Document details for 'Integrating sleep, physical activity, and diet quality to estimate all-cause mortality risk: a combined compositional clustering and survival analysis of the NHANES 2005-2006 cycle'

Authors Del Pozo Cruz, B., McGregor, D.E., Del Pozo-Cruz, J., Buman, M., Palarea Albaladejo, J., Alfonso-Rosa, R.M. and Chastin, S.F.M.
Publication details American Journal of Epidemiology, kwaa057. Oxford Academic.
Publisher details Oxford Academic
Keywords 24-hour lifestyle behaviors, early death, cluster analysis, compositional data analysis
Abstract We aimed to compare all-cause mortality risk across clusters of adults 50+ (n = 1,035) with common lifestyle behaviors patterns. Log-ratio coordinates of 24h movement pattern and z-scores of diet quality were used as input into a model-based clustering analysis. A Cox regression model was fitted to ascertain the all-cause mortality risk associated with each cluster. Participants were clustered into 4 groups: (1) a group characterized by a better physical activity profile and longer sleep duration coupled with an average diet quality (Cluster 1); (2) a group with the poorest activity profile and shortest sleep but also the best diet quality (Cluster 2); (3) another group featuring lower levels of activity of either intensity and higher levels of sedentary behavior and also a poor diet quality score (Cluster 3); and lastly (4) a group with an average diet quality and the best activity profile in the sample (Cluster 4). The Cox regression model fitted suggested that a combination of a poorer diet and activity profile increased the prospective risk of all-cause mortality. Our estimations reaffirm the importance of considering diet quality and the 24h movement pattern when developing interventions to improve health and, ultimately, risk of premature mortality.
Last updated 2020-06-10

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