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BMC Public Health
Published in: BMC Public Health 1/2014

Open Access 01-12-2014 | Research article

Lifestyle factors and multimorbidity: a cross sectional study

Authors: Martin Fortin, Jeannie Haggerty, José Almirall, Tarek Bouhali, Maxime Sasseville, Martin Lemieux

Published in: BMC Public Health | Issue 1/2014

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Abstract

Background

Lifestyle factors have been associated mostly with individual chronic diseases. We investigated the relationship between lifestyle factors (individual and combined) and the co-occurrence of multiple chronic diseases.

Methods

Cross-sectional analysis of results from the Program of Research on the Evolution of a Cohort Investigating Health System Effects (PRECISE) in Quebec, Canada. Subjects aged 45 years and older. A randomly-selected cohort in the general population recruited by telephone. Multimorbidity (3 or more chronic diseases) was measured by a simple count of self-reported chronic diseases from a list of 14. Five lifestyle factors (LFs) were evaluated: 1) smoking habit, 2) alcohol consumption, 3) fruit and vegetable consumption, 4) physical activity, and 5) body mass index (BMI). Each LF was given a score of 1 (unhealthy) if recommended behavioural targets were not achieved and 0 otherwise. The combined effect of unhealthy LFs (ULFs) was evaluated using the total sum of scores.

Results

A total of 1,196 subjects were analyzed. Mean number of ULFs was 2.6 ± 1.1 SD. When ULFs were considered separately, there was an increased likelihood of multimorbidity with low or high BMI [Odd ratio (95% Confidence Interval): men, 1.96 (1.11-3.46); women, 2.57 (1.65-4.00)], and present or past smoker [men, 3.16 (1.74-5.73)]. When combined, in men, 4-5 ULFs increased the likelihood of multimorbidity [5.23 (1.70-16.1)]; in women, starting from a threshold of 2 ULFs [1.95 (1.05-3.62)], accumulating more ULFs progressively increased the likelihood of multimorbidity.

