Association between a lifestyle score and all-cause mortality: A prospective analysis of the Chilean National Health Survey 2009-2010

Objective To investigate the association between a lifestyle score and all-cause mortality in the Chilean population. Design Prospective study Settings The score was based on seven modifiable behaviours: salt intake, fruit and vegetable intake, alcohol consumption, sleep duration, smoking, physical activity, and sedentary behaviours. 1-point was assigned for each healthy recommendation. Points were summed to create an unweighted score from 0 (less healthy) to 7 (healthiest). According to their score, participants were then classified into: less healthy (0-2 points), moderately healthy (3-4 points), and the healthiest (5-7 points). Associations between the categories of lifestyle score and all-cause mortality were investigated using Cox proportional hazard models adjusted for confounders. Nonlinear associations were also investigated. Participants 2,706 participants from the Chilean National Health Survey 2009-2010. Results After a median follow-up of 10.9 years, 286 (10.6%) participants died. In the maximally adjusted model, and compared with the healthiest participants, those less healthy had 2.55 (95% CI: 1.75 to 3.71) times higher mortality risk due to any cause. Similar trends were identified for the moderately healthy group. Moreover, there was a significant trend toward increasing the mortality risk when increasing unhealthy behaviours (HR model 3: 1.61 [95% CI: 1.34 to 1.94]). There was no evidence of nonlinearity between the lifestyle score and all-cause mortality. Conclusion Individuals in the less healthy lifestyle category had higher mortality risk than the healthiest group. Therefore, public health strategies should be implemented to promote adherence to a healthy lifestyle across the Chilean population.