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dc.contributor.authorViallon, Vivian
dc.contributor.authorFreisling, Heinz
dc.contributor.authorMatta, Komodo
dc.contributor.authorNannsen, Anne Østergaard
dc.contributor.authorDahm, Christina C.
dc.contributor.authorTjønneland, Anne
dc.contributor.authorEriksen, Anne Kirstine
dc.contributor.authorKaaks, Rudolf
dc.contributor.authorKatzke, Verena A.
dc.contributor.authorSchulze, Matthias B.
dc.contributor.authorMasala, Giovanna
dc.contributor.authorTagliabue, Giovanna
dc.contributor.authorSimeon, Vittorio
dc.contributor.authorTumino, Rosario
dc.contributor.authorMilani, Lorenzo
dc.contributor.authorDerksen, Jeroen W. G.
dc.contributor.authorvan der Schouw, Yvonne T.
dc.contributor.authorNøst, Therese Haugdahl
dc.contributor.authorBorch, Kristin Benjaminsen
dc.contributor.authorSandanger, Torkjel Manning
dc.contributor.authorQuirós, J. Ramón
dc.contributor.authorRodriguez-Barranco, Miguel
dc.contributor.authorBonet, Catalina
dc.contributor.authorAizpurua-Atxega, Amaia
dc.contributor.authorCirera, Lluís
dc.contributor.authorGuevara, Marcela
dc.contributor.authorSundström, Björn
dc.contributor.authorWinkvist, Anna
dc.contributor.authorHeath, Alicia K.
dc.contributor.authorGunter, Marc J.
dc.contributor.authorWeiderpass Vainio, Elisabete
dc.contributor.authorJohansson, Mattias
dc.contributor.authorFerrari, Pietro
dc.date.accessioned2024-08-26T13:03:35Z
dc.date.available2024-08-26T13:03:35Z
dc.date.issued2024-07-15
dc.description.abstractThe healthy lifestyle index (HLI), defined as the unweighted sum of individual lifestyle components, was used to investigate the combined role of lifestyle factors on health-related outcomes. We introduced weighted outcome-specific versions of the HLI, where individual lifestyle components were weighted according to their associations with disease outcomes. Within the European Prospective Investigation into Cancer and Nutrition (EPIC), we examined the association between the standard and the outcome-specific HLIs and the risk of T2D, CVD, cancer, and all-cause premature mortality. Estimates of the hazard ratios (HRs), the Harrell’s C-index and the population attributable fractions (PAFs) were compared. For T2D, the HR for 1-SD increase of the standard and T2D-specific HLI were 0.66 (95% CI: 0.64, 0.67) and 0.43 (0.42, 0.44), respectively, and the C-index were 0.63 (0.62, 0.64) and 0.72 (0.72, 0.73). Similar, yet less pronounced differences in HR and C-index were observed for standard and outcome-specific estimates for cancer, CVD and all-cause mortality. PAF estimates for mortality before age 80 were 57% (55%, 58%) and 33% (32%, 34%) for standard and mortality-specific HLI, respectively. The use of outcome-specific HLI could improve the assessment of the role of lifestyle factors on disease outcomes, thus enhancing the definition of public health recommendations.en_US
dc.identifier.citationViallon, Freisling, Matta, Nannsen, Dahm, Tjønneland, Eriksen, Kaaks, Katzke, Schulze, Masala, Tagliabue, Simeon, Tumino, Milani, Derksen, van der Schouw, Nøst, Borch, Sandanger, Quirós, Rodriguez-Barranco, Bonet, Aizpurua-Atxega, Cirera, Guevara, Sundström, Winkvist, Heath, Gunter, Weiderpass Vainio, Johansson, Ferrari. On the use of the healthy lifestyle index to investigate specific disease outcomes. Scientific Reports. 2024;14(1)en_US
dc.identifier.cristinIDFRIDAID 2288172
dc.identifier.doi10.1038/s41598-024-66772-w
dc.identifier.issn2045-2322
dc.identifier.urihttps://hdl.handle.net/10037/34422
dc.language.isoengen_US
dc.publisherSpringer Natureen_US
dc.relation.journalScientific Reports
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2024 The Author(s)en_US
dc.rights.urihttps://creativecommons.org/licenses/by/4.0en_US
dc.rightsAttribution 4.0 International (CC BY 4.0)en_US
dc.titleOn the use of the healthy lifestyle index to investigate specific disease outcomesen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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Attribution 4.0 International (CC BY 4.0)
Except where otherwise noted, this item's license is described as Attribution 4.0 International (CC BY 4.0)