健康的生活方式与非传染性疾病的风险呈负相关，而非传染性疾病是导致死亡的主要原因。然而，很少有研究使用纵向数据来评估改变生活方式行为对全因死亡率和癌症死亡率的影响。在欧洲癌症与营养前瞻性调查 (EPIC) 队列中，308,497 名无癌症成年人（71% 为女性）的生活方式概况）对九个国家招募时年龄在 35-70 岁之间的人进行了评估，基线调查问卷和后续调查问卷平均间隔 7 年进行。健康生活方式指数 (HLI) 在两个时间点进行评估，综合了吸烟状况、酒精摄入量、体重指数和体力活动的信息，范围从 0 到 16 个单位。变化分数计算为基线和随访时 HLI 之间的差异。使用 Cox 回归对 HLI 变化与全因死亡率和癌症死亡率之间的关联进行建模，并通过死亡率提前期（RAP，以年为单位）估计 HLI 变化对加速死亡率的影响。在进行后续调查问卷后，对参与者进行了随访平均 9.9 年，记录了 21,696 例死亡（8407 例癌症死亡）。与 HLI 保持稳定（在 1 个单位内）的参与者相比，HLI 改善超过 1 个单位与全因死亡率和癌症死亡率呈负相关（风险比 [HR]：0.84；95% 置信区间 [CI]：0.81、0.88 ；和 HR：0.87；95% CI：0.82，0.92；而 HLI 恶化超过一个单位与死亡率增加相关（全因死亡率 HR：1.26；95% CI：1.20，1.33；癌症死亡率 HR：1.19；95% CI：1.09，1.29）。与稳定的参与者相比，HLI 恶化超过 1 的参与者的死亡风险增加了 1.62 (1.44, 1.96) 年，而 HLI 改善相同程度的参与者的死亡风险延迟了 1.19 (0.65, 2.32) 年。 HLI。在成年期间改变更健康的生活方式与全因死亡率和癌症死亡率以及延迟死亡风险呈负相关。相反，改变不健康的生活方式与死亡率和死亡风险加速呈正相关。© 2024。世界卫生组织。

Healthy lifestyles are inversely associated with the risk of noncommunicable diseases, which are leading causes of death. However, few studies have used longitudinal data to assess the impact of changing lifestyle behaviours on all-cause and cancer mortality.Within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, lifestyle profiles of 308,497 cancer-free adults (71% female) aged 35-70 years at recruitment across nine countries were assessed with baseline and follow-up questionnaires administered on average of 7 years apart. A healthy lifestyle index (HLI), assessed at two time points, combined information on smoking status, alcohol intake, body mass index, and physical activity, and ranged from 0 to 16 units. A change score was calculated as the difference between HLI at baseline and follow-up. Associations between HLI change and all-cause and cancer mortality were modelled with Cox regression, and the impact of changing HLI on accelerating mortality rate was estimated by rate advancement periods (RAP, in years).After the follow-up questionnaire, participants were followed for an average of 9.9 years, with 21,696 deaths (8407 cancer deaths) documented. Compared to participants whose HLIs remained stable (within one unit), improving HLI by more than one unit was inversely associated with all-cause and cancer mortality (hazard ratio [HR]: 0.84; 95% confidence interval [CI]: 0.81, 0.88; and HR: 0.87; 95% CI: 0.82, 0.92; respectively), while worsening HLI by more than one unit was associated with an increase in mortality (all-cause mortality HR: 1.26; 95% CI: 1.20, 1.33; cancer mortality HR: 1.19; 95% CI: 1.09, 1.29). Participants who worsened HLI by more than one advanced their risk of death by 1.62 (1.44, 1.96) years, while participants who improved HLI by the same amount delayed their risk of death by 1.19 (0.65, 2.32) years, compared to those with stable HLI.Making healthier lifestyle changes during adulthood was inversely associated with all-cause and cancer mortality and delayed risk of death. Conversely, making unhealthier lifestyle changes was positively associated with mortality and an accelerated risk of death.© 2024. World Health Organization.