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Healthy lifestyle behaviours and all-cause and cardiovascular mortality among 0.9 million Chinese adults

Zhang X, Lu J, Wu C, Cui J, Wu Y, Hu A, Li J, Li X

The international journal of behavioral nutrition and physical activity, 2021

903,499 participants

Abstract

BACKGROUND: Healthy lifestyle behaviours are effective means to reduce the burden of diseases. This study was aimed to fill the knowledge gaps on the distribution, associated factors, and potential health benefits on mortality of four healthy lifestyle behaviours in China.

METHODS: During 2015-2019, participants aged 35-75 years from 31 provinces were recruited by the China PEACE Million Persons Project. Four healthy lifestyle behaviours were investigated in our study, including non-smoking, none or moderate alcohol use, sufficient leisure time physical activity (LTPA), and healthy diet.

RESULTS: Among 903,499 participants, 74.1% were non-smokers, 96.0% had none or moderate alcohol use, 23.6% had sufficient LTPA, 11.1% had healthy diet, and only 2.8% had all the four healthy lifestyle behaviours. The adherence varied across seven regions; the highest median of county-level adherence to all the four healthy lifestyle behaviours was in North China (3.3%) while the lowest in the Southwest (0.8%) (p < 0.05). Participants who were female, elder, non-farmers, urban residents, with higher income or education, hypertensive or diabetic, or with a cardiovascular disease (CVD) history were more likely to adhere to all the four healthy lifestyle behaviours (p < 0.001). County-level per capital Gross Domestic Product (GDP) was positively associated with sufficient LTPA (p < 0.05 for both rural and urban areas) and healthy diet (p < 0.01 for urban areas), while negatively associated with…

How strong is the evidence?

Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 903,499 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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