Key result
High adherence to healthy lifestyle scores is linked to ~35% lower risk of non-communicable diseases.
Why the study?
Numerous simple lifestyle scores have been developed for specific non-communicable diseases (NCDs), but their comparative associations with the incidence and mortality of NCDs had not been systematically investigated.
Do higher lifestyle scores reduce the incidence and mortality of major non-communicable diseases (cancer, CVD, T2D) in adults?
Cohort (n=76,399)
Yes
Do higher lifestyle scores reduce the incidence and mortality of major non-communicable diseases (cancer, CVD, T2D) in adults?
Hazard Ratio: 0.65 (95% CI 0.62–0.7)
p-value: p=<0.001
Adherence to healthy lifestyle scores, particularly those incorporating smoking and BMI, is strongly associated with reduced incidence and mortality of major non-communicable diseases, extending their utility beyond single-disease prediction.
High adherence associated with lower NCD incidence; extends multi-disease scores but leaves open intervention effects.
Numerous simple lifestyle scores have been developed for specific non-communicable diseases (NCDs). This research aimed to investigate and compare the associations of various lifestyle scores with the incidence and mortality of NCDs. In 76,399 participants from the UK Biobank, we investigated the associations of 13 lifestyle scores with the incidence and mortality of cancer, cardiovascular disease (CVD), type 2 diabetes (T2D), and a composite of these NCDs. Cox proportional-hazards regression models were used to estimate hazard ratios (HRs) for associations between lifestyle scores and NCD outcomes. During a median follow-up time of 10.5 years, 12,214 incident NCD cases and 2250 NCD deaths were documented. Higher lifestyle scores were generally associated with a reduced risk of overall NCDs (HRs ranging from 0.65 to 0.89) and NCD mortality (0.51-0.92). Cancer (HRs ranging from 0.72 to 0.98) and CVD (0.55-0.87) risk were less dependent on lifestyle behaviors than T2D (0.18-0.74). Notably, the top three scores associated with cancer outcomes included smoking as a component, and those for T2D included body mass index (BMI). For overall NCD outcomes, lifestyle scores including both smoking and BMI showed the strongest associations. Healthy Lifestyle Score and the Chronic Disease Risk Index were the overall best-performing scores to predict NCD risk and mortality. These findings suggest that the use of lifestyle scores designed for a single disease group can be extended for predicting multiple NCDs and mortality. Both smoking and BMI should be included in lifestyle scores aiming to predict overall NCD risk and mortality for future research and recommendations.
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Ding et al. (2025) conducted a cohort in Non-communicable diseases (Cancer, Cardiovascular Disease, Type 2 Diabetes) (n=76,399). Higher lifestyle scores (e.g., Chronic Disease Risk Index, Healthy Lifestyle Score) vs. Lowest category of lifestyle scores (least healthy lifestyle) was evaluated on Incidence of overall non-communicable diseases (NCDs) (HR 0.65, 95% CI 0.62-0.70, p=<0.001). Higher adherence to lifestyle scores, particularly the Chronic Disease Risk Index, significantly reduced the risk of incident non-communicable diseases (HR 0.65) compared to the lowest adherence category.
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