title: Healthy lifestyles reduce the incidence of chronic diseases and dementia: evidence from the Caerphilly cohort study.
abstract: BACKGROUND
  Healthy lifestyles based on non-smoking, an acceptable BMI, a high fruit and vegetable intake, regular physical activity, and low/moderate alcohol intake, are associated with reductions in the incidence of certain chronic diseases, but to date there is limited evidence on cognitive function and dementia.
  
  
  METHODS
  In 1979 healthy behaviours were recorded on 2,235 men aged 45-59 years in Caerphilly, UK. During the following 30 years incident diabetes, vascular disease, cancer and death were recorded, and in 2004 cognitive state was determined.
  
  
  RESULTS
  Men who followed four or five of the behaviours had an odds ratio (OR) and confidence intervals (CI) for diabetes, corrected for age and social class, of 0.50 (95% CI: 0.19, 1.31; P for trend with increasing numbers of healthy behaviours <0.0005). For vascular disease the OR was 0.50 (95% CI: 0.30, 0.84; P for trend <0.0005), and there was a delay in vascular disease events of up to 12 years. Cancer incidence was not significantly related to lifestyle although there was a reduction associated with non-smoking (OR: 0.65; 95% CI: 0.54, 0.79). All-cause mortality was reduced in men following four or five behaviours (OR 0.40; 95% CI: 0.24, 0.67; P for trend <0.005). After further adjustment for NART, the OR for men following four or five healthy behaviours was 0.36 (95% CI: 0.12, 1.09; P for trend <0.001) for cognitive impairment, and 0.36 (95% CI: 0.07, 1.99; P for trend <0.02) for dementia. The adoption of a healthy lifestyle by men was low and appears not to have changed during the subsequent 30 years, with under 1% of men following all five of the behaviours and 5% reporting four or more in 1979 and in 2009.
  
  
  CONCLUSIONS
  A healthy lifestyle is associated with increased disease-free survival and reduced cognitive impairment but the uptake remains low.
authors.affiliation: Cochrane Institute of Primary Care and Public Health, Cardiff University, Cardiff, United Kingdom.
authors.forename: Peter
authors.initials: P
authors.lastname: Elwood
authors.affiliation: Cochrane Institute of Primary Care and Public Health, Cardiff University, Cardiff, United Kingdom.
authors.forename: Julieta
authors.initials: J
authors.lastname: Galante
authors.affiliation: Cochrane Institute of Primary Care and Public Health, Cardiff University, Cardiff, United Kingdom.
authors.forename: Janet
authors.initials: J
authors.lastname: Pickering
authors.affiliation: Cochrane Institute of Primary Care and Public Health, Cardiff University, Cardiff, United Kingdom.
authors.forename: Stephen
authors.initials: S
authors.lastname: Palmer
authors.affiliation: Cochrane Institute of Primary Care and Public Health, Cardiff University, Cardiff, United Kingdom.
authors.forename: Antony
authors.initials: A
authors.lastname: Bayer
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
authors.forename: Yoav
authors.initials: Y
authors.lastname: Ben-Shlomo
authors.affiliation: Welsh Institute for Health and Social Care, University of South Wales, Pontypridd, United Kingdom.
authors.forename: Marcus
authors.initials: M
authors.lastname: Longley
authors.affiliation: Cochrane Institute of Primary Care and Public Health, Cardiff University, Cardiff, United Kingdom.
authors.forename: John
authors.initials: J
authors.lastname: Gallacher
mesh_terms: D000428:Alcohol Drinking / Q000009:adverse effects; D000544:Alzheimer Disease / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D015992:Body Mass Index; D003071:Cognition / Q000502:physiology; D003704:Dementia / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D018572:Disease-Free Survival; D015444:Exercise; D005638:Fruit; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D006113:United Kingdom / Q000453:epidemiology; D014675:Vegetables