requested "on-the-fly" machine translation of selected content from our databases. This functionality is provided solely for your convenience and is in no way intended to replace human translation. Show full disclaimer
Neither ProQuest nor its licensors make any representations or warranties with respect to the translations. The translations are automatically generated "AS IS" and "AS AVAILABLE" and are not retained in our systems. PROQUEST AND ITS LICENSORS SPECIFICALLY DISCLAIM ANY AND ALL EXPRESS OR IMPLIED WARRANTIES, INCLUDING WITHOUT LIMITATION, ANY WARRANTIES FOR AVAILABILITY, ACCURACY, TIMELINESS, COMPLETENESS, NON-INFRINGMENT, MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. Your use of the translations is subject to all use restrictions contained in your Electronic Products License Agreement and by using the translation functionality you agree to forgo any and all claims against ProQuest or its licensors for your use of the translation functionality and any output derived there from. Hide full disclaimer
Details
1 International Agency for Research On Cancer (IARC-WHO), Lyon, France (GRID:grid.17703.32) (ISNI:0000 0004 0598 0095)
2 Aarhus University, Department of Public Health, Aarhus, Denmark (GRID:grid.7048.b) (ISNI:0000 0001 1956 2722)
3 Danish Cancer Society Research Center, Copenhagen, Denmark (GRID:grid.417390.8) (ISNI:0000 0001 2175 6024); University of Copenhagen, Department of Public Health, Copenhagen, Denmark (GRID:grid.5254.6) (ISNI:0000 0001 0674 042X)
4 Danish Cancer Society Research Center, Copenhagen, Denmark (GRID:grid.417390.8) (ISNI:0000 0001 2175 6024)
5 Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (GRID:grid.7497.d) (ISNI:0000 0004 0492 0584)
6 German Institute of Human Nutrition Potsdam-Rehbruecke, Department of Molecular Epidemiology, Nuthetal, Germany (GRID:grid.418213.d) (ISNI:0000 0004 0390 0098); German Center for Diabetes Research (DZD), Neuherberg, Germany (GRID:grid.452622.5); University of Potsdam, Institute of Nutritional Science, Nuthetal, Germany (GRID:grid.11348.3f) (ISNI:0000 0001 0942 1117)
7 Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy (GRID:grid.11348.3f)
8 Fondazione IRCCS Istituto Nazionale Dei Tumori, Cancer Registry Unit, Milan, Italy (GRID:grid.417893.0) (ISNI:0000 0001 0807 2568)
9 University “L. Vanvitelli”, Unit of Medical Statistics, Naples, Italy (GRID:grid.417893.0)
10 Hyblean Association for Epidemiological Research, AIRE–ONLUS, Ragusa, Italy (GRID:grid.417893.0)
11 Città Della Salute E Della Scienza University-Hospital, and Center for Cancer Prevention (CPO), Unit of Cancer Epidemiology, Turin, Italy (GRID:grid.417893.0)
12 University Medical Center Utrecht, Utrecht University, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands (GRID:grid.5477.1) (ISNI:0000000120346234)
13 NTNU - Norwegian University of Science and Technology, K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Trondheim, Norway (GRID:grid.5947.f) (ISNI:0000 0001 1516 2393); UiT The Arctic University of Norway, Department of Community Medicine, Tromsø, Norway (GRID:grid.10919.30) (ISNI:0000 0001 2259 5234)
14 UiT The Arctic University of Norway, Department of Community Medicine, Tromsø, Norway (GRID:grid.10919.30) (ISNI:0000 0001 2259 5234)
15 Public Health Directorate, Asturias, Spain (GRID:grid.10919.30)
16 Escuela Andaluza de Salud Pública (EASP), Granada, Spain (GRID:grid.413740.5) (ISNI:0000 0001 2186 2871); Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain (GRID:grid.507088.2); Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain (GRID:grid.466571.7) (ISNI:0000 0004 1756 6246)
17 Catalan Institute of Oncology - ICO, L’Hospitalet de Llobregat, Unit of Nutrition and Cancer, Barcelona, Spain (GRID:grid.418701.b) (ISNI:0000 0001 2097 8389); Bellvitge Biomedical Research Institute - IDIBELL, L’Hospitalet de Llobregat, Nutrition and Cancer Group; Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Barcelona, Spain (GRID:grid.418284.3) (ISNI:0000 0004 0427 2257)
18 Ministry of Health of the Basque Government, Sub Directorate for Public Health and Addictions of Gipuzkoa, San Sebastián, Spain (GRID:grid.431260.2) (ISNI:0000 0001 2315 3219); Biodonostia Health Research Institute, Epidemiology of Chronic and Communicable Diseases Group, San Sebastián, Spain (GRID:grid.432380.e) (ISNI:0000 0004 6416 6288)
19 Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain (GRID:grid.466571.7) (ISNI:0000 0004 1756 6246); Murcia Regional Health Council, IMIB-Arrixaca, Department of Epidemiology, Murcia, Spain (GRID:grid.452553.0) (ISNI:0000 0004 8504 7077)
20 Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain (GRID:grid.466571.7) (ISNI:0000 0004 1756 6246); Instituto de Salud Pública y Laboral de Navarra, Pamplona, Spain (GRID:grid.419126.9) (ISNI:0000 0004 0375 9231); Navarra Institute for Health Research (IdiSNA), Pamplona, Spain (GRID:grid.508840.1) (ISNI:0000 0004 7662 6114)
21 Umeå University, Department of Public Health and Clinical Medicine, Umeå, Sweden (GRID:grid.12650.30) (ISNI:0000 0001 1034 3451)
22 Sustainable Health, Umeå University, Department of Public Health and Clinical Medicine, Umeå, Sweden (GRID:grid.12650.30) (ISNI:0000 0001 1034 3451); The Sahlgrenska Academy, University of Gothenburg, Department of Internal Medicine and Clinical Nutrition, Gothenburg, Sweden (GRID:grid.8761.8) (ISNI:0000 0000 9919 9582)
23 Imperial College London, Department of Epidemiology and Biostatistics, School of Public Health, London, UK (GRID:grid.7445.2) (ISNI:0000 0001 2113 8111)