Lifestyles and their relative contribution to biological aging across multiple organ systems: change analysis from the China Multi-Ethnic Cohort Study

Abstract

Biological aging exhibits heterogeneity across multi organ systems. However, it remains unclear how is lifestyle associated with overall and organ-specific aging and which factors contribute most in Southwest China.To examine the associations of healthy lifestyle with comprehensive and organ-specific biological ages and which factors contribute most.This study involved 8,396 participants who completed two surveys from the China Multi-Ethnic Cohort (CMEC) Study. The healthy lifestyle index (HLI) was developed using five lifestyle factors: smoking, alcohol, diet, exercise, and sleep. The comprehensive and organ-specific biological ages (BAs) were calculated using the Klemera-Doubal method based on longitudinal clinical laboratory measurements, and validation were conducted to select BA reflecting related diseases. Fixed effects model was used to examine associations between HLI or its components and the acceleration of validated BAs. We further evaluated the relative contribution of lifestyle components to comprehension and organ systems BAs using quantile G-computation.About two-thirds of participants changed HLI scores between surveys. After validation, three organ-specific BAs (the cardiopulmonary, metabolic, and liver BAs) were identified as reflective of specific diseases and included in further analyses with the comprehensive BA. The health alterations in healthy lifestyle index showed a protective association with the acceleration of all biological ages, with a mean shift of -0.19 (95%CI: -0.34, -0.03) in the comprehensive biological age acceleration. Diet and smoking were the major contributors to overall negative associations of five lifestyle factors with the comprehensive BA and metabolic BA accounting for 24% and 55% respectively.Healthy lifestyle changes were inversely related to comprehensive and organ-specific biological aging in Southwest China, with diet and smoking contributing most to comprehensive and metabolic BA separately. Our findings highlight the potential of lifestyle interventions to decelerate aging and identify intervention targets to limit organ-specific aging in less-developed regions.