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Nutritional status, lifestyle habits and cancer mortality: a population-based prospective cohort study

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European Journal of Nutrition Aims and scope Submit manuscript

Abstract

Purpose

We aimed to investigate the relationship between overall nutritional status and cancer mortality.

Methods

A total of 12 262 US adults from six consecutive surveys of the National Health and Nutrition Examination Survey (NHANES 2003–2014) were analyzed. The overall health nutritional biomarkers index (HNBI) score, capturing characteristics of 17 biomarkers was developed to assess the overall nutritional status. The lower the HNBI score, the healthier nutritional status would be. Hazard ratio (HR) and 95% confidence intervals (95% CIs) were calculated by Cox proportional hazards regression models to evaluate the association between the HNBI score and cancer mortality.

Results

The lower overall HNBI score was associated with decreased risk of cancer mortality, compared with participants in the 4th quartile of overall HNBI score, the HR (95% CIs) for participants in the 1st quartiles was 0.54 (0.33–0.89) (P-trend = 0.019). Healthier lifestyle habits and not obesity interacted with HNBI score, compared with participants with higher HNBI score and smoking currently/not exercising regularly/obesity, participants with lower HNBI score and not smoking currently/exercising regularly/not obesity were associated with lower risk of cancer mortality, the HR (95% CIs) were 0.43 (0.26–0.73), 0.57 (0.33–0.97), and 0.62 (0.47–0.97), respectively. These significant associations remained among participants who were followed-up more than 2 years.

Conclusion

Our findings suggested that healthier overall nutritional status was associated with lower risk of cancer mortality among US adults. Not smoking, exercise regularly and not obesity interacted with overall nutritional status. Adherence to better overall nutritional status, lifestyle habits and optimal weight would prevent premature death from cancer.

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Availability of data and materials

Data described in the manuscript, code book, and analytic code will be made publicly and freely available without restriction at https://www.cdc.gov/nchs/nhanes/.

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Acknowledgements

We thank the investigators, the staff, and the participants of the National Health and Nutrition Examination Survey for their valuable contribution.

Funding

This study was supported by the National Natural Science Foundation of China (Grant numbers: 82073536 and 81573134).

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Author notes

  1. Xiaoyan Wu and Wenjie Wang contributed equally to this work

Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, School of Public Health, Guilin Medical University, 1 Zhiyuan Road, Guilin, 541000, People’s Republic of China

    Xiaoyan Wu

  2. School of Public Health, School of Medicine, Chronic Disease Research Institute, Zhejiang University, Hangzhou, 310058, People’s Republic of China

    Wenjie Wang

  3. Department of Nutrition and Food Hygiene, School of Public Health, The National Key Discipline, Harbin Medical University, Harbin, 150081, People’s Republic of China

    Wenjie Wang, Dandan Zhang & Fangzhou Zhu

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  1. Xiaoyan Wu
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Contributions

WJW, DDZ, FZZ and XYW were involved in the conception and design of the study. All authors contributed to the interpretation and critical revision of manuscript. The statistical analyses were conducted by WJW and XYW.

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Correspondence to Xiaoyan Wu.

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The authors declare that there is no conflict of interest regarding the publication of this article.

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The NHANES protocol was approved by the National Center for Health Statistics Research Ethics Review Board, and all participants provided informed consent.

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All participants gave their informed consent prior to their inclusion in the study.

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Wu, X., Wang, W., Zhang, D. et al. Nutritional status, lifestyle habits and cancer mortality: a population-based prospective cohort study. Eur J Nutr 61, 1343–1352 (2022). https://doi.org/10.1007/s00394-021-02739-1

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