title: The association between adult attained height and sitting height with mortality in the European Prospective Investigation into Cancer and Nutrition (EPIC).
abstract: Adult height and sitting height may reflect genetic and environmental factors, including early life nutrition, physical and social environments. Previous studies have reported divergent associations for height and chronic disease mortality, with positive associations observed for cancer mortality but inverse associations for circulatory disease mortality. Sitting height might be more strongly associated with insulin resistance; however, data on sitting height and mortality is sparse. Using the European Prospective Investigation into Cancer and Nutrition study, a prospective cohort of 409,748 individuals, we examined adult height and sitting height in relation to all-cause and cause-specific mortality. Height was measured in the majority of participants; sitting height was measured in ~253,000 participants. During an average of 12.5 years of follow-up, 29,810 deaths (11,931 from cancer and 7,346 from circulatory disease) were identified. Hazard ratios (HR) with 95% confidence intervals (CI) for death were calculated using multivariable Cox regression within quintiles of height. Height was positively associated with cancer mortality (men: HRQ5 vs. Q1 = 1.11, 95%CI = 1.00-1.24; women: HRQ5 vs. Q1 = 1.17, 95%CI = 1.07-1.28). In contrast, height was inversely associated with circulatory disease mortality (men: HRQ5 vs. Q1 = 0.63, 95%CI = 0.56-0.71; women: HRQ5 vs. Q1 = 0.81, 95%CI = 0.70-0.93). Although sitting height was not associated with cancer mortality, it was inversely associated with circulatory disease (men: HRQ5 vs. Q1 = 0.64, 95%CI = 0.55-0.75; women: HRQ5 vs. Q1 = 0.60, 95%CI = 0.49-0.74) and respiratory disease mortality (men: HRQ5 vs. Q1 = 0.45, 95%CI = 0.28-0.71; women: HRQ5 vs. Q1 = 0.60, 95%CI = 0.40-0.89). We observed opposing effects of height on cancer and circulatory disease mortality. Sitting height was inversely associated with circulatory disease and respiratory disease mortality.
authors.affiliation: School of Public Health, Imperial College London, London, United Kingdom.|Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.
authors.forename: Norie
authors.identifier: http://orcid.org/0000-0002-9936-1476
authors.initials: N
authors.lastname: Sawada
authors.affiliation: School of Public Health, Imperial College London, London, United Kingdom.
authors.forename: Petra A
authors.initials: PA
authors.lastname: Wark
authors.affiliation: School of Public Health, Imperial College London, London, United Kingdom.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Merritt
authors.affiliation: Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.
authors.forename: Shoichiro
authors.initials: S
authors.lastname: Tsugane
authors.affiliation: School of Public Health, Imperial College London, London, United Kingdom.
authors.forename: Heather A
authors.initials: HA
authors.lastname: Ward
authors.affiliation: International Agency for Research on Cancer, Lyon, France.
authors.forename: Sabina
authors.initials: S
authors.lastname: Rinaldi
authors.affiliation: Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway.|Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway.|Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.|Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland.
authors.forename: Elisabete
authors.initials: E
authors.lastname: Weiderpass
authors.affiliation: Health Across Generations Team, CESP, Université Paris-Sud, UVSQ, INSERM, Université Paris-Saclay, Villejuif, France.
authors.forename: Laureen
authors.initials: L
authors.lastname: Dartois
authors.affiliation: Health Across Generations Team, CESP, Université Paris-Sud, UVSQ, INSERM, Université Paris-Saclay, Villejuif, France.
authors.forename: Mathilde
authors.initials: M
authors.lastname: His
authors.affiliation: Health Across Generations Team, CESP, Université Paris-Sud, UVSQ, INSERM, Université Paris-Saclay, Villejuif, France.
