Clustering of lifestyle risk factors in a general adult population.

BACKGROUND The objective of the study was to evaluate the degree of clustering of common lifestyle risk factors in a general adult population and to define subgroups with elevated clustering. METHODS Data on lifestyle risk factors (smoking, low vegetable and fruit consumption, excessive alcohol intake, and low physical activity), sociodemographics, and health perception were collected by questionnaire from 16,789 men and women aged 20 to 59. RESULTS About 20% of the subjects had at least three lifestyle risk factors. Prevalence of risk factors was higher among unemployed, low-educated subjects and those who had experienced health deterioration. All lifestyle risk factors showed significant clustering, except for low physical activity and excessive alcohol consumption. The strongest association was observed for alcohol and smoking (prevalence odds ratio (POR): 2.38; 95% confidence interval: 2.18-2.61). Clustering of smoking and alcohol consumption was strongest among the young subjects (POR: 3.78) and, although moderately, clustering of lifestyle risk factors was elevated in subjects who had experienced a deterioration in health. CONCLUSIONS These findings suggest that common lifestyle risk factors cluster among adult subjects. The tendency for risk factors to aggregate has important implications for health promotion. Information on high-risk groups will help in planning future preventive strategies.

[1]  Wei Chen,et al.  Age-related patterns of the clustering of cardiovascular risk variables of syndrome X from childhood to young adulthood in a population made up of black and white subjects: the Bogalusa Heart Study. , 2000, Diabetes.

[2]  G. Berenson,et al.  Cardiovascular risk factors and behavior lifestyles of young women: implications from findings of the Bogalusa Heart Study. , 1997, The American journal of the medical sciences.

[3]  D. Kromhout,et al.  Cardiovascular risk factors in relation to educational level in 36 000 men and women in The Netherlands. , 1996, European heart journal.

[4]  N. Betts,et al.  Clustering of Lifestyle Behaviors: The Relationship between Cigarette Smoking, Alcohol Consumption, and Dietary Intake , 2000, American journal of health promotion : AJHP.

[5]  R. Doll,et al.  The causes of cancer: quantitative estimates of avoidable risks of cancer in the United States today. , 1981, Journal of the National Cancer Institute.

[6]  R. Beaglehole,et al.  Alcohol consumption guidelines: relative safety vs absolute risks and benefits , 1995, The Lancet.

[7]  J. Viikari,et al.  Clustering of risk habits in young adults. The Cardiovascular Risk in Young Finns Study. , 1995, American journal of epidemiology.

[8]  N Slimani,et al.  Estimation of reproducibility and relative validity of the questions included in the EPIC Physical Activity Questionnaire. , 1997, International journal of epidemiology.

[9]  O. Raitakari,et al.  Clustering of risk factors for coronary heart disease in children and adolescents. The Cardiovascular Risk in Young Finns Study , 1994, Acta paediatrica.

[10]  K. Patrick,et al.  Physical Activity and Public Health: A Recommendation From the Centers for Disease Control and Prevention and the American College of Sports Medicine , 1995 .

[11]  L. Breslow,et al.  Persistence of health habits and their relationship to mortality. , 1980, Preventive medicine.

[12]  J. Strain,et al.  Clustering of Biological Risk Factors for Cardiovascular Disease and the Longitudinal Relationship with Lifestyle of an Adolescent Population: The Northern Ireland Young Hearts Project , 1999, Journal of cardiovascular risk.

[13]  S. Wannamethee,et al.  Hypertension, serum insulin, obesity and the metabolic syndrome , 1998, Journal of Human Hypertension.

[14]  Gerald S. Berenson,et al.  Persistence of multiple cardiovascular risk clustering related to syndrome X from childhood to young adulthood. The Bogalusa Heart Study. , 1994, Archives of internal medicine.

[15]  B. Fagerberg,et al.  The Metabolic Syndrome, LDL Particle Size, and Atherosclerosis: The Atherosclerosis and Insulin Resistance (AIR) Study , 2000, Arteriosclerosis, thrombosis, and vascular biology.

[16]  A. Manley Physical Activity And Health: A Report Of The Surgeon General , 2004 .

[17]  L. Beilin,et al.  Clustering of Cardiovascular Risk Factors in Australian Adolescents: Association with Dietary Excesses and Deficiencies , 1995, Journal of cardiovascular risk.

[18]  N. Owen,et al.  Low-rate smokers. , 1995, Preventive medicine.

[19]  W.T.M. Ooijendijk,et al.  Consensus over de Nederlandse norm voor gezond bewegen , 2000 .

[20]  D. Shopland The Health consequences of smoking; cardiovascular disease : a report of the Surgeon General , 1983 .

[21]  D Kromhout,et al.  The Dutch EPIC food frequency questionnaire. II. Relative validity and reproducibility for nutrients. , 1997, International journal of epidemiology.