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

Overview of attention for article published in BMC Medicine, June 2016
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  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (96th percentile)

Mentioned by

7 news outlets
24 tweeters
6 Facebook pages


35 Dimensions

Readers on

121 Mendeley
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Modifiable causes of premature death in middle-age in Western Europe: results from the EPIC cohort study
Published in
BMC Medicine, June 2016
DOI 10.1186/s12916-016-0630-6
Pubmed ID

David C. Muller, Neil Murphy, Mattias Johansson, Pietro Ferrari, Konstantinos K. Tsilidis, Marie-Christine Boutron-Ruault, Francoise Clavel, Laureen Dartois, Kuanrong Li, Rudolf Kaaks, Cornelia Weikert, Manuela Bergmann, Heiner Boeing, Anne Tjønneland, Kim Overvad, M. Luisa Redondo, Antonio Agudo, Elena Molina-Portillo, Jone M. Altzibar, Lluís Cirera, Eva Ardanaz, Kay-Tee Khaw, Nicholas J. Wareham, Timothy J. Key, Ruth C. Travis, Christina Bamia, Philippos Orfanos, Antonia Trichopoulou, Domenico Palli, Valeria Pala, Rosario Tumino, Paolo Vineis, Salvatore Panico, H. Bas Bueno-de-Mesquita, W. M. Monique Verschuren, Ellen A. Struijk, Petra H. Peeters, Gunnar Engström, Olle Melander, Malin Sund, Elisabete Weiderpass, Guri Skeie, Eiliv Lund, Teresa Norat, Marc Gunter, Elio Riboli, Paul Brennan


Life expectancy is increasing in Europe, yet a substantial proportion of adults still die prematurely before the age of 70 years. We sought to estimate the joint and relative contributions of tobacco smoking, hypertension, obesity, physical inactivity, alcohol and poor diet towards risk of premature death. We analysed data from 264,906 European adults from the EPIC prospective cohort study, aged between 40 and 70 years at the time of recruitment. Flexible parametric survival models were used to model risk of death conditional on risk factors, and survival functions and attributable fractions (AF) for deaths prior to age 70 years were calculated based on the fitted models. We identified 11,930 deaths which occurred before the age of 70. The AF for premature mortality for smoking was 31 % (95 % confidence interval (CI), 31-32 %) and 14 % (95 % CI, 12-16 %) for poor diet. Important contributions were also observed for overweight and obesity measured by waist-hip ratio (10 %; 95 % CI, 8-12 %) and high blood pressure (9 %; 95 % CI, 7-11 %). AFs for physical inactivity and excessive alcohol intake were 7 % and 4 %, respectively. Collectively, the AF for all six risk factors was 57 % (95 % CI, 55-59 %), being 35 % (95 % CI, 32-37 %) among never smokers and 74 % (95 % CI, 73-75 %) among current smokers. While smoking remains the predominant risk factor for premature death in Europe, poor diet, overweight and obesity, hypertension, physical inactivity, and excessive alcohol consumption also contribute substantially. Any attempt to minimise premature deaths will ultimately require all six factors to be addressed.

Twitter Demographics

The data shown below were collected from the profiles of 24 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 121 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 121 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 30 25%
Student > Master 18 15%
Student > Ph. D. Student 12 10%
Student > Bachelor 11 9%
Student > Doctoral Student 6 5%
Other 21 17%
Unknown 23 19%
Readers by discipline Count As %
Medicine and Dentistry 41 34%
Nursing and Health Professions 9 7%
Social Sciences 7 6%
Agricultural and Biological Sciences 7 6%
Sports and Recreations 4 3%
Other 20 17%
Unknown 33 27%

Attention Score in Context

This research output has an Altmetric Attention Score of 76. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 02 December 2021.
All research outputs
of 19,539,469 outputs
Outputs from BMC Medicine
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Outputs of similar age
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Outputs of similar age from BMC Medicine
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Altmetric has tracked 19,539,469 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 98th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,914 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 39.3. This one has done well, scoring higher than 89% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 277,215 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 96% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them