The association between healthy lifestyle and multimorbidity of non-communicable chronic diseases trajectory: evidence from a perspective study in UK biobank

Although a few studies have found that healthy lifestyle is linked to a range of non-communicable chronic diseases (NCDs), its association with the onset, progression, and prognosis of multimorbidity of NCDs (MNCDs) has never been studied. A total of 332 444 adults aged 39-73 years who were free of heart disease, stroke, diabetes, and cancer at baseline were selected. Then we used multi-state model to analyze the associations between healthy lifestyle and transition trajectory were analyzed with results expressed as hazard ratio (HR) and 95% confidence interval. A total of 62 994 participants developed first NCDs (FNCDs). After adjustment for potential confounders, healthy lifestyle was negatively associated with the transition trajectory from baseline to FNCD (HR = 0.38), from FNCDs to MNCDs (HR = 0.30), etc. Further, the transition trajectory from FNCDs to MNCDs became more pronounced among the offspring who aged ˂60 (HRFNCDs → MNCDs = 0.29), who never took medicine(HRFNCDs → MNCDs = 0.25). Besides, possessing all five healthy lifestyle factors could extend the life expectancy of MNCD participants. This study suggests that healthy lifestyle is associated with almost all transition phases of MNCDs development and decreases the mortality risk of MNCDs.