Clinical research study
Adherence to Healthy Lifestyle Habits in US Adults, 1988-2006

https://doi.org/10.1016/j.amjmed.2008.11.013Get rights and content

Abstract

Background

Lifestyle choices are associated with cardiovascular disease and mortality. The purpose of this study was to compare adherence to healthy lifestyle habits in adults between 1988 and 2006.

Methods

Analysis of adherence to 5 healthy lifestyle trends (≥5 fruits and vegetables/day, regular exercise >12 times/month, maintaining healthy weight [body mass index 18.5-29.9 kg/m2], moderate alcohol consumption [up to 1 drink/day for women, 2/day for men] and not smoking) in the National Health and Nutrition Examination Survey 1988-1994 were compared with results from the National Health and Nutrition Examination Survey 2001-2006 among adults aged 40-74 years.

Results

Over the last 18 years, the percent of adults aged 40-74 years with a body mass index ≥30 kg/m2 has increased from 28% to 36% (P <.05); physical activity 12 times a month or more has decreased from 53% to 43% (P <.05); smoking rates have not changed (26.9% to 26.1%); eating 5 or more fruits and vegetables a day has decreased from 42% to 26% (P <.05), and moderate alcohol use has increased from 40% to 51% (P <.05). Adherence to all 5 healthy habits has gone from 15% to 8% (P <.05). Although adherence to a healthy lifestyle was lower among minorities, adherence decreased more among non-Hispanic Whites over the period. Individuals with a history of hypertension/diabetes/cardiovascular disease were no more likely to be adherent to a healthy lifestyle than people without these conditions.

Conclusions

Generally, adherence to a healthy lifestyle pattern has decreased during the last 18 years, with decreases documented in 3 of 5 healthy lifestyle habits. These findings have broad implications for the future risk of cardiovascular disease in adults.

Section snippets

Methods

The study was a comparative analysis of middle-aged adults aged 40-74 years participating in the NHANES III 1988-1994 and 2001-2006, national data sets that are available for public use. The study was reviewed by the Institutional Review Board of the Medical University of South Carolina and was exempt. The study populations and study variables were matched to be as identical as possible in the 2 data sets. Below is a description of the population and study variables from each of the surveys.

Results

Over the last 16 years, the percent of adults aged 40-74 years with a BMI ≥30 has increased from 28% to 36% (P <.05); physical activity 12 times a month or more has decreased from 53% to 43% (P <.05); smoking rates have not changed (26.9% to 26.1%); eating 5 or more fruits and vegetables a day has decreased from 42% to 26% (P <.05); and moderate alcohol use has increased from 40% to 52% (P <.05). Adherence to all 5 healthy habits as a group has gone from 15% to 8% (P <.05).

Comparing men and

Discussion

Generally, adherence to a healthy lifestyle pattern has decreased during the last 18 years; adherence to all 5 healthy habits as a group has gone from 15% to 8% (P <.05). Men overall and non-Hispanic whites (both men and women) have a pattern of declining adherence to a healthy lifestyle that exceeds their respective comparison groups. Of equal or greater concern is the finding that individuals with cardiovascular disease, hypertension, diabetes, or hyperlipidemia do not adhere to a healthy

References (40)

  • M.J. Reeves et al.

    Healthy lifestyle characteristics among adults in the United States, 2000

    Arch Intern Med

    (2005)
  • K. Bibbins-Domingo et al.

    Adolescent overweight and future adult coronary heart disease

    N Engl J Med

    (2007)
  • Plan and operation of the Third National Health and Nutrition Survey, 1988-1994Series 1: programs and collection procedures

    Vital Health Stat 1

    (1994)
  • B.E. Ainsworth et al.

    Compendium of physical activities: classification of energy costs of human physical activities

    Med Sci Sports Exerc

    (1993)
  • Exercise for patients with coronary artery disease

    Med Sci Sports Exerc

    (1994)
  • Alcoholic beverages

    Dietary Guidelines for Americans

    (2005)
  • A.F. Subar et al.

    Comparative validation of the Block, Willett, and National Cancer Institute food frequency questionnaires: the Eating at America's Table Study

    Am J Epidemiol

    (2001)
  • Diet*Calc Analysis Program, Version 1.4.3National Cancer Institute, Applied Research Program

    (November 1, 2005)
  • C. Li et al.

    Increasing trends in waist circumference and abdominal obesity among US adults

    Obesity

    (2007)
  • A.H. Mokdad et al.

    Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001

    JAMA

    (2003)
  • Cited by (253)

    • Nutrition and blood pressure

      2021, Nutritional Management of Renal Disease, Fourth Edition
    • Measuring the impact of the built environment on health, wellbeing, and performance: Techniques, methods, and implications for design research

      2024, Measuring the Impact of the Built Environment on Health, Wellbeing, and Performance: Techniques, Methods, and Implications for Design Research
    View all citing articles on Scopus

    Funding: This study was supported in part by grant 5 D55HP05150 from the Health Resources and Services Administration. Preliminary findings were presented at the North American Primary Care Research Group meeting in Puerto Rico, November 18, 2008.

    Conflict of Interest: The authors of this study have no conflicts of interest to disclose.

    Authorship: All authors had full access to all of the data in the study and had a role in writing the manuscript.

    View full text