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Health See other Health Articles Title: Some Combinations of Lifestyle Factors More Risky Than Others Medscape Medical News Levels of daily physical activity and sleep duration in combination with other lifestyle behaviors may influence longevity, a study has shown. The all-cause mortality risk for individuals with high scores on a health risk index that combines measures of smoking, alcohol use, dietary behavior, physical inactivity, sedentary behavior, and sleep duration was significantly higher than for those scoring lower on the combined measure, Ding Ding, PhD, from the Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, New South Wales, Australia, and colleagues report in an article published online December 8 in PLOS Medicine. Researchers observed the highest risks associated with certain combinations of behaviors, including those involving physical inactivity, prolonged sitting, and long sleep duration, as well as those involving smoking and high alcohol intake. To examine the association between the six-item lifestyle risk index (created by summing the six health behavior measures) and all-cause mortality and to describe the most commonly occurring combinations of lifestyle risk behaviors and the mortality risk for each unique lifestyle combination, the investigators used mortality registration data during a 6-year follow-up period among 231,048 Australians aged 45 years or older, representing 1,409,591 person-years of follow-up. According to lifestyle questionnaires completed at baseline, 7.2% of study participants were smokers, 19.1% consumed more than 14 drinks of alcohol per week, 22.9% were not meeting physical activity recommendations, 17.2% were classified as having poor diet, 25.0% sat for more than 7 hours per day, and 23.1% slept too little (less than 7 hours) or too much (more than 9 hours), the authors report. Nearly one third (31.2%) of the participants reported no risk behaviors, and thus had a lifetime risk index score of 0. Of the remaining participants, 36.7%, 21.4%, 8.1%, 2.1%, 0.4%, and 0.04% had lifetime risk index scores of 1, 2, 3, 4, 5 and 6, respectively. Of all the single risk behaviors, smoking had the strongest association with all-cause mortality, with an adjusted hazard ratio (HR) of 1.90, according to the authors. Analyses of the commonly occurring risk combinations showed several relatively strong associations with all-cause mortality, including physical inactivity plus prolonged sitting time (HR = 2.42), physical inactivity plus long sleep duration (HR = 2.68), high alcohol intake plus physical inactivity plus prolonged sitting time (HR = 2.51), physical inactivity plus prolonged sitting time plus short sleep duration (HR = 2.59), physical inactivity plus prolonged sitting time plus long sleep duration (HR = 4.23), smoking plus high alcohol intake (HR = 2.80), and smoking plus high alcohol intake plus short sleep duration (HR = 4.68). "There was a clear association between the number of risk factors, as indicated by the lifestyle risk score, and all-cause mortality," the authors write. "Overall, all six risk factors accounted for a third of the person-year loss due to mortality when socioeconomic characteristics were held constant." Although statistically significant effect modification was observed by sex, education, body mass index, and cancer diagnosis in the past 10 years, "the overall difference in effect sizes across subgroups or when adjusting for additional covariates was small, and the patterns of associations were consistent," the authors explain. "This reinforces an important message for public health and clinical practice that adherence to low-risk lifestyles is likely to be protective for all." The inclusion of prolonged sitting and sleep duration as additional risk factors provides new insight into the contribution these behaviors, particularly in light of growing research suggesting both may contribute to chronic disease risk, according to the authors. In this analysis, prolonged sitting time was the most common single risk factor. Although alone it had only a small effect on all-cause mortality (HR = 1.15); in combination with physical inactivity, the association with mortality was more robust (HR = 2.42). With respect to sleep duration as a lone risk factor, "short sleep duration was only marginally associated with mortality (HR = 1.09), while long sleep duration was associated with much higher risk (HR = 1.44)," the authors report. Although "[t]he mechanism for the association between long sleep duration and mortality is not well understood," they write, "[m]ost studies suggest that long sleep duration tends to be associated with sleep fragmentation, fatigue, depression, and underlying disease and poor health," indicating that the association may be a function of residual confounding. The observation that risk combinations involving long sleep duration, prolonged sitting, and/or physical inactivity were among those with the strongest associations with mortality "may suggest that the underlying characteristics associated with such behavioral patterns involving long sleep, sedentariness, and inactivity, perhaps not limited to major occult disease or failing health, may have contributed to the elevated risk for morality," the authors write. The study "reaffirms the importance of healthy lifestyles, here evidenced for adults aged 45 y and older," according to the authors. In particular, they conclude, "[t]he prevalent combinations of risk factors suggest new strategic targeting for chronic disease prevention." This study was funded by a National Health and Medical Research Council Early Career Fellowship. The authors have disclosed no relevant financial relationships. PLOS Med. Published online December 8, 2015. 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#1. To: Tatarewicz (#0)
Why any thinking, feeling person would want to spend a day longer in this deranged world than they had to -- it is a puzzlement. Trying to sit, drink and sleep my way to an early grave but it's not working.
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