Impact of lifestyle in middle-aged women on mortality

Evidence from the Royal College of General Practitioners’ Oral Contraception Study

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

BACKGROUND: Although many individuals have multiple lifestyle risk factors, few studies have investigated the impact of lifestyle risk factor combinations among women.

AIM: To investigate the relationship between individual and combinations of lifestyle risk factors in middle-aged women with subsequent mortality, and to estimate the associated population attributable risks.

DESIGN OF STUDY: Prospective cohort study.

SETTING: Royal College of General Practitioners' (RCGP) Oral Contraception Study, UK.

METHOD: In 1994-1995, women remaining under follow-up in the RCGP Oral Contraception Study were sent a lifestyle survey, from which modifiable risk factors were identified: pack-years smoked, physical inactivity, never drinking versus consuming at least 7 units of alcohol weekly, and being underweight, overweight, or obese. The cohort was followed to December 2006 or death. Population attributable risks were calculated.

RESULTS: Of 10 059 women studied, 896 died. Pack-years smoked (11-20 years: adjusted hazard ratio [HR] = 1.82, 95% confidence interval [CI] = 1.46 to 2.27; >20 years: adjusted HR = 2.34, 95% CI = 2.00 to 2.74); never drinking alcohol (adjusted HR = 1.66, 95% CI = 1.34 to 2.05); being underweight (adjusted = HR 1.66, 95% CI = 1.03 to 2.68); and physical inactivity (<15 hours/week: adjusted HR = 1.73, 95% CI = 1.46 to 2.04) were significantly associated with mortality compared with their respective reference group. Women with multiple lifestyle risk factors had higher mortality risks than those reporting one factor. The population attributable risk of the combination of smoking, physical inactivity, body mass index outside normal range, and alcohol (never drinking or excess intake) was 59% (95% CI = 31% to 78%).

CONCLUSION: Assuming a causal relationship between lifestyle and mortality, avoidance of four lifestyle risk factors would have prevented 60% of the deaths. The importance of avoiding smoking and undertaking physical inactivity during midlife should continue to be emphasised.
Original languageEnglish
Pages (from-to)563-569
Number of pages7
JournalThe British Journal of General Practice
Volume60
Issue number577
DOIs
Publication statusPublished - 1 Aug 2010

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Contraception
General Practitioners
Life Style
Confidence Intervals
Mortality
Thinness
Alcohol Drinking
Smoking
Population
Drinking
Reference Values
Body Mass Index
Cohort Studies
Alcohols
Prospective Studies

Keywords

  • epidemiology
  • follow-up studies
  • lifestyle
  • mortality
  • women

Cite this

@article{b4b15965e45948f8b51a7d7360a1b13f,
title = "Impact of lifestyle in middle-aged women on mortality: Evidence from the Royal College of General Practitioners’ Oral Contraception Study",
abstract = "BACKGROUND: Although many individuals have multiple lifestyle risk factors, few studies have investigated the impact of lifestyle risk factor combinations among women. AIM: To investigate the relationship between individual and combinations of lifestyle risk factors in middle-aged women with subsequent mortality, and to estimate the associated population attributable risks. DESIGN OF STUDY: Prospective cohort study. SETTING: Royal College of General Practitioners' (RCGP) Oral Contraception Study, UK. METHOD: In 1994-1995, women remaining under follow-up in the RCGP Oral Contraception Study were sent a lifestyle survey, from which modifiable risk factors were identified: pack-years smoked, physical inactivity, never drinking versus consuming at least 7 units of alcohol weekly, and being underweight, overweight, or obese. The cohort was followed to December 2006 or death. Population attributable risks were calculated. RESULTS: Of 10 059 women studied, 896 died. Pack-years smoked (11-20 years: adjusted hazard ratio [HR] = 1.82, 95{\%} confidence interval [CI] = 1.46 to 2.27; >20 years: adjusted HR = 2.34, 95{\%} CI = 2.00 to 2.74); never drinking alcohol (adjusted HR = 1.66, 95{\%} CI = 1.34 to 2.05); being underweight (adjusted = HR 1.66, 95{\%} CI = 1.03 to 2.68); and physical inactivity (<15 hours/week: adjusted HR = 1.73, 95{\%} CI = 1.46 to 2.04) were significantly associated with mortality compared with their respective reference group. Women with multiple lifestyle risk factors had higher mortality risks than those reporting one factor. The population attributable risk of the combination of smoking, physical inactivity, body mass index outside normal range, and alcohol (never drinking or excess intake) was 59{\%} (95{\%} CI = 31{\%} to 78{\%}). CONCLUSION: Assuming a causal relationship between lifestyle and mortality, avoidance of four lifestyle risk factors would have prevented 60{\%} of the deaths. The importance of avoiding smoking and undertaking physical inactivity during midlife should continue to be emphasised.",
keywords = "epidemiology, follow-up studies, lifestyle, mortality, women",
author = "Lisa Iversen and Hannaford, {Philip C} and Lee, {Amanda J} and Elliott, {Alison M} and Shona Fielding",
year = "2010",
month = "8",
day = "1",
doi = "10.3399/bjgp10X515052",
language = "English",
volume = "60",
pages = "563--569",
journal = "The British Journal of General Practice",
issn = "0960-1643",
publisher = "Royal College of General Practitioners",
number = "577",

