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:2706 participants from the Chilean National Health Survey 2009-2010.Results:After a median follow-up of 10 center dot 9 years, 286 (10 center dot 6 %) participants died. In the maximally adjusted model, and compared with the healthiest participants, those less healthy had 2 center dot 55 (95 % CI 1 center dot 75, 3 center dot 71) times higher mortality risk due to any cause. Similar trends were identified for the moderately healthy group. Moreover, there was a significant trend towards increasing the mortality risk when increasing unhealthy behaviours (hazard ratio model 3: 1 center dot 61 (95 % CI 1 center dot 34, 1 center dot 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.