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Boutron-Ruault
authors.affiliation: Division of Cancer Epidemiology; German Cancer Research Center (DKFZ), Heidelberg, Germany.
authors.forename: Renée
authors.initials: R
authors.lastname: Turzanski-Fortner
authors.affiliation: Division of Cancer Epidemiology; German Cancer Research Center (DKFZ), Heidelberg, Germany.
authors.forename: Rudolf
authors.initials: R
authors.lastname: Kaaks
authors.affiliation: Aarhus University, Department of Public Health, Section for Epidemiology, Aarhus, Denmark.|Aalborg University Hospital, Department of Cardiology, Aalborg Hospital Science and Innovation Center, Aalborg, Denmark.
authors.forename: Kim
authors.initials: K
authors.lastname: Overvad
authors.affiliation: Public Health Directorate, Asturias, Spain.
authors.forename: María-Luisa
authors.initials: ML
authors.lastname: Redondo
authors.affiliation: Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain.
authors.forename: Noemie
authors.initials: N
authors.lastname: Travier
authors.affiliation: Escuela Andaluza de Salud Pública. Instituto de Investigación Biosanitaria ibs. Granada, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain.|CIBER de Epidemiología y Salud Pública, Madrid, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Molina-Portillo
authors.affiliation: Public Health Direction and Biodonostia-Ciberesp, Basque Regional Health Department, San Sebastian, Spain.
authors.forename: Miren
authors.initials: M
authors.lastname: Dorronsoro
authors.affiliation: Unidad de Registro y Estadística de Mortalidad, Unit of Mortality Coding and Statistics, Servicio de Epidemiología, Consejería de Sanidad, Department of Epidemiology, Murcia's Regional Health Council, Murcia, Spain.
authors.forename: Lluis
authors.initials: L
authors.lastname: Cirera
authors.affiliation: CIBER de Epidemiología y Salud Pública, Madrid, Spain.|Navara Public Health Institute, Pamplona, Spain.|IdiSNA, Navara Institute for Health Research, Pamplona, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Ardanaz
authors.affiliation: Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
authors.forename: Aurora
authors.initials: A
authors.lastname: Perez-Cornago
authors.affiliation: Hellenic Health Foundation, Athens, Greece.|WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece.
authors.forename: Antonia
authors.initials: A
authors.lastname: Trichopoulou
authors.affiliation: Hellenic Health Foundation, Athens, Greece.|WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece.|Department of Epidemiology, Harvard School of Public Health, Boston, United States of America.
authors.forename: Pagona
authors.initials: P
authors.lastname: Lagiou
authors.affiliation: Hellenic Health Foundation, Athens, Greece.
authors.forename: Elissavet
authors.initials: E
authors.lastname: Valanou
authors.affiliation: Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute-ISPO, Florence, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Masala
authors.affiliation: Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Pala
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Petra
authors.initials: P
authors.lastname: Hm Peeters
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: T van der Schouw
authors.affiliation: Department of Clinical Sciences, Lund University, Malmö, Sweden.
authors.forename: Olle
authors.initials: O
authors.lastname: Melander
authors.affiliation: Department of Surgery, Skane University Hospital Malmo Lund University, Malmö, Sweden.
authors.forename: Jonas
authors.initials: J
authors.lastname: Manjer
authors.affiliation: Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway.
authors.forename: Marisa
authors.initials: M
authors.lastname: da Silva
authors.affiliation: Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway.
authors.forename: Guri
authors.initials: G
authors.lastname: Skeie
authors.affiliation: Danish Cancer Society Research Center, Copenhagen, Denmark.
authors.forename: Anne
authors.initials: A
authors.lastname: Tjønneland
authors.affiliation: Danish Cancer Society Research Center, Copenhagen, Denmark.
authors.forename: Anja
authors.initials: A
authors.lastname: Olsen
authors.affiliation: International Agency for Research on Cancer, Lyon, France.
authors.forename: Marc
authors.initials: M
authors.lastname: J Gunter
authors.affiliation: School of Public Health, Imperial College London, London, United Kingdom.
authors.forename: Elio
authors.initials: E
authors.lastname: Riboli
authors.affiliation: School of Public Health, Imperial College London, London, United Kingdom.
authors.forename: Amanda
authors.initials: A
authors.lastname: J Cross
mesh_terms: D000328:Adult; D000368:Aged; D001827:Body Height; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality / Q000473:pathology; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality / Q000473:pathology; D011379:Prognosis; D011446:Prospective Studies; D012140:Respiratory Tract Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality / Q000473:pathology; D016019:Survival Analysis