TY - JOUR
T1 - Lifestyle behavior patterns and mortality among adults in the NHANES 1988–1994 population
T2 - A latent profile analysis
AU - Davis, Jennifer S.
AU - Banfield, Emilyn
AU - Lee, Hwa Young
AU - Peng, Ho Lan
AU - Chang, Shine
AU - Wood, Alexis C.
N1 - Funding Information:
This work was partially funded by a grant from the University of Texas M.D. Anderson Cancer Center Duncan Family Institute of Cancer Prevention and Risk Assessment. Dr. Wood is supported by a USDA grant ( CRIS 309-5-001-058 ). This work is also a publication of the US Department of Agriculture (USDA/ARS) Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine (Houston, TX) funded in part by the USDA ARS (Cooperative Agreement 6250-51000 ). The contents of this publication do not necessarily reflect the views or policies of the USDA, nor does mention of trade names, commercial products, or organizations imply endorsement from the US government.
Funding Information:
This work was partially funded by a grant from the University of Texas M.D. Anderson Cancer Center Duncan Family Institute of Cancer Prevention and Risk Assessment. Dr. Wood is supported by a USDA grant (CRIS 309-5-001-058). This work is also a publication of the US Department of Agriculture (USDA/ARS) Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine (Houston, TX) funded in part by the USDA/ARS (Cooperative Agreement 6250-51000). The contents of this publication do not necessarily reflect the views or policies of the USDA, nor does mention of trade names, commercial products, or organizations imply endorsement from the US government.
Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2019/3
Y1 - 2019/3
N2 - Evidence suggests interdependent associations of individual modifiable behaviors with health outcomes. However, such interrelations have not been accounted for in previous behavior-outcome associations. We conducted latent profile analysis (LPA) on self-reported levels of alcohol consumption, restaurant dining, vitamin/mineral supplement use, physical activity (PA) and smoke exposure (first- and second-hand smoke) separately for smokers (N = 4530) and non-smokers (N = 13,421) using data from the third National Health and Nutrition Examination Survey (NHANES III) to identify subgroups with similar levels within and across behaviors. Cox-proportional hazards models were used to compare mortality rates between subgroups from cancer, cardiovascular disease (CVD) and all-causes at an average of 16.4 (±6.1) years follow-up. Five behavioral typologies were identified in non-smokers (“Moderates”, “Low Risk Factors”, “Restaurant Diners”, “Moderate Passive Smokers” and “Heavy Passive Smokers”), and four in smokers (“Moderates”, “Low Risk Factors”, “Heavy Smokers” and “Physically Active”). As a group, “Moderates” had levels of each behavior that were not significantly different from at least one other group. Compared to “Moderates”, in non-smokers “Restaurant Diners” had lower hazard from all-cause (hazard ratio (HR):0.84, 95% CI:0.74–0.97) and CVD (HR:0.59, 0.43–0.82) mortality, while “Low Risk Factors” had higher cancer mortality (HR:1.38,1.03–1.84). In smokers, compared to “Moderates”, higher hazards for mortality were found for “Heavy Smokers” (all cause: HR:1.34, 1.12–1.60; CVD: HR:1.52, 1.04–2.23; cancer: HR:1.41 1.02–1.96) and “Low Risk Factors” (all-cause: HR:1.58, 1.14–2.17). Taken together, when restaurant dining, PA and smoking exposures are grouped together, novel predictions for mortality occur, suggesting data on multiple behaviors may be informative for risk stratification.
AB - Evidence suggests interdependent associations of individual modifiable behaviors with health outcomes. However, such interrelations have not been accounted for in previous behavior-outcome associations. We conducted latent profile analysis (LPA) on self-reported levels of alcohol consumption, restaurant dining, vitamin/mineral supplement use, physical activity (PA) and smoke exposure (first- and second-hand smoke) separately for smokers (N = 4530) and non-smokers (N = 13,421) using data from the third National Health and Nutrition Examination Survey (NHANES III) to identify subgroups with similar levels within and across behaviors. Cox-proportional hazards models were used to compare mortality rates between subgroups from cancer, cardiovascular disease (CVD) and all-causes at an average of 16.4 (±6.1) years follow-up. Five behavioral typologies were identified in non-smokers (“Moderates”, “Low Risk Factors”, “Restaurant Diners”, “Moderate Passive Smokers” and “Heavy Passive Smokers”), and four in smokers (“Moderates”, “Low Risk Factors”, “Heavy Smokers” and “Physically Active”). As a group, “Moderates” had levels of each behavior that were not significantly different from at least one other group. Compared to “Moderates”, in non-smokers “Restaurant Diners” had lower hazard from all-cause (hazard ratio (HR):0.84, 95% CI:0.74–0.97) and CVD (HR:0.59, 0.43–0.82) mortality, while “Low Risk Factors” had higher cancer mortality (HR:1.38,1.03–1.84). In smokers, compared to “Moderates”, higher hazards for mortality were found for “Heavy Smokers” (all cause: HR:1.34, 1.12–1.60; CVD: HR:1.52, 1.04–2.23; cancer: HR:1.41 1.02–1.96) and “Low Risk Factors” (all-cause: HR:1.58, 1.14–2.17). Taken together, when restaurant dining, PA and smoking exposures are grouped together, novel predictions for mortality occur, suggesting data on multiple behaviors may be informative for risk stratification.
KW - Latent profile analysis
KW - Lifestyle patterns
KW - Mortality
KW - NHANES
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U2 - 10.1016/j.ypmed.2019.01.012
DO - 10.1016/j.ypmed.2019.01.012
M3 - Article
C2 - 30660707
AN - SCOPUS:85060737361
SN - 0091-7435
VL - 120
SP - 131
EP - 139
JO - Preventive Medicine
JF - Preventive Medicine
ER -