{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T05:56:49Z","timestamp":1768888609427,"version":"3.49.0"},"reference-count":51,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"unspecified","delay-in-days":18,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Zhejiang Science and Technology Plan for Disease Prevention and Control","award":["2025JK273"],"award-info":[{"award-number":["2025JK273"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81971558"],"award-info":[{"award-number":["81971558"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007834","name":"Natural Science Foundation of Ningbo","doi-asserted-by":"crossref","award":["2024J317"],"award-info":[{"award-number":["2024J317"]}],"id":[{"id":"10.13039\/100007834","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100007834","name":"Natural Science Foundation of Ningbo","doi-asserted-by":"crossref","award":["2024J333"],"award-info":[{"award-number":["2024J333"]}],"id":[{"id":"10.13039\/100007834","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Resp Res"],"accepted":{"date-parts":[[2025,12,16]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study aims to evaluate the association of Life\u2019s Essential 8 (LE8) with chronic lower respiratory disease (CLRD)-specific mortality and impaired lung health outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This population-based cohort study used data from the National Health and Nutrition Examination Survey (NHANES, 2007\u20132018), including adults aged 20\u201379 years (n=10\u2009135), with lung function measurements available for a subset (n=3188). Multivariable Cox proportional hazards and restricted cubic spline models were employed to assess the associations between LE8 scores and CLRD-specific mortality. Logistic and linear regression models evaluated the associations between LE8 scores and lung health. All models were adjusted for sociodemographic variables (age, sex, race\/ethnicity, education, income-to-poverty ratio), cardiovascular disease, respiratory disease and smoking history. Sensitivity analyses were conducted to assess the stability of the results. The primary outcome was CLRD-specific mortality, and the secondary outcome was lung health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Over a median follow-up of 7.83 years, 50 CLRD-specific deaths were recorded. Higher LE8 scores were associated with reduced risks of CLRD-specific mortality (adjusted HR (aHR), 0.56 (0.40\u20130.79)), with a linear dose-response relationship observed (P for non-linear=0.574). Furthermore, each 10-point increase in total LE8 score was associated with impaired lung health, including lower odds of asthma (adjusted OR (aOR), 0.88 (0.83\u20130.93)), chronic bronchitis (aOR, 0.81 (0.74\u20130.88)), emphysema (aOR, 0.59 (0.52\u20130.65)), chronic obstructive pulmonary disease (aOR, 0.63 (0.45\u20130.89)) and lower relative risk of a restrictive spirometry pattern (adjusted relative risk ratio (aRRR), 0.66 (0.56\u20130.79)). Positive correlations were observed between total LE8 scores and lung function (p&lt;0.001). The findings were robust in sensitivity analyses and consistent across key subgroups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher LE8 scores were associated with reduced CLRD-specific mortality and improved lung health. Promoting LE8 adherence could significantly alleviate respiratory disease burdens and mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjresp-2025-003254","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T16:30:32Z","timestamp":1768840232000},"page":"e003254","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Association of life\u2019s essential 8 with chronic respiratory disease mortality and lung health: a national cohort study"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3317-4333","authenticated-orcid":false,"given":"Yunling","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Nosocomial Infection Administration, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7662-275X","authenticated-orcid":false,"given":"yonghong","family":"Feng","sequence":"additional","affiliation":[{"name":"Shanghai Key Laboratory of Tuberculosis, Tongji University Affiliated Shanghai Pulmonary Hospital, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zirui","family":"Dai","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, The First Affiliated Hospital of Ningbo University, Ningbo, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minghui","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Nosocomial Infection Administration, Ningbo University School of Medicine, Ningbo, Zhejiang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huimin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, The First Affiliated Hospital of Ningbo University, ZheJiang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chao","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Ningbo University, Ningbo, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kunlong","family":"Xiong","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Ningbo University, Ningbo, 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