Publicação
Lifestyle risk factors and all-cause and cause-specific mortality in the Mexico city prospective study: assessing the influence of reverse causation
| Resumo: | Background: We examined the association between individual lifestyle risk factors with all-cause and cause-specific mortality. Methods: Prospective cohort study including 155,002 participants from the Mexico City Prospective Study. Cox regression models were used to estimate the association between individual lifestyle risk factors and all-cause and cause-specific mortality. Participants with prevalent diseases at baseline and participants who died during the first 2, 5, 10, and 15 years of follow-up were excluded to account for reverse causation. Results: 27,469 people died during 18.3 years of follow-up years. Overweight and moderate alcohol consumption were inversely associated with all-cause mortality, while low physical activity and smoking were positively associated when all participants were included, regardless of prevalent disease or duration of follow-up. The direction of the association of overweight with all-cause mortality changed from inverse to positive after excluding the first 10 years of follow-up. Compared with normal weight, the hazard ratio (95 % confidence interval) was 1.17 (1.13,1.22) for obesity after excluding those who died in the first 5 years of follow-up and 1.71 (1.59,1.84) after excluding the first 15 years of follow-up. The magnitude of the association of alcohol intake, low physical activity, and smoking with mortality attenuated, whereas for fruits and vegetables increased, after excluding longer periods of follow-up. Limitations: The data were collected exclusively in Mexico City; lifestyle risk factors were self-reported and thus prone to misclassification bias. Conclusions: Reverse causation may influence both the magnitude and the direction of the associations between lifestyle risk factors and mortality. |
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| Autores principais: | Ferrari, Gerson |
| Outros Autores: | de Maio Nascimento, Marcelo; Petermann-Rocha, Fanny; Rezende, Leandro F.M.; O'Donovan, Gary; Gouveia, Elvio; Cristi-Montero, Carlos; Marques, Adilson |
| Assunto: | Bias Lifestyle risk factor Mortality Prospective study Reverse causation |
| Ano: | 2024 |
| País: | Portugal |
| Tipo de documento: | artigo |
| Tipo de acesso: | acesso restrito |
| Instituição associada: | Universidade de Lisboa |
| Idioma: | inglês |
| Origem: | Repositório da Universidade de Lisboa |
| Resumo: | Background: We examined the association between individual lifestyle risk factors with all-cause and cause-specific mortality. Methods: Prospective cohort study including 155,002 participants from the Mexico City Prospective Study. Cox regression models were used to estimate the association between individual lifestyle risk factors and all-cause and cause-specific mortality. Participants with prevalent diseases at baseline and participants who died during the first 2, 5, 10, and 15 years of follow-up were excluded to account for reverse causation. Results: 27,469 people died during 18.3 years of follow-up years. Overweight and moderate alcohol consumption were inversely associated with all-cause mortality, while low physical activity and smoking were positively associated when all participants were included, regardless of prevalent disease or duration of follow-up. The direction of the association of overweight with all-cause mortality changed from inverse to positive after excluding the first 10 years of follow-up. Compared with normal weight, the hazard ratio (95 % confidence interval) was 1.17 (1.13,1.22) for obesity after excluding those who died in the first 5 years of follow-up and 1.71 (1.59,1.84) after excluding the first 15 years of follow-up. The magnitude of the association of alcohol intake, low physical activity, and smoking with mortality attenuated, whereas for fruits and vegetables increased, after excluding longer periods of follow-up. Limitations: The data were collected exclusively in Mexico City; lifestyle risk factors were self-reported and thus prone to misclassification bias. Conclusions: Reverse causation may influence both the magnitude and the direction of the associations between lifestyle risk factors and mortality. |
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