@article{3166755,
    title = "Healthy lifestyle index and risk of gastric adenocarcinoma in the EPIC
cohort study",
    author = "Buckland, G. and Travier, N. and Huerta, J. M. and Bueno-de-Mesquita, H. and B(As) and Siersema, P. D. and Skeie, G. and Weiderpass, E. and Engeset, and D. and Ericson, U. and Ohlsson, B. and Agudo, A. and Romieu, I. and and Ferrari, P. and Freisling, H. and Colorado-Yohar, S. and Li, K. and and Kaaks, R. and Pala, V. and Cross, A. J. and Riboli, E. and Trichopoulou, and A. and Lagiou, P. and Bamia, C. and Boutron-Ruault, M. C. and and Fagherazzi, G. and Dartois, L. and May, A. M. and Peeters, P. H. and and Panico, S. and Johansson, M. and Wallner, B. and Palli, D. and Key, T. and J. and Khaw, K. T. and Ardanaz, E. and Overvad, K. and Tjonneland, A. and and Dorronsoro, M. and Sanchez, M. J. and Quiros, J. R. and Naccarati, and A. and Tumino, R. and Boeing, H. and Gonzalez, C. A.",
    journal = "International Journal  of Cancer",
    year = "2015",
    volume = "137",
    number = "3",
    pages = "598-606",
    publisher = "Wiley",
    issn = "0020-7136",
    doi = "10.1002/ijc.29411",
    keywords = "healthy lifestyle score; gastric cancer; cohort; EPIC",
    abstract = "Several modifiable lifestyle factors, including smoking, alcohol,
certain dietary factors and weight are independently associated with
gastric cancer (GC); however, their combined impact on GC risk is
unknown. We constructed a healthy lifestyle index to investigate the
joint influence of these behaviors on GC risk within the European
Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The
analysis included 461,550 participants (662 first incident GC cases)
with a mean follow-up of 11.4 years. A healthy lifestyle index was
constructed, assigning 1 point for each healthy behavior related to
smoking status, alcohol consumption and diet quality (represented by the
Mediterranean diet) for assessing overall GC and also body mass index
for cardia GC and 0 points otherwise. Risk of GC was calculated using
Cox proportional hazards regression models while adjusting for relevant
confounders. The highest versus lowest score in the healthy lifestyle
index was associated with a significant lower risk of GC, by 51%
overall (HR 0.49 95% CI 0.35, 0.70), by 77% for cardia GC (HR 0.23
95% CI 0.08, 0.68) and by 47% for noncardia GC (HR 0.53 (95% CI 0.32,
0.87), p-trends<0.001. Population attributable risk calculations showed
that 18.8% of all GC and 62.4% of cardia GC cases could have been
prevented if participants in this population had followed the healthy
lifestyle behaviors of this index. Adopting several healthy lifestyle
behaviors including not smoking, limiting alcohol consumption, eating a
healthy diet and maintaining a normal weight is associated with a large
decreased risk of GC.
What’s new? Several modifiable lifestyle factors, including smoking
status, alcohol consumption, diet quality and weight, have been
independently associated with gastric cancer. Behavioral patterns often
cluster, however, lifestyle scores can be used to analyse overlapping
risk factors. In this study, the authors used a healthy-lifestyle index
to evaluate the combined effects of all of the above factors on the risk
of developing gastric cancer (GC). They found that following a healthy
lifestyle dramatically decreases the burden of gastric cancer."
}