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Combined Impact of Lifestyle Factors on Prospective Change in Body Weight and Waist Circumference in Participants of the EPIC-PANACEA Study

  • Anne M. May
  • Dora Romaguera
  • Noemie Travier
  • Ulf Ekelund
  • Manuela M. Bergmann
  • Rudolf Kaaks
  • Birgit Teucher
  • Annika Steffen
  • Heiner Boeing
  • Jytte Halkjaer
  • Anne Tjonneland
  • Marianne Uhre Jakobsen
  • Kim Overvad
  • Laureen Dartois
  • Guy Fagherazzi
  • Marie-Christine Boutron-Ruault
  • J. Ramon Quiros
  • Antonio Agudo
  • Carlos Gonzalez
  • Maria-Jose Sanchez
  • Pilar Amiano
  • Jose-Maria Huerta
  • Eva Ardanaz
  • Nicholas J. Wareham
  • Francesca L. Crowe
  • Androniki Naska
  • Philippos Orfanos
  • Antonia Trichopoulou
  • Domenico Palli
  • Claudia Agnoli
  • Rosario Tumino
  • Paolo Vineis
  • Salvatore Panico
  • H. Bas Bueno-de-Mesquita
  • Monique Verschuren
  • Isabel Drake
  • Emily Sonestedt
  • Tonje Braaten
  • Sabina Rinaldi
  • Isabelle Romieu
  • Nadia Slimani
  • Teresa Norat
  • Elio Riboli
  • Petra H. M. Peeters
Publishing year: 2012
Language: English
Publication/Series: PLoS ONE
Volume: 7
Issue: 11
Document type: Journal article
Publisher: Public Library of Science

Abstract english

Background: The evidence that individual dietary and lifestyle factors influence a person's weight and waist circumference is well established; however their combined impact is less well documented. Therefore, we investigated the combined effect of physical activity, nutrition and smoking status on prospective gain in body weight and waist circumference. Methods: We used data of the prospective EPIC-PANACEA study. Between 1992 and 2000, 325,537 participants (94,445 men and 231,092 women, aged between 25-70) were recruited from nine European countries. Participants were categorised into two groups (positive or negative health behaviours) for each of the following being physically active, adherent to a healthy (Mediterranean not including alcohol) diet, and never-smoking for a total score ranging from zero to three. Anthropometric measures were taken at baseline and were mainly self-reported after a medium follow-up time of 5 years. Results: Mixed-effects linear regression models adjusted for age, educational level, alcohol consumption, baseline body mass index and follow-up time showed that men and women who reported to be physically active, never-smoking and adherent to the Mediterranean diet gained over a 5-year period 537 (95% CI -706, -368) and 200 (-478, -87) gram less weight and 0.95 (-1.27, -0.639) and 0.99 (-1.29, -0.69) cm less waist circumference, respectively, compared to participants with zero healthy behaviours. Conclusion: The combination of positive health behaviours was associated with significantly lower weight and waist circumference gain.


  • Nutrition and Dietetics


  • Nutrition Epidemiology
  • ISSN: 1932-6203
Emily Sonestedt
E-mail: emily [dot] sonestedt [at] med [dot] lu [dot] se

Associate senior lecturer

Nutrition Epidemiology

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