title: Effects of combined healthy lifestyle factors on functional vascular aging: the Rotterdam Study.
abstract: OBJECTIVE
  To evaluate whether components of a healthy lifestyle, combined and individually, are associated with arterial stiffness as a marker of functional vascular aging.
  
  
  METHODS
  We included 3235 participants aged 61-96 years from the Rotterdam Study. Measures of arterial stiffness included: aortic pulse wave velocity and carotid distensibility coefficient. Participants were scored one point for each of healthy lifestyle factors: consumption of five or more of fruits and/or vegetables per day, 75 min or more vigorous physical activity per week, 18.5 ≤ BMI ≤ 24. 9, never smoked and light-to-moderate alcohol intake (maximum seven glasses for women and 14 glasses for men) per week. Also a combined score (0-5) was computed by adding the five factors. Linear regression analysis was used to evaluate the association of healthy lifestyle and measures of arterial stiffness adjusting for confounders.
  
  
  RESULTS
  Participants had -0.113 [95% confidence interval (CI): -0.196, -0.029] difference in mean aortic pulse wave velocity m/s per unit increment of the lifestyle factors score, independent of cardiovascular risk factors. Higher fruit and vegetable consumption -0.221 (95% CI: -0.409, -0.034) and physical activity -0.239 (95% CI: -0.433, -0.044) were also significantly associated with reduced aortic pulse wave velocity. The corresponding estimates in carotid distensibility coefficient lacked statistical significance when we adjusted for cardiovascular risk factors.
  
  
  CONCLUSIONS
  Combining multiple healthy lifestyle factors is associated with reduced aortic stiffness, a measure of functional vascular aging and independent of cardiovascular risk factors.
authors.affiliation: aDepartment of Epidemiology bDepartment of Internal Medicine, Section of Geriatric Medicine cDepartment of Biostatistics, Erasmus MC, Rotterdam, the Netherlands.
authors.forename: Leila
authors.initials: L
authors.lastname: Karimi
authors.forename: Francesco U S
authors.initials: FU
authors.lastname: Mattace-Raso
authors.forename: Joost
authors.initials: J
authors.lastname: van Rosmalen
authors.forename: Frank
authors.initials: F
authors.lastname: van Rooij
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.forename: Oscar H
authors.initials: OH
authors.lastname: Franco
mesh_terms: D000368:Aged; D000375:Aging; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000503:physiopathology / Q000517:prevention & control; D002339:Carotid Arteries / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D063177:Pulse Wave Analysis; D012044:Regression Analysis; D012307:Risk Factors; D059289:Vascular Stiffness