Association Between Healthy Lifestyle Score and Risk of Multiple Myeloma: A Case–Control Study Publisher Pubmed



Khosroshahi R A ; Shahmohammadi F ; Ebrahimi Mousavi S ; Zamanian N ; Jowshan M R ; Hajifathali A ; Zahedi H ; Shadnoush M
Source: Scientific Reports Published:2026

Abstract

Multiple myeloma (MM) is a type of blood cancer that has both genetic and environmental causes. However, there is limited information available on how lifestyle factors affect MM risk. The current study looked at the relationship between a Healthy Lifestyle Score (HLS) and MM risk in Iranian adults. This is a hospital case-control-based study from Aug 2020 to March 2024, where 149 patients were newly diagnosed with MM and 359 hospital-based controls without MM. The four components of HLS (0–4) were related to diet, physical activity, BMI, and smoking. The HLS distribution among the control groups was divided into tertiles (T1- 0-1, T2-2, T3-3-4). Using multivariable binary logistic regression to estimate OR’s and 95% CI’s for MM within HLS tertiles and per 1-point increase in HLS using crude, demographic adjustment (including energy intake), and 3 models for full adjustment. HLS levels were observed to have lower odds of MM. When adjusted, results demonstrate that the odds ratio (OR) between T1 and T2, as well as T1 and T3, are 0.48 (95% CI = 0.25–0.90) and 0.20 (95% CI = 0.07–0.45). The trend was statistically significant with a P-value < 0.001. A 1-point increase in HLS was associated with 49% decreased odds of MM when considering all lifestyle factors (OR = 0.51; 95% CI = 0.36–0.72; P < 0.001). When examining the results separately by individual components of HLS, the associations between smoking and body mass index (BMI) were consistent with the risk of MM. However, when adjusting for other variables considered in the overall HLS analysis, neither physical activity nor adherence to the Mediterranean Diet was found to be independently associated with the risk of MM. Higher HLS has been shown to correlate negatively on an individual basis with odds of developing MM in a dose-response manner. Additional studies to assess potential exposure of patients prior to the development of disease will help determine whether or not the association is true and, if so, to clarify potential causality. © The Author(s) 2026.