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Title: Lifestyle factors and risk of multimorbidity of cancer and cardiometabolic diseases: a multinational cohort study
Author: Freisling, Heinz
Viallon, Vivian
Lennon, Hannah
Bagnardi, Vincenzo
Ricci, Cristian
Butterworth, Adam S.
Sweeting, Michael
Muller, David C.
Romieu, Isabelle
Bazelle, Pauline
Kvaskoff, Marina
Arveux, Patrick
Severi, Gianluca
Bamia, Christina
Kühn, Tilman
Kaaks, Rudolf
Bergmann, Manuela M.
Boeing, Heiner
Tjønneland, Anne
Olsen, Anja
Overvad, Kim
Dahm, Christina C.
Menendez, Virginia
Agudo, Antonio
Sánchez, Maria Jose
Amiano, Pilar
Santiuste, Carmen
Barricarte, Aurelio
Tong, Tammy Y. N.
Schmidt, Julie A.
Tzoulaki, Ioanna
Tsilidis, Konstantinos K.
Ward, Heather
Palli, Domenico
Agnoli, Claudia
Tumino, Rosario
Ricceri, Fulvio
Panico, Salvatore
Picavet, H. Susan J.
Bakker, Marije F.
Monninkhof, Evelyn M.
Nilsson, Peter M.
Manjer, Jonas
Rolandsson, Olov
Thysell, Elin
Weiderpass, Elisabete
Jenab, Mazda
Riboli, Elio
Vineis, Paolo
Danesh, John
Wareham, Nick J.
Gunter, Marc J.
Ferrari, Pietro
Keywords: Obesitat
Malalties cardiovasculars
Cardiovascular diseases
Issue Date: 10-Jan-2020
Publisher: BioMed Central
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 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.
Note: Reproducció del document publicat a:
It is part of: BMC Medicine, 2020, vol. 18
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Appears in Collections:Publicacions de projectes de recerca finançats per la UE
Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

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