Conclusions

The present study provides support to the association of lifestyle factors and multimorbidity.
Appendix
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Literature
1.
2.
3.
U.S. Department of Health and Human Services: Physical Activity and Health: A Report of the Surgeon General. 1996, Atlanta, GA: Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion
4.
U.S. Department of Health and Human Services: The Health Consequences of Smoking: A Report of the Surgeon General. 2004, Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health
5.
Cuenca-Garcia M, Ortega FB, Ruiz JR, Gonzalez-Gross M, Labayen I, Jago R, Martinez-Gomez D, Dallongeville J, Bel-Serrat S, Marcos A, Manios Y, Breidenassel C, Widhalm K, Gottrand F, Ferrari M, Kafatos A, Molnár D, Moreno LA, De Henauw S, Castillo MJ, Sjöström M, HELENA Study Group: Combined influence of healthy diet and active lifestyle on cardiovascular disease risk factors in adolescents. Scand J Med Sci Sports. 2014, 24: 553-562. 10.1111/sms.12022.CrossRefPubMed
6.
Akesson A, Weismayer C, Newby PK, Wolk A: Combined effect of low-risk dietary and lifestyle behaviors in primary prevention of myocardial infarction in women. Arch Intern Med. 2007, 167: 2122-2127. 10.1001/archinte.167.19.2122.CrossRefPubMed
7.
Sasazuki S, Inoue M, Iwasaki M, Sawada N, Shimazu T, Yamaji T, Tsugane S: Combined impact of five lifestyle factors and subsequent risk of cancer: the Japan Public Health Center Study. Prev Med. 2012, 54: 112-116. 10.1016/j.ypmed.2011.11.003.CrossRefPubMed
8.
Breslow L, Enstrom JE: Persistence of health habits and their relationship to mortality. Prev Med. 1980, 9 (4): 469-483. 10.1016/0091-7435(80)90042-0.CrossRefPubMed
9.
King DE, Mainous AG, Matheson EM, Everett CJ: Impact of healthy lifestyle on mortality in people with normal blood pressure, LDL cholesterol, and C-reactive protein. Eur J Prev Cardiol. 2013, 20 (1): 73-79. 10.1177/1741826711425776.CrossRefPubMed
10.
Matheson EM, King DE, Everett CJ: Healthy lifestyle habits and mortality in overweight and obese individuals. J Am Board Fam Med. 2012, 25 (1): 9-15. 10.3122/jabfm.2012.01.110164.CrossRefPubMed
11.
Odegaard AO, Koh WP, Gross MD, Yuan JM, Pereira MA: Combined lifestyle factors and cardiovascular disease mortality in Chinese men and women: the Singapore Chinese health study. Circulation. 2011, 124: 2847-2854. 10.1161/CIRCULATIONAHA.111.048843.CrossRefPubMedPubMedCentral
12.
Chiuve SE, McCullough ML, Sacks FM, Rimm EB: Healthy lifestyle factors in the primary prevention of coronary heart disease among men: benefits among users and nonusers of lipid-lowering and antihypertensive medications. Circulation. 2006, 114: 160-167. 10.1161/CIRCULATIONAHA.106.621417.CrossRefPubMed
13.
Ford ES, Bergmann MM, Kroger J, Schienkiewitz A, Weikert C, Boeing H: Healthy living is the best revenge: findings from the European Prospective Investigation Into Cancer and Nutrition-Potsdam study. Arch Intern Med. 2009, 169: 1355-1362.CrossRefPubMed
14.
Forman JP, Stampfer MJ, Curhan GC: Diet and lifestyle risk factors associated with incident hypertension in women. JAMA. 2009, 302: 401-411. 10.1001/jama.2009.1060.CrossRefPubMedPubMedCentral
15.
Kurth T, Moore SC, Gaziano JM, Kase CS, Stampfer MJ, Berger K, Buring JE: Healthy lifestyle and the risk of stroke in women. Arch Intern Med. 2006, 166 (13): 1403-1409. 10.1001/archinte.166.13.1403.CrossRefPubMed
16.
Mozaffarian D, Kamineni A, Carnethon M, Djousse L, Mukamal KJ, Siscovick D: Lifestyle risk factors and new-onset diabetes mellitus in older adults: the cardiovascular health study. Arch Intern Med. 2009, 169 (8): 798-807. 10.1001/archinternmed.2009.21.CrossRefPubMedPubMedCentral
17.
Myint PK, Luben RN, Wareham NJ, Bingham SA, Khaw KT: Combined effect of health behaviours and risk of first ever stroke in 20,040 men and women over 11 years’ follow-up in Norfolk cohort of European Prospective Investigation of Cancer (EPIC Norfolk): prospective population study. BMJ. 2009, 338: b349-10.1136/bmj.b349.CrossRefPubMedPubMedCentral
18.
Reis JP, Loria CM, Sorlie PD, Park Y, Hollenbeck A, Schatzkin A: Lifestyle factors and risk for new-onset diabetes: a population-based cohort study. Ann Intern Med. 2011, 155: 292-299. 10.7326/0003-4819-155-5-201109060-00006.CrossRefPubMedPubMedCentral
19.
Autenrieth CS, Kirchberger I, Heier M, Zimmermann AK, Peters A, Doring A, Thorand B: Physical activity is inversely associated with multimorbidity in elderly men: results from the KORA-Age Augsburg study. Prev Med. 2013, 57: 17-19. 10.1016/j.ypmed.2013.02.014.CrossRefPubMed
20.
Agborsangaya CB, Lau D, Lahtinen M, Cooke T, Johnson JA: Multimorbidity prevalence and patterns across socioeconomic determinants: a cross-sectional survey. BMC Public Health. 2012, 12: 201-10.1186/1471-2458-12-201.CrossRefPubMedPubMedCentral
21.
Booth HP, Prevost AT, Gulliford MC: Impact of body mass index on prevalence of multimorbidity in primary care: cohort study. Fam Pract. 2014, 31 (1): 38-43. 10.1093/fampra/cmt061.CrossRefPubMed
22.
de S Santos Machado V, Valadares AL, Costa-Paiva LH, Osis MJ, Sousa MH, Pinto-Neto AM: Aging, obesity, and multimorbidity in women 50 years or older: a population-based study. Menopause. 2013, 20 (8): 818-824. 10.1097/GME.0b013e31827fdd8c.CrossRefPubMed
23.
De Souza Santos Machado V, Valadares AL, Da Costa-Paiva LS, Moraes SS, Pinto-Neto AM: Multimorbidity and associated factors in Brazilian women aged 40 to 65 years: a population-based study. Menopause. 2012, 19 (5): 569-575. 10.1097/gme.0b013e3182455963.CrossRefPubMed
24.
Nagel G, Peter R, Braig S, Hermann S, Rohrmann S, Linseisen J: The impact of education on risk factors and the occurrence of multimorbidity in the EPIC-Heidelberg cohort. BMC Public Health. 2008, 8: 384-10.1186/1471-2458-8-384.CrossRefPubMedPubMedCentral
25.
26.
Haggerty J, Fortin M, Beaulieu M-D, Hudon C, Loignon C, Préville M, Roberge D: At the interface of community and healthcare systems: a longitudinal cohort study on evolving health and the impact of primary healthcare from the patient’s perspective. BMC Health Serv Res. 2010, 10: 258-10.1186/1472-6963-10-258.CrossRefPubMedPubMedCentral
27.
Bayliss EA, Ellis JL, Steiner JF: Seniors’ self-reported multimorbidity captured biopsychosocial factors not incorporated into two other data-based morbidity measures. J Clin Epidemiol. 2009, 62: 550-557. 10.1016/j.jclinepi.2008.05.002.CrossRefPubMed
28.
Poitras ME, Fortin M, Hudon C, Haggerty J, Almirall J: Validation of the disease burden morbidity assessment by self-report in a French-speaking population. BMC Health Serv Res. 2012, 12: 35-10.1186/1472-6963-12-35.CrossRefPubMedPubMedCentral
29.
30.
31.
32.
Tamakoshi A, Tamakoshi K, Lin Y, Yagyu K, Kikuchi S: Healthy lifestyle and preventable death: findings from the Japan Collaborative Cohort (JACC) Study. Prev Med. 2009, 48 (5): 486-492. 10.1016/j.ypmed.2009.02.017.CrossRefPubMed
33.
King TK, Marcus BH, Pinto BM, Emmons KM, Abrams DB: Cognitive-behavioral mediators of changing multiple behaviors: smoking and a sedentary lifestyle. Prev Med. 1996, 25 (6): 684-691. 10.1006/pmed.1996.0107.CrossRefPubMed
34.
Sallit J, Ciccazzo M, Dixon Z: A cognitive-behavioral weight control program improves eating and smoking behaviors in weight-concerned female smokers. J Am Diet Assoc. 2009, 109 (8): 1398-1405. 10.1016/j.jada.2009.05.009.CrossRefPubMed
35.
Fortin M, Hudon C, Haggerty J, van den Akker M, Almirall J: Prevalence estimates of multimorbidity: a comparative study of two sources. BMC Health Serv Res. 2010, 10: 111-10.1186/1472-6963-10-111.CrossRefPubMedPubMedCentral
Metadata
Title
Lifestyle factors and multimorbidity: a cross sectional study
Authors
Martin Fortin
Jeannie Haggerty
José Almirall
Tarek Bouhali
Maxime Sasseville
Martin Lemieux
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2014
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-14-686

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