Risk factors for mortality in the Nurses’ Health Study: a competing risks analysis
Open accessAbstract
Few studies have examined multiple risk factors for mortality or formally compared their associations across specific causes of death. The authors used competing risks survival analysis to evaluate associations of lifestyle and dietary factors with all-cause and cause-specific mortality among 50,112 participants in the Nurses' Health Study. There were 4,893 deaths between 1986 and 2004: 1,026 from cardiovascular disease, 931 from smoking-related cancers, 1,430 from cancers not related to smoking, and 1,506 from all other causes. Age, body mass index at age 18 years, weight change, height, current smoking and pack-years of smoking, glycemic load, cholesterol intake, systolic blood pressure and use of blood pressure medications, diabetes, parental myocardial infarction before age 60 years, and time since menopause were directly related to all-cause mortality, whereas there were inverse associations for physical activity and intakes of nuts, polyunsaturated fat, and cereal fiber. Moderate alcohol consumption was associated with decreased mortality. A model that incorporated differences in the associations of some risk factors with specific causes of death had a significantly better fit compared with a model in which all risk factors had common associations across all causes. In the future, this new model may be used to identify individuals at increased risk of mortality.
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The mechanisms through which hPDI could reduce CHD risk are likely shared with the mechanisms for type 2 diabetes risk reduction.
“The mechanisms through which hPDI could reduce CHD risk are likely shared with the mechanisms for type 2 diabetes risk reduction.(2, 24–32)”
From Healthful and Unhealthful Plant-Based Diets and the Risk of Coronary Heart Disease in U.S. Adults (2017) · cites this paper as [31]
These dietary factors could aid in weight loss/maintenance, enhance glycemic control and insulin regulation, improve lipid profile, reduce blood pressure, improve vascular health, decrease inflammation, and foster more favorable diet-gut microbiome interactions, thereby lowering CHD risk.
“all of which could aid in weight loss/maintenance, enhance glycemic control and insulin regulation, improve lipid profile, reduce blood pressure, improve vascular health, decrease inflammation, and foster more favorable diet- gut microbiome interactions (e.g. through lowered levels of trimethylamine N-oxide), thereby lowering CHD risk.”
From Healthful and Unhealthful Plant-Based Diets and the Risk of Coronary Heart Disease in U.S. Adults (2017) · cites this paper as [31]
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- Authors
- Baer, H. J., Glynn, R. J., Hu, F. B., Hankinson, S. E., Willett, W. C., Colditz, G. A., Stampfer, M., & Rosner, B.
- Affiliations
- Brigham and Women's Hospital (US)
- Corresponding author
- Baer, Heather J.
- ORCID
- Venue
- American Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2010-12-06
- Volume
- 173
- Issue
- 3
- Pages
- 319-329
- ISSN
- 0002-9262 (ISSN-L)
- 1476-6256
- PMC
- PMC3105270
- OpenAlex
- W2103592177
- Cited by
- 153
- References
- 43
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 10 · 2023: 9 · 2022: 6 · 2021: 6 · 2020: 4 · 2019: 12 · 2018: 8 · 2017: 10 · 2016: 11 · 2015: 19 · 2014: 18 · 2013: 17 · 2012: 13
- FWCI
- 7.69
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Epidemiology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- Funders
- National Cancer Institute (P01CA087969, [P01 CA87969)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Oncology › Cancer Risks and Factors
- Keywords
- mortality risk factors, competing risks, cause-specific mortality, all-cause mortality, lifestyle factors, dietary factors, cardiovascular mortality, tobacco-related cancer, body mass index, weight change, glycemic load, cholesterol intake, blood pressure, diabetes mellitus, menopause, physical activity, nuts, polyunsaturated fat, cereal fiber, alcohol consumption, Nurses' Health Study
- MeSH terms
- Adolescent, Adult, Cause of Death, Chronic Disease, Follow-Up Studies, Humans, Life Style, Middle Aged, Mortality, Nurses, Surveys and Questionnaires, Risk Factors, Smoking, United States, Health Behavior, Proportional Hazards Models, Risk Assessment, Young Adult
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