Article Figures & Tables
Figures
- Figure 1:
Hazard ratios (HRs) for incident cancer per 1 increment in ideal cardiovascular health metric. Hazard ratios and 95% confidence intervals (CIs) were estimated by Cox proportional hazards models stratified by year of birth (5-yr intervals) and using age as the timescale. Hazard ratios were adjusted for sex, marital/cohabitation status, education and occupation at baseline. In NutriNet-Santé, results were additionally adjusted for alcohol use and family history of cancer. In Whitehall II, results were additionally adjusted for alcohol use and race/ethnicity. The overall HR and CI was estimated using random-effects meta-analysis.
- Figure 2:
Hazard ratios (HRs) per 1 increment in ideal cardiovascular health metric for site-specific cancer — A) lung cancer, B) breast cancer, C) prostate cancer, D) colon cancer. Hazard ratios and 95% confidence intervals (CIs) were estimated by Cox proportional hazards models stratified by year of birth (5-yr intervals) and using age as the timescale. Hazards ratios were adjusted for sex, marital/cohabitation status, education and occupation at baseline. In NutriNet-Santé, results were additionally adjusted for alcohol use and family history of cancer. In Whitehall II, results were additionally adjusted for alcohol use and race/ethnicity. The overall HR and CI was estimated using random-effects meta-analysis.
- Figure 3:
Hazard ratios (HRs) for incident cancer per 1 increment in ideal cardiovascular health metric excluding the smoking metric and adjusted for smoking status. Hazard ratios and 95% confidence intervals (CIs) were estimated by Cox proportional hazards models stratified by year of birth (5-yr intervals) and using age as the timescale. Hazards ratios were adjusted for sex, marital/cohabitation status, education, occupation at baseline and smoking metric. In NutriNet-Santé, results were additionally adjusted for alcohol use and family history of cancer. In Whitehall II, results were additionally adjusted for alcohol use and race/ethnicity. The overall HR and CI was estimated using random-effects meta-analysis.
Tables
- Table 1:
Definition of ideal cardiovascular health metrics in NutriNet-Santé, Whitehall II and GAZEL
Metric Recommended ideal level Smoking All cohorts: Never or quit ≥ 12 mo Body mass index All cohorts: < 25 Physical activity NutriNet-Santé and Whitehall II: ≥ 75 min/wk of vigorous activity, ≥ 150 min/wk of moderate activity or a combination of the two
GAZEL: any sports activity in a competition contextHealthy diet NutriNet-Santé: ≥ 4 optimal diet items out of the following 5 items: the equivalent of 5 servings per day of fruits and vegetables or 400 g/d, ≥ 2 times/wk fish consumption or average consumption of ≥ 100 g/d, average salt consumption < 1.5 g/d, average fibre intake ≥ 25 g/d, sugar-sweetened beverages ≤ 155 g/d
Whitehall II: 3 optimal out of the following 3 items: 2 servings of a fruit and vegetable portion per day and fish consumption ≥ 3 times/wk
GAZEL: 3 optimal out of the following 3 items: fruit portion every day or almost every day, vegetables portion every day or almost every day, and fish consumption ≥ 3 times/wkBlood pressure NutriNet-Santé and Whitehall II: < 120/80 mm Hg, untreated GAZEL: No diagnosis of hypertension and untreated Fasting plasma glucose* NutriNet-Santé and Whitehall II: < 100 mg/dL, untreated GAZEL: No diagnosis of diabetes and untreated Total cholesterol† NutriNet-Santé and Whitehall II: < 200 mg/dL, untreated GAZEL: No diagnosis of dyslipidemia and untreated - Table 2:
Baseline characteristics and incidence rates of cancer in the individual cohort studies
Characteristic No. (%)* NutriNet-Santé Study
n = 16 237Whitehall II Study
n = 9418GAZEL Cohort Study
n = 14 063Age, yr, mean ± SD 51.3 ± 13.5 44.8 ± 6.0 45.2 ± 3.5 Men 4488 (27.6) 6413 (68.1) 10 550 (75.0) Education level* High 5778 (35.6) 2486 (26.4) 3599 (25.6) Intermediate 7853 (48.4) 2535 (26.9) 9709 (69.0) Low 2606 (16.0) 4397 (46.7) 755 (5.4) Occupational position† High 7329 (45.1) 2828 (30.0) 3628 (25.8) Intermediate 3880 (23.9) 4595 (48.8) 9487 (67.5) Low 5028 (31.0) 1995 (21.2) 948 (6.7) Marital/cohabitation status Married/cohabiting 11 664 (71.8) 7006 (74.4) 12 623 (89.8) Single 2312 (14.2) 1538 (16.3) 483 (3.4) Divorced 1760 (10.8) 761 (8.1) 804 (5.7) Widowed 501 (3.1) 113 (1.2) 153 (1.1) Race/ethnicity: White NA 8522 (90.5) NA Family history of cancer 7285 (44.9) NA NA Alcohol, units/wk 0 NA 1679 (17.8) 1561 (16.6)§ 1–13 NA 5202 (55.2) 4942 (52.4)§ ≥ 14 NA 2537 (26.9) 2927 (31.0)§ Alcohol, g/d 8.82 (11.6) NA NA No. of ideal cardiovascular health metrics, median (IQR) 3 (2–4) 4 (3–4) 5 (4–6) Cardiovascular health score categories‡ Low, 0–2 ideal metrics 4389 (27.0) 1657 (17.6) 762 (5.4) Moderate, 3–4 ideal metrics 8491 (52.3) 5772 (61.3) 7921 (56.3) High, 5–7 ideal metrics 2760 (17.0) 1989 (21.1) 5380 (38.3) No. of incident cancer 948 (5.8) 1916 (20.3) 2025 (14.4) Incidence rate of cancer per 1000 person years, 95% CI 6.3 (5.9–6.7) 7.5 (7.2–7.8) 6.8 (6.5–7.1) Note: CI = confidence interval, IQR = interquartile range, NA = not available, SD = standard deviation.
* Unless stated otherwise.
↵* Education categories in NutriNet-Santé were 1) less than high school (low), 2) less than 2 years after high school (intermediate) and 3) more than or equal to 2 years after high school (high); in Whitehall, 1) lower secondary school (low), 2) higher secondary school (intermediate) and 3) university or higher university degree (high); and in GAZEL, 1) primary school (low), 2) lower secondary school (intermediate) and 3) university or higher university degree (high).
↵† Occupation categories in NutriNet-Santé were 1) employee/worker/farmer (low), 2) intermediary profession (intermediate) and 3) craftsperson, merchant, company director, specialized personnel, intellectual profession (high); in Whitehall II, 1) administrative (low), 2) professional/executive (intermediate) and 3) clerical/support (high); and in GAZEL, 1) watchman, worker (low), 2) commercial and technical agent, internship agent and others (intermediate) and 3) administrative and technical executives, teachers (high).
↵‡ The cardiovascular health metrics included nonsmoking, and ideal levels of body weight, physical activity, diet, blood pressure, fasting blood glucose and total cholesterol. For definitions of the metrics, see Table 1.
↵§ Data on alcohol use available in GAZEL cohort in n = 9430.
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