Effect of positive health factors and all-cause mortality in men.

Abstract

Although several health-related factors are independently associated with diverse health outcomes, their combined affect on mortality has not been fully described. We examined the combined effect of several positive health factors, including having normal weight (body mass index = 18.5-24.9 kg.m), not smoking (not current smoker), consuming a moderate alcohol intake (1-14 drinks per week), being physically active (moderate to high level), and having a higher cardiorespiratory fitness (top two-thirds), on all-cause mortality in 38,110 men aged 20-84 yr from the Aerobics Center Longitudinal Study. There were 2642 deaths during an average of 16 yr of follow-up. Compared with men with zero positive health factors, the multivariable-adjusted hazard ratios (HR) of all-cause mortality with one, two, three, four, and five positive health factors were 0.78 (95% confidence interval (CI) = 0.64-0.95), 0.61 (95% CI = 0.50-0.73), 0.54 (95% CI = 0.44-0.65), 0.43 (95% CI = 0.35-0.52), and 0.39 (95% CI = 0.31-0.48), respectively (P for trend <0.001). The combination of five positive health factors accounted for 29% (95% CI = 14%-40%) of population-attributable risk for all-cause mortality. Our findings suggest that targeting more of these modifiable health factors may provide substantial health benefits in middle-aged men.