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Table 3 Population attributable fractions of deaths prior to age 70 given the distribution of covariates in the EPIC cohort, using waist-to-hip ratio to assess for obesity

From: Modifiable causes of premature death in middle-age in Western Europe: results from the EPIC cohort study

   All participants Never smokers Current smokers
  Covariatea Overallb Cumulativec Overallb Cumulativec Overallb Cumulativec
Women and Men Smoking 0.31 (0.31–0.32) 0.31 (0.31–0.32) 0.56 (0.55–0.56) 0.56 (0.55–0.56)
  Diet 0.14 (0.12–0.16) 0.41 (0.39–0.43) 0.12 (0.10–0.14) 0.12 (0.10–0.14) 0.16 (0.13–0.18) 0.63 (0.62–0.64)
  Overweight and obesity (WHR) 0.10 (0.08–0.12) 0.47 (0.45–0.49) 0.10 (0.08–0.11) 0.21 (0.18–0.23) 0.10 (0.08–0.12) 0.67 (0.66–0.68)
  High blood pressure 0.09 (0.07–0.11) 0.52 (0.50–0.54) 0.09 (0.08–0.11) 0.28 (0.25–0.31) 0.08 (0.07–0.10) 0.70 (0.69–0.71)
  Physical inactivity 0.07 (0.05–0.09) 0.56 (0.54–0.57) 0.08 (0.06–0.10) 0.34 (0.31–0.36) 0.07 (0.05–0.09) 0.72 (0.71–0.74)
  Alcohol intake 0.04 (0.03–0.04) 0.57 (0.55–0.59) 0.02 (0.01–0.02) 0.35 (0.32–0.37) 0.05 (0.04–0.06) 0.74 (0.73–0.75)
  Combined 0.57 (0.55–0.59)   0.35 (0.32–0.37)   0.74 (0.73–0.75)  
Women Smoking 0.26 (0.25–0.26) 0.26 (0.25–0.26) 0.55 (0.54–0.55) 0.55 (0.54–0.55)
  Diet 0.14 (0.11–0.16) 0.36 (0.33–0.38) 0.12 (0.09–0.15) 0.12 (0.09–0.15) 0.16 (0.13–0.19) 0.62 (0.60–0.63)
  Overweight and obesity (WHR) 0.07 (0.05–0.09) 0.40 (0.38–0.43) 0.07 (0.05–0.09) 0.18 (0.15–0.22) 0.07 (0.05–0.10) 0.65 (0.63–0.66)
  High blood pressure 0.10 (0.07–0.12) 0.46 (0.43–0.48) 0.11 (0.08–0.13) 0.27 (0.23–0.30) 0.09 (0.07–0.11) 0.68 (0.66–0.70)
  Physical inactivity 0.06 (0.03–0.09) 0.49 (0.46–0.52) 0.07 (0.03–0.10) 0.32 (0.28–0.35) 0.06 (0.03–0.09) 0.70 (0.68–0.72)
  Alcohol intake 0.02 (0.01–0.03) 0.50 (0.47–0.53) 0.01 (0.01–0.02) 0.32 (0.28–0.36) 0.03 (0.02–0.04) 0.71 (0.69–0.72)
  Combined 0.50 (0.47–0.53)   0.32 (0.28–0.36)   0.71 (0.69–0.72)  
Men Smoking 0.37 (0.35–0.38) 0.37 (0.35–0.38) 0.57 (0.56–0.57) 0.57 (0.56–0.57)
  Diet 0.13 (0.09–0.17) 0.45 (0.43–0.48) 0.13 (0.09–0.17) 0.13 (0.09–0.17) 0.14 (0.10–0.18) 0.63 (0.61–0.65)
  Overweight and obesity (WHR) 0.13 (0.11–0.16) 0.53 (0.50–0.55) 0.12 (0.09–0.14) 0.23 (0.19–0.27) 0.13 (0.11–0.16) 0.69 (0.67–0.70)
  High blood pressure 0.08 (0.05–0.12) 0.57 (0.54–0.60) 0.08 (0.05–0.12) 0.29 (0.25–0.34) 0.07 (0.04–0.11) 0.71 (0.69–0.73)
  Physical inactivity 0.07 (0.05–0.10) 0.60 (0.57–0.63) 0.07 (0.05–0.10) 0.35 (0.30–0.39) 0.07 (0.05–0.10) 0.74 (0.72–0.75)
  Alcohol intake 0.06 (0.05–0.07) 0.63 (0.60–0.65) 0.04 (0.02–0.05) 0.37 (0.32–0.41) 0.07 (0.06–0.09) 0.76 (0.74–0.77)
  Combined 0.63 (0.60–0.65)   0.37 (0.32–0.41)   0.76 (0.74–0.77)  
  1. aAttributable fractions were calculated based on the difference in expected cumulative risk given the observed covariate distributions in EPIC and the expected cumulative risk under the following scenarios. Smoking: A population of never smokers. Diet: A population of people in the healthy category. Blood pressure: A population of people with normal blood pressure. High alcohol intake: A population who drink at most 1–2 drinks per day. Physical activity: A population of people in the active category. Overweight and obesity: A population of people with WHR below the lowest sex-specific quintile. These attributable risks thus represent a “best-case”, in that they are calculated based on a hypothetical reference population with risk factors removed entirely
  2. bEstimated using predictions from a model mutually adjusted for all listed covariates as well as age at baseline. Attributable fractions are based on modifying one covariate at a time, with the distribution of the remaining covariates left as observed in EPIC
  3. cThe cumulative attributable fraction after the sequential addition of each covariate