The journal of nutrition, health & aging

, Volume 18, Issue 3, pp 314–321 | Cite as

Lifestyle habits and mortality from all and specific causes of death: 40-year follow-up in the Italian Rural Areas of the Seven Countries Study

  • A. Menotti
  • P. E. PudduEmail author
  • M. Lanti
  • G. Maiani
  • G. Catasta
  • A. Alberti Fidanza



Three lifestyle factors were investigated in a population study to explore their relationships with a long-term mortality.

Material and Methods

In a cohort of 1564 men aged 45–64 and examined in 1965 within the Italian Rural Areas of the Seven Countries Study, smoking habits, physical activity at work and eating habits (as derived from factor analysis) were determined. During the follow-up 693 men died in 20 years and 1441 in 40 years.


In Cox proportional hazards models men smoking cigarettes (versus never smokers), those having a sedentary activity (versus the very active) and those following the Diet Score 1, indexing an unhealthy Diet (versus men with a Diet close to the healthy Mediterranean style) had highly significant hazards ratios (HR) in relations with 20- and 40-year mortality from all causes, coronary heart disease (CHD), cardiovascular disease (CVD) and cancer. HR for all causes in 40 years were 1.44 (95% confidence intervals, CI, 1.27 and 1.64) for smokers, 1.43 (CI 1.23 and 1.67) for sedentary people, and 1.31 (CI 1.15 and 1.50) for men with unhealthy diet. Larger HR were found for CHD, CVD and cancers deaths. Combination of 3 unhealthy risk factors versus their absence was associated with 4.8-year life loss in the 20-year follow-up and 10.7-year in the 40-year follow-up.


Lifestyle behavior linked to physical activity and smoking and eating habits is strongly associated with mortality and survival in middle aged men during long-term follow-up.

Key words

Lifestyle mortality survival Seven Countries Study 40-year follow-up. 


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Copyright information

© Serdi and Springer-Verlag France 2014

Authors and Affiliations

  • A. Menotti
    • 1
  • P. E. Puddu
    • 2
    • 5
    Email author
  • M. Lanti
    • 1
  • G. Maiani
    • 3
  • G. Catasta
    • 3
  • A. Alberti Fidanza
    • 4
  1. 1.Association for Cardiac ResearchRomeItaly
  2. 2.Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatrical SciencesSapienza University of RomeRomeItaly
  3. 3.Istituto Nazionale di Ricerca per gli Alimenti e la NutrizioneRomeItaly
  4. 4.Department of Neurosciences, Human Nutrition SectionUniversity of Rome Tor VergataRomeItaly
  5. 5.Laboratory of Biotechnologies Applied to Cardiovascular Medicine, Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatrical Sciences, SapienzaUniversity of RomeRomaItaly

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