Modifiable causes of premature death in middle-age in Western Europe: Results from the EPIC cohort study

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Modifiable causes of premature death in middle-age in Western Europe : Results from the EPIC cohort study. / Muller, David C.; Murphy, Neil; Johansson, Mattias; Ferrari, Pietro; Tsilidis, Konstantinos K.; Boutron-Ruault, Marie Christine; Clavel, Francoise; Dartois, Laureen; Li, Kuanrong; Kaaks, Rudolf; Weikert, Cornelia; Bergmann, Manuela; Boeing, Heiner; Tjønneland, Anne; Overvad, Kim; Redondo, M. Luisa; Agudo, Antonio; Molina-Portillo, Elena; Altzibar, Jone M.; Cirera, Lluís; Ardanaz, Eva; Khaw, Kay Tee; Wareham, Nicholas J.; Key, Timothy J.; Travis, Ruth C.; Bamia, Christina; Orfanos, Philippos; Trichopoulou, Antonia; Palli, Domenico; Pala, Valeria; Tumino, Rosario; Vineis, Paolo; Panico, Salvatore; Bueno-de-Mesquita, H. Bas; Verschuren, W. M Monique; Struijk, Ellen A.; Peeters, Petra H.; Engström, Gunnar; Melander, Olle; Sund, Malin; Weiderpass, Elisabete; Skeie, Guri; Lund, Eiliv; Norat, Teresa; Gunter, Marc; Riboli, Elio; Brennan, Paul.

In: BMC Medicine, Vol. 14, No. 1, 87, 14.06.2016.

Research output: Contribution to journalArticle

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Muller, DC, Murphy, N, Johansson, M, Ferrari, P, Tsilidis, KK, Boutron-Ruault, MC, Clavel, F, Dartois, L, Li, K, Kaaks, R, Weikert, C, Bergmann, M, Boeing, H, Tjønneland, A, Overvad, K, Redondo, ML, Agudo, A, Molina-Portillo, E, Altzibar, JM, Cirera, L, Ardanaz, E, Khaw, KT, Wareham, NJ, Key, TJ, Travis, RC, Bamia, C, Orfanos, P, Trichopoulou, A, Palli, D, Pala, V, Tumino, R, Vineis, P, Panico, S, Bueno-de-Mesquita, HB, Verschuren, WMM, Struijk, EA, Peeters, PH, Engström, G, Melander, O, Sund, M, Weiderpass, E, Skeie, G, Lund, E, Norat, T, Gunter, M, Riboli, E & Brennan, P 2016, 'Modifiable causes of premature death in middle-age in Western Europe: Results from the EPIC cohort study', BMC Medicine, vol. 14, no. 1, 87. https://doi.org/10.1186/s12916-016-0630-6

APA

Muller, D. C., Murphy, N., Johansson, M., Ferrari, P., Tsilidis, K. K., Boutron-Ruault, M. C., ... Brennan, P. (2016). Modifiable causes of premature death in middle-age in Western Europe: Results from the EPIC cohort study. BMC Medicine, 14(1), [87]. https://doi.org/10.1186/s12916-016-0630-6

CBE

Muller DC, Murphy N, Johansson M, Ferrari P, Tsilidis KK, Boutron-Ruault MC, Clavel F, Dartois L, Li K, Kaaks R, Weikert C, Bergmann M, Boeing H, Tjønneland A, Overvad K, Redondo ML, Agudo A, Molina-Portillo E, Altzibar JM, Cirera L, Ardanaz E, Khaw KT, Wareham NJ, Key TJ, Travis RC, Bamia C, Orfanos P, Trichopoulou A, Palli D, Pala V, Tumino R, Vineis P, Panico S, Bueno-de-Mesquita HB, Verschuren WMM, Struijk EA, Peeters PH, Engström G, Melander O, Sund M, Weiderpass E, Skeie G, Lund E, Norat T, Gunter M, Riboli E, Brennan P. 2016. Modifiable causes of premature death in middle-age in Western Europe: Results from the EPIC cohort study. BMC Medicine. 14(1). https://doi.org/10.1186/s12916-016-0630-6

MLA

Vancouver

Muller DC, Murphy N, Johansson M, Ferrari P, Tsilidis KK, Boutron-Ruault MC et al. Modifiable causes of premature death in middle-age in Western Europe: Results from the EPIC cohort study. BMC Medicine. 2016 Jun 14;14(1). 87. https://doi.org/10.1186/s12916-016-0630-6

Author

Muller, David C. ; Murphy, Neil ; Johansson, Mattias ; Ferrari, Pietro ; Tsilidis, Konstantinos K. ; Boutron-Ruault, Marie Christine ; Clavel, Francoise ; Dartois, Laureen ; Li, Kuanrong ; Kaaks, Rudolf ; Weikert, Cornelia ; Bergmann, Manuela ; Boeing, Heiner ; Tjønneland, Anne ; Overvad, Kim ; Redondo, M. Luisa ; Agudo, Antonio ; Molina-Portillo, Elena ; Altzibar, Jone M. ; Cirera, Lluís ; Ardanaz, Eva ; Khaw, Kay Tee ; Wareham, Nicholas J. ; Key, Timothy J. ; Travis, Ruth C. ; Bamia, Christina ; Orfanos, Philippos ; Trichopoulou, Antonia ; Palli, Domenico ; Pala, Valeria ; Tumino, Rosario ; Vineis, Paolo ; Panico, Salvatore ; Bueno-de-Mesquita, H. Bas ; Verschuren, W. M Monique ; Struijk, Ellen A. ; Peeters, Petra H. ; Engström, Gunnar ; Melander, Olle ; Sund, Malin ; Weiderpass, Elisabete ; Skeie, Guri ; Lund, Eiliv ; Norat, Teresa ; Gunter, Marc ; Riboli, Elio ; Brennan, Paul. / Modifiable causes of premature death in middle-age in Western Europe : Results from the EPIC cohort study. In: BMC Medicine. 2016 ; Vol. 14, No. 1.

