Clustering of Unhealthy Behaviors in the Aerobics Center Longitudinal Study

Abstract

BackgroundClustering of unhealthy behaviors has been reported in previous studies; however the link with all-cause mortality and differences between those with and without chronic disease requires further investigation.ObjectivesTo observe the clustering effects of unhealthy diet, fitness, smoking, and excessive alcohol consumption in adults with and without chronic disease and to assess all-cause mortality risk according to the clustering of unhealthy behaviors.MethodsParticipants were 13,621 adults (aged 20–84) from the Aerobics Center Longitudinal Study. Four health behaviors were observed (diet, fitness, smoking, and drinking). Baseline characteristics of the study population and bivariate relations between pairs of the health behaviors were evaluated separately for those with and without chronic disease using cross-tabulation and a chi-square test. The odds of partaking in unhealthy behaviors were also calculated. Latent class analysis (LCA) was used to assess clustering. Cox regression was used to assess the relationship between the behaviors and mortality.ResultsThe four health behaviors were related to each other. LCA results suggested that two classes existed. Participants in class 1 had a higher probability of partaking in each of the four unhealthy behaviors than participants in class 2. No differences in health behavior clustering were found between participants with and without chronic disease. Mortality risk increased relative to the number of unhealthy behaviors participants engaged in.ConclusionUnhealthy behaviors cluster together irrespective of chronic disease status. Such findings suggest that multi-behavioral intervention strategies can be similar in those with and without chronic disease.

Longitudinal Person-Related Determinants of Physical Activity in Young Adults

“…Research suggests that risk behaviors tend to cluster within individuals (12,14,24,51). Likewise, our results showed that smoking men were less vigorously active than their nonsmoking peers.…”

Racism and Health I

“…Failure to model this accumulation of adversity may fail to capture, and effectively address, the full burden of social exposure. Unhealthy behaviors such as poor nutrition, physical inactivity, cigarette smoking and excessive alcohol intake are clustered in individuals with and without chronic diseases (Héroux et al, 2012). Similarly, discrimination and other psychosocial stressors are clustered with each other and co-occur more frequently in disadvantaged racial populations (Sternthal, Slopen & Williams, 2011).…”

Combined Impact of Negative Lifestyle Factors on Cardiovascular Risk in Children: A Randomized Prospective Study

“…Clustering of cardiovascular disease risk factors, which imparts an even greater risk than the sum of the individual risk factors in adults, also takes place in childhood and tracks into adolescence, as shown in this study. For instance, it could be shown that unhealthy diet, fitness, smoking, and excessive alcohol consumption were related to each other among adults [11] and that the presence of these factors was related to cardiovascular disease mortality. [12] Moreover, skipping breakfast seems to co-occur with other unhealthy lifestyle habits such as smoking and physical inactivity.…”

“…[8] Parental factors such as physical inactivity, [9] smoking [9] and overweight also contribute. [10] Because these individual factors are not independent of each other and often appear in combination, [11] it is important to know their combined impact on CVR. This has been shown in a prospective study in adults in which the relative risk of cardiovascular disease mortality increased with a decreasing number of positive lifestyle factors such as healthy eating, a physically active lifestyle, low alcohol consumption and the absence of smoking.…”