Healthy lifestyle is inversely associated with mortality in cancer survivors: Results from the Third National Health and Nutrition Examination Survey (NHANES III)

PLoS One. 2019 Jun 26;14(6):e0218048. doi: 10.1371/journal.pone.0218048. eCollection 2019.

Abstract

Individual lifestyle behaviors have been associated with prolonged survival in cancer survivors, but little information is available on the association between combined lifestyle behaviors and mortality in this population. Data from 522 cancer survivors participating in the Third National Health and Nutrition Examination Survey (NHANES III) were analyzed. Behaviors pertaining to lifetime healthy body weight maintenance, physical activity, smoking, diet quality (assessed by the Healthy Eating Index) and moderate alcohol consumption were combined in a lifestyle score (range 0-5). Cox proportional hazards regression models were used to calculate multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CI). Both in continuous and categorical models, the lifestyle score was statistically significantly associated with lower mortality in the total study population (HRcontinuous = 0.81, 95% CI: 072, 0.90, per 1 unit increase; HR1-2 vs. 0 total = 0.71, 95% CI: 0.56, 0.92; HR3-5 vs. 0 total = 0.57, 95% CI: 0.38, 0.85, in the fully adjusted model) and in sex-specific analyses. Cancer survivors with high or moderate lifestyle score had lower risk of premature death compared to survivors with zero lifestyle score. Future studies are required in order to verify our findings and to investigate underlying mechanisms of the mortality-adherence association.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cancer Survivors*
  • Female
  • Healthy Lifestyle*
  • Humans
  • Male
  • Middle Aged
  • Nutrition Surveys

Grants and funding

This work was supported by Krebsliga Schweiz under Grant KFS-4114-02-2017 to SR. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.