RT Journal Article
T1 Modifiable causes of premature death in middle-age in Western Europe: results from the EPIC cohort study.
A1 Muller, David C
A1 Murphy, Neil
A1 Johansson, Mattias
A1 Ferrari, Pietro
A1 Tsilidis, Konstantinos K
A1 Boutron-Ruault, Marie-Christine
A1 Clavel, Francoise
A1 Dartois, Laureen
A1 Li, Kuanrong
A1 Kaaks, Rudolf
A1 Weikert, Cornelia
A1 Bergmann, Manuela
A1 Boeing, Heiner
A1 Tjønneland, Anne
A1 Overvad, Kim
A1 Redondo, M Luisa
A1 Agudo, Antonio
A1 Molina-Portillo, Elena
A1 Altzibar, Jone M
A1 Cirera, Lluís
A1 Ardanaz, Eva
A1 Khaw, Kay-Tee
A1 Wareham, Nicholas J
A1 Key, Timothy J
A1 Travis, Ruth C
A1 Bamia, Christina
A1 Orfanos, Philippos
A1 Trichopoulou, Antonia
A1 Palli, Domenico
A1 Pala, Valeria
A1 Tumino, Rosario
A1 Vineis, Paolo
A1 Panico, Salvatore
A1 Bueno-de-Mesquita, H Bas
A1 Verschuren, W M Monique
A1 Struijk, Ellen A
A1 Peeters, Petra H
A1 Engström, Gunnar
A1 Melander, Olle
A1 Sund, Malin
A1 Weiderpass, Elisabete
A1 Skeie, Guri
A1 Lund, Eiliv
A1 Norat, Teresa
A1 Gunter, Marc
A1 Riboli, Elio
A1 Brennan, Paul
K1 Absolute risk
K1 Attributable fraction
K1 Modifiable risk factors
K1 Mortality
K1 Premature death
AB 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. 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. 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. 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.
YR 2016
FD 2016-06-14
LK http://hdl.handle.net/10668/10171
UL http://hdl.handle.net/10668/10171
LA en
DS RISalud
RD Apr 7, 2025