Table 3

Effect of Combined Low-Risk Behaviors in Relation to Risk of Myocardial Infarction

GroupLow-Risk Group No. of Events (% Men)Age-Standardized Incidence Rate
(95% CI)
Compared With High-Risk Group
RR (95% CI)
Compared With the Remainder of the Study Population
RR (95% CI)
Population Attributable Risk§
% (95% CI)
1 low-risk factor: healthy diet (RFS top quintile)177 (18)495 (417–572)0.74 (0.58–0.96)0.82 (069–0.96)16 (4–35)
2 low-risk factors: healthy diet (RFS top quintile), alcohol consumption 10–30 g/day74 (8.7)429 (321–537)0.65 (0.48–0. 87)0.75 (0.59–0.95)23 (4–39)
3 low-risk factors: healthy diet (RFS top quintile), alcohol consumption 10–30 g/day, no smoking36 (5.4)321 (208–433)0.36 (0.25–0.53)0.54 (0.39–0.76)44 (23–49)
4 low-risk factors#: healthy diet (RFS top quintile), alcohol consumption 10–30 g/day, no smoking, physically active (≥40 min/day of walking/bicycling and ≥1 h/week of exercise)9 (1.7)218 (73–363)0.24 (0.12–0.47)0.36 (0.19–0.69)64 (30–81)
5 low-risk factors: healthy diet (RFS top quintile), alcohol consumption 10–30 g/day, no smoking, physically active (≥40 min/day of walking/bicycling and ≥1 h/week of exercise), waist circumference <95 cm3 (1.0)131 (0–279)0.14 (0.04–0.43)0.21 (0.07–0.66)79 (34–93)

RFS = Recommended Food Score; other abbreviations as in Table 2.

  • All relative risks were adjusted for age (continuous), educational achievement (≤9, 10 to 12, >12 years), family history of myocardial infarction (yes/no), use of aspirin (yes/no), marital status (unmarried, married, divorced, widowed), non-Recommended Food Score (quintiles), and total energy intake (continuous).

  • Per 100,000 person-years.

  • The high-risk group (8.3% of the study population and 166 cases of myocardial infarction [age-standardized incidence rate 979 cases per 100,000 person-years]) included men with no low-risk factors and was characterized by the following: median 2.9 servings/day of vegetables and fruit, 3.0 servings/day of whole grains, and 1.4 servings/week of fish; 24 pack-years of tobacco smoking (55% reported to be current smokers); 36% reported neither ≥40 min of daily walking/bicycling nor ≥1 h per week of exercise; and a median waist circumference 101 cm.

  • § Estimated compared with the remainder of the total study population, representing 91.3%, 94.6%, 98.3%, and 99%, respectively, for each additional low-risk factor.

  • The model was also adjusted for smoking, physical activity, and waist circumference.

  • The model was also adjusted for physical activity and waist circumference.

  • # The model was also adjusted for waist circumference.