{
  "abstract": "Objective To examine the joint association of a composite lifestyle score and the number of chronic musculoskeletal pain sites with all-cause mortality.Methods This prospective study included 36 106 participants from the third survey of the Trøndelag Health Survey Study (2006–2008) in Norway, with up to 14 years of follow-up. We estimated HRs with 95% CIs for all-cause mortality associated with the number of chronic pain sites and a composite lifestyle score based on body mass index, smoking status, leisure-time physical activity, alcohol consumption and intake of fruit and vegetables. Each factor was scored from 0 to 2, yielding a total score ranging from 0 to 10, with higher scores indicating a healthier lifestyle.Results During an average follow-up of 12.5 years, 4436 (12%) participants died. Compared with individuals without chronic musculoskeletal pain and with the healthiest lifestyle (score 8–10 points), individuals with the poorest lifestyle (score 0–3 points) had an HR for all-cause mortality of 1.78 (95% CI 1.50 to 2.11) if they had no chronic pain and an HR of 1.86 (95% CI 1.48 to 2.33) if they had ≥5 chronic pain sites. In comparison, individuals with the healthiest lifestyle and ≥5 chronic pain sites had an HR of 0.92 (95% CI 0.70 to 1.22).Conclusions Individuals with multiple unhealthy lifestyle factors have nearly twice the risk of death from all causes compared with those with the healthiest lifestyle. We found no synergistic effect between multisite pain and the composite lifestyle score on mortality.",
  "authors": [
    {
      "affiliations": [
        "Musculoskeletal Research Hub, Charles Perkins Centre, Sydney Musculoskeletal Health, The University of Sydney, Faculty of Medicine and Health, Sydney, New South Wales, Australia",
        "School of Rural Health, University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Carlos Mesa Castrillon"
    },
    {
      "affiliations": [
        "Musculoskeletal Research Hub, Charles Perkins Centre, Sydney Musculoskeletal Health, The University of Sydney, Faculty of Medicine and Health, Sydney, New South Wales, Australia"
      ],
      "name": "Emma Kwan-Yee Ho"
    },
    {
      "affiliations": [
        "Musculoskeletal Research Hub, Charles Perkins Centre, Sydney Musculoskeletal Health, The University of Sydney, Faculty of Medicine and Health, Sydney, New South Wales, Australia"
      ],
      "name": "Katharine Roberts"
    },
    {
      "affiliations": [
        "School of Health and Wellbeing, University of Glasgow, Glasgow, UK"
      ],
      "name": "Hamish Foster"
    },
    {
      "affiliations": [
        "Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway",
        "Clinic of Emergency Medicine and Prehospital Care, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway"
      ],
      "name": "Tom Ivar Lund Nilsen"
    },
    {
      "affiliations": [
        "Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway"
      ],
      "name": "Anna Marcuzzi"
    },
    {
      "affiliations": [
        "Musculoskeletal Research Hub, Charles Perkins Centre, Sydney Musculoskeletal Health, The University of Sydney, Faculty of Medicine and Health, Sydney, New South Wales, Australia"
      ],
      "name": "Paulo H Ferreira"
    },
    {
      "affiliations": [
        "Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway"
      ],
      "name": "Paul Jarle Mork"
    },
    {
      "affiliations": [
        "Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway"
      ],
      "name": "Eivind Schjelderup Skarpsno"
    }
  ],
  "title": "Joint influence of lifestyle and chronic musculoskeletal pain on all-cause mortality: the HUNT Study",
  "uid": "ac3b74ce-57bc-571e-969e-e9328f426558"
}