RIS

TY - JOUR

T1 - Modifiable causes of premature death in middle-age in Western Europe

T2 - Results from the EPIC cohort study

AU - Muller, David C.

AU - Murphy, Neil

AU - Johansson, Mattias

AU - Ferrari, Pietro

AU - Tsilidis, Konstantinos K.

AU - Boutron-Ruault, Marie Christine

AU - Clavel, Francoise

AU - Dartois, Laureen

AU - Li, Kuanrong

AU - Kaaks, Rudolf

AU - Weikert, Cornelia

AU - Bergmann, Manuela

AU - Boeing, Heiner

AU - Tjønneland, Anne

AU - Overvad, Kim

AU - Redondo, M. Luisa

AU - Agudo, Antonio

AU - Molina-Portillo, Elena

AU - Altzibar, Jone M.

AU - Cirera, Lluís

AU - Ardanaz, Eva

AU - Khaw, Kay Tee

AU - Wareham, Nicholas J.

AU - Key, Timothy J.

AU - Travis, Ruth C.

AU - Bamia, Christina

AU - Orfanos, Philippos

AU - Trichopoulou, Antonia

AU - Palli, Domenico

AU - Pala, Valeria

AU - Tumino, Rosario

AU - Vineis, Paolo

AU - Panico, Salvatore

AU - Bueno-de-Mesquita, H. Bas

AU - Verschuren, W. M Monique

AU - Struijk, Ellen A.

AU - Peeters, Petra H.

AU - Engström, Gunnar

AU - Melander, Olle

AU - Sund, Malin

AU - Weiderpass, Elisabete

AU - Skeie, Guri

AU - Lund, Eiliv

AU - Norat, Teresa

AU - Gunter, Marc

AU - Riboli, Elio

AU - Brennan, Paul

PY - 2016/6/14

Y1 - 2016/6/14

N2 - Background: Life expectancy is increasing in Europe, yet a substantial proportion of adults still die prematurely before the age of 70 years. We sought to estimate the joint and relative contributions of tobacco smoking, hypertension, obesity, physical inactivity, alcohol and poor diet towards risk of premature death. Methods: We analysed data from 264,906 European adults from the EPIC prospective cohort study, aged between 40 and 70 years at the time of recruitment. Flexible parametric survival models were used to model risk of death conditional on risk factors, and survival functions and attributable fractions (AF) for deaths prior to age 70 years were calculated based on the fitted models. Results: We identified 11,930 deaths which occurred before the age of 70. The AF for premature mortality for smoking was 31 % (95 % confidence interval (CI), 31-32 %) and 14 % (95 % CI, 12-16 %) for poor diet. Important contributions were also observed for overweight and obesity measured by waist-hip ratio (10 %; 95 % CI, 8-12 %) and high blood pressure (9 %; 95 % CI, 7-11 %). AFs for physical inactivity and excessive alcohol intake were 7 % and 4 %, respectively. Collectively, the AF for all six risk factors was 57 % (95 % CI, 55-59 %), being 35 % (95 % CI, 32-37 %) among never smokers and 74 % (95 % CI, 73-75 %) among current smokers. Conclusions: While smoking remains the predominant risk factor for premature death in Europe, poor diet, overweight and obesity, hypertension, physical inactivity, and excessive alcohol consumption also contribute substantially. Any attempt to minimise premature deaths will ultimately require all six factors to be addressed.

AB - Background: Life expectancy is increasing in Europe, yet a substantial proportion of adults still die prematurely before the age of 70 years. We sought to estimate the joint and relative contributions of tobacco smoking, hypertension, obesity, physical inactivity, alcohol and poor diet towards risk of premature death. Methods: We analysed data from 264,906 European adults from the EPIC prospective cohort study, aged between 40 and 70 years at the time of recruitment. Flexible parametric survival models were used to model risk of death conditional on risk factors, and survival functions and attributable fractions (AF) for deaths prior to age 70 years were calculated based on the fitted models. Results: We identified 11,930 deaths which occurred before the age of 70. The AF for premature mortality for smoking was 31 % (95 % confidence interval (CI), 31-32 %) and 14 % (95 % CI, 12-16 %) for poor diet. Important contributions were also observed for overweight and obesity measured by waist-hip ratio (10 %; 95 % CI, 8-12 %) and high blood pressure (9 %; 95 % CI, 7-11 %). AFs for physical inactivity and excessive alcohol intake were 7 % and 4 %, respectively. Collectively, the AF for all six risk factors was 57 % (95 % CI, 55-59 %), being 35 % (95 % CI, 32-37 %) among never smokers and 74 % (95 % CI, 73-75 %) among current smokers. Conclusions: While smoking remains the predominant risk factor for premature death in Europe, poor diet, overweight and obesity, hypertension, physical inactivity, and excessive alcohol consumption also contribute substantially. Any attempt to minimise premature deaths will ultimately require all six factors to be addressed.

KW - Absolute risk

KW - Attributable fraction

KW - Modifiable risk factors

KW - Mortality

KW - Premature death

UR - http://www.scopus.com/inward/record.url?scp=84976875301&partnerID=8YFLogxK

U2 - 10.1186/s12916-016-0630-6

DO - 10.1186/s12916-016-0630-6

M3 - Article

VL - 14

JO - BMC Medicine

JF - BMC Medicine

SN - 1741-7015

IS - 1

M1 - 87

ER -