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

Forskningsoutput: TidskriftsbidragArtikel i vetenskaplig tidskrift

Abstract

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.

Detaljer

Författare
  • David C. Muller
  • Neil Murphy
  • Mattias Johansson
  • Pietro Ferrari
  • Konstantinos K. Tsilidis
  • Marie Christine Boutron-Ruault
  • Francoise Clavel
  • Laureen Dartois
  • Kuanrong Li
  • Rudolf Kaaks
  • Cornelia Weikert
  • Manuela Bergmann
  • Heiner Boeing
  • Anne Tjønneland
  • Kim Overvad
  • M. Luisa Redondo
  • Antonio Agudo
  • Elena Molina-Portillo
  • Jone M. Altzibar
  • Lluís Cirera
  • Eva Ardanaz
  • Kay Tee Khaw
  • Nicholas J. Wareham
  • Timothy J. Key
  • Ruth C. Travis
  • Christina Bamia
  • Philippos Orfanos
  • Antonia Trichopoulou
  • Domenico Palli
  • Valeria Pala
  • Rosario Tumino
  • Paolo Vineis
  • Salvatore Panico
  • H. Bas Bueno-de-Mesquita
  • W. M Monique Verschuren
  • Ellen A. Struijk
  • Petra H. Peeters
  • Malin Sund
  • Elisabete Weiderpass
  • Guri Skeie
  • Eiliv Lund
  • Teresa Norat
  • Marc Gunter
  • Elio Riboli
  • Paul Brennan
Enheter & grupper
Externa organisationer
  • International Agency for Research on Cancer, World Health Organization
  • Imperial College London
  • Institut Gustave Roussy
  • INSERM U1018
  • German Cancer Research Centre
  • German Institute of Human Nutrition
  • Danish Cancer Society Research Center
  • Aarhus University
  • Public Health Directorate
  • Catalan Institute of Oncology
  • CIBER Epidemiology and Public Health (CIBERESP)
  • Instituto BIO-Donostia
  • University of Murcia
  • Health Research Institute of Navarra (IDISNA)
  • University of Cambridge
  • University of Oxford
  • National and Kapodistrian University of Athens
  • Cancer Research and Prevention Institute
  • Istituto Nazionale dei Tumori
  • Civic and M.P.Arezzo Hospital
  • Human Genetic Foundation (HuGeF)
  • University of Naples Federico II
  • University of Malaya
  • University Medical Center Utrecht
  • Umeå University
  • Folkhälsans forskningscentrum
  • UiT The Arctic University of Norway, Tromsø
  • Skåne University Hospital
Forskningsområden

Ämnesklassifikation (UKÄ) – OBLIGATORISK

  • Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
  • Klinisk medicin

Nyckelord

Originalspråkengelska
Artikelnummer87
TidskriftBMC Medicine
Volym14
Utgåva nummer1
StatusPublished - 2016 jun 14
PublikationskategoriForskning
Peer review utfördJa