}

TY - JOUR

T1 - Impact of lifestyle in middle-aged women on mortality

T2 - Evidence from the Royal College of General Practitioners’ Oral Contraception Study

AU - Iversen, Lisa

AU - Hannaford, Philip C

AU - Lee, Amanda J

AU - Elliott, Alison M

AU - Fielding, Shona

PY - 2010/8/1

Y1 - 2010/8/1

N2 - BACKGROUND: Although many individuals have multiple lifestyle risk factors, few studies have investigated the impact of lifestyle risk factor combinations among women. AIM: To investigate the relationship between individual and combinations of lifestyle risk factors in middle-aged women with subsequent mortality, and to estimate the associated population attributable risks. DESIGN OF STUDY: Prospective cohort study. SETTING: Royal College of General Practitioners' (RCGP) Oral Contraception Study, UK. METHOD: In 1994-1995, women remaining under follow-up in the RCGP Oral Contraception Study were sent a lifestyle survey, from which modifiable risk factors were identified: pack-years smoked, physical inactivity, never drinking versus consuming at least 7 units of alcohol weekly, and being underweight, overweight, or obese. The cohort was followed to December 2006 or death. Population attributable risks were calculated. RESULTS: Of 10 059 women studied, 896 died. Pack-years smoked (11-20 years: adjusted hazard ratio [HR] = 1.82, 95% confidence interval [CI] = 1.46 to 2.27; >20 years: adjusted HR = 2.34, 95% CI = 2.00 to 2.74); never drinking alcohol (adjusted HR = 1.66, 95% CI = 1.34 to 2.05); being underweight (adjusted = HR 1.66, 95% CI = 1.03 to 2.68); and physical inactivity (<15 hours/week: adjusted HR = 1.73, 95% CI = 1.46 to 2.04) were significantly associated with mortality compared with their respective reference group. Women with multiple lifestyle risk factors had higher mortality risks than those reporting one factor. The population attributable risk of the combination of smoking, physical inactivity, body mass index outside normal range, and alcohol (never drinking or excess intake) was 59% (95% CI = 31% to 78%). CONCLUSION: Assuming a causal relationship between lifestyle and mortality, avoidance of four lifestyle risk factors would have prevented 60% of the deaths. The importance of avoiding smoking and undertaking physical inactivity during midlife should continue to be emphasised.

AB - BACKGROUND: Although many individuals have multiple lifestyle risk factors, few studies have investigated the impact of lifestyle risk factor combinations among women. AIM: To investigate the relationship between individual and combinations of lifestyle risk factors in middle-aged women with subsequent mortality, and to estimate the associated population attributable risks. DESIGN OF STUDY: Prospective cohort study. SETTING: Royal College of General Practitioners' (RCGP) Oral Contraception Study, UK. METHOD: In 1994-1995, women remaining under follow-up in the RCGP Oral Contraception Study were sent a lifestyle survey, from which modifiable risk factors were identified: pack-years smoked, physical inactivity, never drinking versus consuming at least 7 units of alcohol weekly, and being underweight, overweight, or obese. The cohort was followed to December 2006 or death. Population attributable risks were calculated. RESULTS: Of 10 059 women studied, 896 died. Pack-years smoked (11-20 years: adjusted hazard ratio [HR] = 1.82, 95% confidence interval [CI] = 1.46 to 2.27; >20 years: adjusted HR = 2.34, 95% CI = 2.00 to 2.74); never drinking alcohol (adjusted HR = 1.66, 95% CI = 1.34 to 2.05); being underweight (adjusted = HR 1.66, 95% CI = 1.03 to 2.68); and physical inactivity (<15 hours/week: adjusted HR = 1.73, 95% CI = 1.46 to 2.04) were significantly associated with mortality compared with their respective reference group. Women with multiple lifestyle risk factors had higher mortality risks than those reporting one factor. The population attributable risk of the combination of smoking, physical inactivity, body mass index outside normal range, and alcohol (never drinking or excess intake) was 59% (95% CI = 31% to 78%). CONCLUSION: Assuming a causal relationship between lifestyle and mortality, avoidance of four lifestyle risk factors would have prevented 60% of the deaths. The importance of avoiding smoking and undertaking physical inactivity during midlife should continue to be emphasised.

KW - epidemiology

KW - follow-up studies

KW - lifestyle

KW - mortality

KW - women

U2 - 10.3399/bjgp10X515052

DO - 10.3399/bjgp10X515052

M3 - Article

VL - 60

SP - 563

EP - 569

JO - The British Journal of General Practice

JF - The British Journal of General Practice

SN - 0960-1643

IS - 577

ER -