TABLE 2.
Associations between components of the healthy lifestyle score and risk of colorectal cancer; results from the UK Biobank1,2
| All participants combined | Men | Women | ||||
|---|---|---|---|---|---|---|
| HLS components | Cases | HR (95% CI) | Cases | HR (95% CI) | Cases | HR (95% CI) |
| BMI, kg/m2 | ||||||
| 18.5–24.9 | 577 | 1 (Ref) | 253 | 1 (Ref) | 324 | 1 (Ref) |
| 25.0–29.9 | 957 | 1.11 (0.999, 1.23) | 593 | 1.13 (0.98, 1.31) | 364 | 1.13 (0.97, 1.32) |
| ≥30.0 | 532 | 1.17 (1.04, 1.32) | 348 | 1.34 (1.13, 1.57) | 184 | 0.98 (0.82, 1.18) |
| Waist-to-hip ratio (by sex-specific tertiles)3 | ||||||
| T1 (low) | 503 | 1 (Ref) | 271 | 1 (Ref) | 232 | 1 (Ref) |
| T2 | 699 | 1.24 (1.11, 1.40) | 406 | 1.34 (1.15, 1.56) | 293 | 1.13 (0.95, 1.35) |
| T3 | 864 | 1.41 (1.26, 1.58) | 517 | 1.53 (1.32, 1.78) | 347 | 1.26 (1.06, 1.49) |
| Physical activity 10+ min, d/wk | ||||||
| Moderate 6–7 and vigorous 3–5 or 6–7 | 287 | 1 (Ref) | 172 | 1 (Ref) | 115 | 1 (Ref) |
| Moderate 1–5 or vigorous 1–2 | 1545 | 1.07 (0.95, 1.22) | 888 | 1.14 (0.97, 1.34) | 657 | 0.98 (0.80, 1.19) |
| None | 234 | 1.09 (0.92, 1.30) | 134 | 1.12 (0.89, 1.40) | 100 | 1.04 (0.80, 1.36) |
| Sedentary time, h/d, by tertiles | ||||||
| <3 | 427 | 1 (Ref) | 208 | 1 (Ref) | 219 | 1 (Ref) |
| 3–4.9 | 802 | 1.08 (0.96, 1.21) | 446 | 1.09 (0.92, 1.28) | 356 | 1.09 (0.92, 1.29) |
| ≥5 | 837 | 1.09 (0.96, 1.22) | 540 | 1.11 (0.95, 1.31) | 297 | 1.07 (0.89, 1.28) |
| Consumption of processed and red meat | ||||||
| <4 times per wk | 214 | 1 (Ref.) | 67 | 1 (Ref) | 147 | 1 (Ref) |
| 5–7 times per wk | 1375 | 1.17 (1.01, 1.35) | 758 | 1.40 (1.09, 1.79) | 617 | 1.09 (0.91, 1.31) |
| ≥8 times per wk | 477 | 1.28 (1.09, 1.51) | 369 | 1.69 (1.30, 2.19) | 108 | 0.92 (0.72, 1.18) |
| Vegetable and fruit intake | ||||||
| >5 servings per d | 620 | 1 (Ref) | 306 | 1 (Ref) | 314 | 1 (Ref) |
| 2–4 servings per d | 1185 | 0.99 (0.90, 1.09) | 694 | 0.98 (0.86, 1.12) | 491 | 0.999 (0.87, 1.15) |
| ≤1 serving per d | 261 | 1.07 (0.93, 1.24) | 194 | 1.09 (0.91, 1.30) | 67 | 1.03 (0.79, 1.34) |
| Alcohol consumption | ||||||
| Nonuser or seldom4 | 519 | 1 (Ref) | 195 | 1 (Ref) | 324 | 1 (Ref) |
| 1–4 times per wk | 988 | 1.003 (0.90, 1.12) | 610 | 1.19 (1.01, 1.39) | 378 | 0.86 (0.74, 1.001) |
| Almost daily | 559 | 1.16 (1.02, 1.31) | 389 | 1.36 (1.14, 1.62) | 170 | 0.98 (0.81, 1.19) |
| Tobacco smoking | ||||||
| Never | 985 | 1 (Ref) | 485 | 1 (Ref) | 500 | 1 (Ref) |
| Former and current, light5 | 960 | 1.18 (1.08, 1.30) | 632 | 1.27 (1.13, 1.43) | 328 | 1.06 (0.92, 1.22) |
| Current, heavy | 121 | 1.34 (1.11, 1.63) | 77 | 1.35 (1.06, 1.72) | 44 | 1.36 (0.99, 1.86) |
| HLS1 (met/not met guideline score)6 | ||||||
| Unhealthy (≤1) | 783 | 1 (Ref) | 626 | 1 (Ref) | 157 | 1 (Ref) |
| Intermediate (2, 3) | 906 | 0.83 (0.75, 0.91) | 466 | 0.81 (0.72, 0.91) | 440 | 0.93 (0.77, 1.11) |
| Healthy (≥4, healthy) | 377 | 0.71 (0.63, 0.81) | 102 | 0.60 (0.49, 0.74) | 275 | 0.84 (0.69, 1.02) |
| P for trend | <0.0001 | <0.0001 | 0.07 | |||
| HLS2 (sex-specific weighted score)7 | ||||||
| Unhealthy | 920 | 1 (Ref) | 555 | 1 (Ref) | 365 | 1 (Ref) |
| Intermediate | 654 | 0.78 (0.70, 0.86) | 378 | 0.75 (0.66, 0.86) | 276 | 0.81 (0.70, 0.95) |
| Healthy | 492 | 0.65 (0.58, 0.73) | 261 | 0.59 (0.51, 0.69) | 231 | 0.74 (0.62, 0.87) |
| P for trend | <0.0001 | <0.0001 | 0.0003 | |||
HLS, healthy lifestyle score.
Adjusted for age at enrollment, sex (only in analysis of all participants combined), education, Townsend deprivation index, bowel screening, and family history. Stratified by birth cohort.
For the HLS1 component, the waist-to-hip ratio was categorized according to WHO guidelines. For the HLS2 component, the waist-to-hip ratio was categorized into tertiles T1 (<0.91), T2 (0.91–0.96) and T3 (>0.96) for men and T1 (<0.78), T2 (0.78–0.84) and T3 (>0.84) for women, according to the distribution of waist-to-hip ratio in noncases.
Seldom: special occasions only, and 1–3 times a month.
Light current smoking is defined as smoking <20 pack-y. Heavy current smoking is defined as smoking ≥20 pack-y.
We provide a detailed explanation for each category in Supplementary Table 1. Each category was scored 0 or 1, with 1 representing having met the guideline. The HLS1 was then constructed by taking the sum of the scores. The HLS1 ranged from 0 to 8, and was analyzed in this study according to 3 categories: unhealthy (score 0, 1), intermediate (2, 3), and healthy (≥4), based on the tertile distribution of HLS1 in noncases.
Each category was scored according to the estimated sex-specific weights, loge-HR, for the 8 components to construct the HLS2 from a multivariable logistic regression analysis. The HLS2 was analyzed in this study according to 3 categories: unhealthy (>1.39), intermediate (1.04–1.39), and healthy (<1.04) for men and unhealthy (>0.28), intermediate (0.12–0.28), and healthy (<0.12) for women, based on the tertile distribution of HLS2 in noncases.