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

<h4>Background</h4> <p>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, alcoho...

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Main Authors: Key, T, Muller, D, Murphy, N, Johansson, M, Ferrari, P, Tsildis, K, Boutron-Rualt, M, Clavel, F, Dartois, L, Li, K, Kaaks, R, Weikert, C, Bergmann, M, Boeing, H, Tjønneland, A, Overvad, K, Redondo, M, Agudo, A, Molina-Portillo, E, Altzibar, J, Cirera, L, Ardanaz, E, Khaw, K, Wareham, N, Travis, R, Bamia, C, Orfanos, P, Trichopoulou, A, Palli, D, Pala, V, Tumino, R, Vineis, P, Panico, S, Bueno-de-Mesquita, H, Verschuren, W, Struijk, E, Peeters, P, Engström, G, Melander, O, Sund, M, Weiderpass, E, Skeie, G, Lund, E, Norat, T, Gunter, M, Riboli, E, Brennan, P
Format: Journal article
Published: BioMed Central 2016
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author Key, T
Muller, D
Murphy, N
Johansson, M
Ferrari, P
Tsildis, K
Boutron-Rualt, M
Clavel, F
Dartois, L
Li, K
Kaaks, R
Weikert, C
Bergmann, M
Boeing, H
Tjønneland, A
Overvad, K
Redondo, M
Agudo, A
Molina-Portillo, E
Altzibar, J
Cirera, L
Ardanaz, E
Khaw, K
Wareham, N
Travis, R
Bamia, C
Orfanos, P
Trichopoulou, A
Palli, D
Pala, V
Tumino, R
Vineis, P
Panico, S
Bueno-de-Mesquita, H
Verschuren, W
Struijk, E
Peeters, P
Engström, G
Melander, O
Sund, M
Weiderpass, E
Skeie, G
Lund, E
Norat, T
Gunter, M
Riboli, E
Brennan, P
author_facet Key, T
Muller, D
Murphy, N
Johansson, M
Ferrari, P
Tsildis, K
Boutron-Rualt, M
Clavel, F
Dartois, L
Li, K
Kaaks, R
Weikert, C
Bergmann, M
Boeing, H
Tjønneland, A
Overvad, K
Redondo, M
Agudo, A
Molina-Portillo, E
Altzibar, J
Cirera, L
Ardanaz, E
Khaw, K
Wareham, N
Travis, R
Bamia, C
Orfanos, P
Trichopoulou, A
Palli, D
Pala, V
Tumino, R
Vineis, P
Panico, S
Bueno-de-Mesquita, H
Verschuren, W
Struijk, E
Peeters, P
Engström, G
Melander, O
Sund, M
Weiderpass, E
Skeie, G
Lund, E
Norat, T
Gunter, M
Riboli, E
Brennan, P
author_sort Key, T
collection OXFORD
description <h4>Background</h4> <p>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.</p> <h4>Methods</h4> <p>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</p> <h4>Results</h4> <p>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.</p> <h4>Conclusions</h4> <p>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.</p>
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spelling oxford-uuid:7f352a5c-c90c-4eac-a8e6-d074f23f7aad2022-03-26T21:15:28ZModifiable causes of premature death in middle-age in Western Europe: results from the EPIC cohort studyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:7f352a5c-c90c-4eac-a8e6-d074f23f7aadSymplectic Elements at OxfordBioMed Central2016Key, TMuller, DMurphy, NJohansson, MFerrari, PTsildis, KBoutron-Rualt, MClavel, FDartois, LLi, KKaaks, RWeikert, CBergmann, MBoeing, HTjønneland, AOvervad, KRedondo, MAgudo, AMolina-Portillo, EAltzibar, JCirera, LArdanaz, EKhaw, KWareham, NTravis, RBamia, COrfanos, PTrichopoulou, APalli, DPala, VTumino, RVineis, PPanico, SBueno-de-Mesquita, HVerschuren, WStruijk, EPeeters, PEngström, GMelander, OSund, MWeiderpass, ESkeie, GLund, ENorat, TGunter, MRiboli, EBrennan, P<h4>Background</h4> <p>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.</p> <h4>Methods</h4> <p>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</p> <h4>Results</h4> <p>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.</p> <h4>Conclusions</h4> <p>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.</p>
spellingShingle Key, T
Muller, D
Murphy, N
Johansson, M
Ferrari, P
Tsildis, K
Boutron-Rualt, M
Clavel, F
Dartois, L
Li, K
Kaaks, R
Weikert, C
Bergmann, M
Boeing, H
Tjønneland, A
Overvad, K
Redondo, M
Agudo, A
Molina-Portillo, E
Altzibar, J
Cirera, L
Ardanaz, E
Khaw, K
Wareham, N
Travis, R
Bamia, C
Orfanos, P
Trichopoulou, A
Palli, D
Pala, V
Tumino, R
Vineis, P
Panico, S
Bueno-de-Mesquita, H
Verschuren, W
Struijk, E
Peeters, P
Engström, G
Melander, O
Sund, M
Weiderpass, E
Skeie, G
Lund, E
Norat, T
Gunter, M
Riboli, E
Brennan, P
Modifiable causes of premature death in middle-age in Western Europe: results from the EPIC cohort study
title Modifiable causes of premature death in middle-age in Western Europe: results from the EPIC cohort study
title_full Modifiable causes of premature death in middle-age in Western Europe: results from the EPIC cohort study
title_fullStr Modifiable causes of premature death in middle-age in Western Europe: results from the EPIC cohort study
title_full_unstemmed Modifiable causes of premature death in middle-age in Western Europe: results from the EPIC cohort study
title_short Modifiable causes of premature death in middle-age in Western Europe: results from the EPIC cohort study
title_sort modifiable causes of premature death in middle age in western europe results from the epic cohort study
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