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BMC Medicine
Published in: BMC Medicine 1/2015

Open Access 01-12-2015 | Research article

The impact of a healthy lifestyle on Disability-Adjusted Life Years: a prospective cohort study

Authors: Anne M May, Ellen A Struijk, Heidi P Fransen, N Charlotte Onland-Moret, G Ardine de Wit, Jolanda MA Boer, Yvonne T van der Schouw, Jeljer Hoekstra, H Bas Bueno-de-Mesquita, Petra HM Peeters, Joline WJ Beulens

Published in: BMC Medicine | Issue 1/2015

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Abstract

Background

The association between single health behaviours and incidence of and premature mortality from major chronic diseases, including myocardial infarction, stroke, diabetes mellitus, and cancer, has been demonstrated thoroughly. However, the association of several healthy behaviours with Disability-Adjusted Life Years (DALYs), which is a measure for total health combining Years Lost due to Disability and the Years of Life Lost due to premature mortality, has not been studied yet.

Methods

A prospective cohort study was conducted among 33,066 healthy men and women aged 20 to 70 years recruited into the EPIC-NL study during 1993 to 1997. Participants’ smoking status, BMI, physical activity, and adherence to a Mediterranean-style diet (excluding alcohol) were investigated separately and combined into a simple health behaviour score ranging from 0 to 4. Participants were followed until the end of 2007 for occurrence of and mortality from the most important chronic diseases. The association between lifestyle (separate lifestyle factors and a simple health behaviour score) and DALYs were adjusted for relevant confounders.

Results

After a median follow-up of 12.4 years, 6,647 disease incidences and 1,482 deaths were documented. Non-smoking, low BMI (BMI <25), being physically active, and adherence to a Mediterranean diet were all associated with a significantly lower disease burden. Persons adhering to all four healthy lifestyle characteristics lived a minimum of 2 years longer in good health (DALYs: −2.13; 95% CI: −2.65 to −1.62) than persons with none. Due to our non-extinct cohort, the total number of DALYs, and consequently the estimates, is underestimated. Therefore, true lifetime health benefits of a healthy lifestyle will be even larger.

Conclusions

Non-smoking, a low BMI, being physically active, and adherence to a Mediterranean diet were associated with a lower disease burden. Each additional healthy lifestyle factor contributed to a longer life in good health.
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Metadata
Title
The impact of a healthy lifestyle on Disability-Adjusted Life Years: a prospective cohort study
Authors
Anne M May
Ellen A Struijk
Heidi P Fransen
N Charlotte Onland-Moret
G Ardine de Wit
Jolanda MA Boer
Yvonne T van der Schouw
Jeljer Hoekstra
H Bas Bueno-de-Mesquita
Petra HM Peeters
Joline WJ Beulens
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2015
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/s12916-015-0287-6

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