부산대학교 도서관

Introduction: There is a lack of comprehensive evaluations regarding the impact of lifestyle factors on premature mortality and life expectancy in the U.S. population.Hypothesis: Life expectancy could be improved by a healthy lifestyle.Methods: Based on the Nurses’ Health Study (1980-2014, n=78,865) and the Health Professionals Follow-up Study (1986-2014, n=38,339), we estimated hazard ratios (HRs) and 95% confidence intervals (CIs) of mortality in relation to five low-risk factors, including never smoking, body mass index (BMI) 18.5-24.9 kg/m2, 30+ minutes/day moderate to vigorous physical activity, moderate alcohol intake, and a high diet quality score (upper 40%). We used data from the NHANES (2013-2014) to estimate the distribution of the low-risk factors, and the CDC WONDER database to derive the age-specific death rates of Americans.Results: During up to 34 years of follow-up, we documented 41,859 deaths, including 13,721 deaths from cancer and 10,639 deaths from CVD. Greater numbers of low-risk factors were linearly associated with lower mortality rates, and the multivariate-adjusted HRs (95% CIs) for adults with five compared with zero low-risk factors were 0.26 (95% CI: 0.22-0.31) for all-cause mortality, 0.35 (95% CI: 0.27-0.46) for cancer mortality and 0.18 (95%CI: 0.12-0.26) for CVD mortality. The population-attributable-risk of U.S. adults was 60.7% (95%CI: 53.1%-67.0%) for all-cause mortality, 51.7% (95%CI: 37.1%-62.9%) for cancer mortality and 70.7% (56.6%-80.3%) for CVD mortality. We projected that life expectancy at the age 50 was on average 14.9 (95% CI: 12.5-17.2) years longer among female Americans with five low-risk lifestyle factors as compared to those with zero low-risk factors; for males, the difference was 12.4 (95% CI: 10.3-14.4) years.Conclusions: Adopting a healthy lifestyle could substantially reduce premature mortality and prolong life expectancy in the U.S. adults.