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Adherence to healthy lifestyle habits in US adults, 1988–2006
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 (>or=5 fruits and vegetables/day, regular exercise >12 times/month, maintaining healthy weight [body mass index 18.5-29.9 kg/m(2)], 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 >or=30 kg/m(2) 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.
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“Adherence to a healthy lifestyle includes stress management; however, fewer than 10% of adults in the United States follow this pattern, including women [46].”
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“Studies have shown the causality relationships between dietary patterns and lifestyle habits versus chronic illnesses (Jacques & Tucker, 2001;King, Mainous, Carnemolla, & Everett, 2009;WHO, 2003).”
From Emerging trends in European food, diets and food industry (2018) · cites this paper as King et al., 2009
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Thomé, K. M., Pinho, G. M., & Hoppe, A. (2018) · British Food Journal · doi:10.1108/bfj-12-2017-0683 · Cited by 53
Dietary habits and health among university students living at or away from home in southern Italy.
Bagordo, F., Grassi, T., Serio, F., Idolo, A., & Donno, A. D. (2013) · AIRUS · Cited by 50
Food intake of individuals with and without diabetes across different countries and ethnic groups
Nöthlings, U., Boeing, H., Maskarinec, G., Sluik, D., Teucher, B., Kaaks, R., Tjønneland, A. M., Halkjær, J., Dethlefsen, C., Overvad, K., et al. (2011) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2011.11 · Cited by 50
“In the NHANES survey, individuals with diabetes have been shown to be no more likely to adhere to healthy lifestyles than individuals without diabetes, which included the consumption of fruit and vegetables (King et al., 2009).”
Differential Effects of Moderate Alcohol Consumption on Performance Among Older and Younger Adults
Sklar, A. L., Gilbertson, R. J., Boissoneault, J., Prather, R. A., & Nixon, S. J. (2012) · Alcoholism Clinical and Experimental Research · doi:10.1111/j.1530-0277.2012.01833.x · Cited by 49
“With current trends in moderate drinking behaviors among older adults (King et al., 2009) and the understudied nature of this question, further characterization of the effects of alcohol on cognitive efficiency in older adults is clearly needed.”
BackgroundPhillips, A. S., & Guarnaccia, C. A. (2017) · Journal of Health Psychology · doi:10.1177/1359105317737606 · Cited by 47
“As a result, adherence to behavior change recommendations is low (King et al., 2009).”
A healthy lifestyle composite measure: Significance and potential uses
Adams, M. L., Katz, D. L., & Shenson, D. (2015) · Preventive Medicine · doi:10.1016/j.ypmed.2015.12.005 · Cited by 50
“These results are consistent with earlier studies (Troost et al., 2012; King et al., 2009; Pronk et al., 2004) that also found very low rates for adults practicing a healthy lifestyle, although the definition of a healthy lifestyle and ages of adults varied.”
ResultVallis, M., Lee‐Baggley, D., Sampalli, T., Ryer, A., Carson, S. R., Kumanan, K., & Edwards, L. (2017) · Public Health · doi:10.1016/j.puhe.2017.10.022 · Cited by 52
Lifestyle behaviours and quality-adjusted life years in middle and older age
Myint, P. K., Smith, R., Luben, R., Surtees, P. G., Wainwright, N. W. J., Wareham, N. J., & Khaw, K. (2011) · Age and Ageing · doi:10.1093/ageing/afr058 · Cited by 46
KONES, R. J., & Rumana, U. (2016) · Annals of Medicine · doi:10.1080/07853890.2016.1271957 · Cited by 47
“In the US, adherence to healthy lifestyle habits has fallen steadily during the past 18 years, despite several large programs to reverse the trend (54,91).”
BackgroundHackett, R. A., Moore, C., Steptoe, A., & Lassale, C. M. (2018) · Scientific Reports · doi:10.1038/s41598-018-35238-1 · Cited by 48
Assessment of antidiabetic potential and phytochemical profiling of Rhazya stricta root extracts
Mahmood, R., Kayani, W. K., Ahmed, T., Malik, F., Hussain, S., Ashfaq, M., Ali, H., Rubnawaz, S., Green, B. D., Calderwood, D., et al. (2020) · BMC Complementary Medicine and Therapies · doi:10.1186/s12906-020-03035-x · Cited by 44
“The rise in the number of patients of type 2 DM is associated with obesity, hypertension, and an increasingly elderly population and one of the main reasons is the unhealthy lifestyle with no adherence to improved diet and poor exercise [2].”
BackgroundTruthmann, J., Busch, M. A., Scheidt‐Nave, C., Mensink, G., Gößwald, A., Endres, M., & Neuhauser, H. K. (2015) · BMC Public Health · doi:10.1186/s12889-015-1929-5 · Cited by 41
“In the United States adherence to five healthy behavioural factors (including fruit and vegetable consumption, regular exercise, healthy weight, alcohol consumption and smoking) in 40 to 74 year olds was as low as 8 % in 2006 and had decreased from 15 % in 1988 [14].”
BackgroundA Proposed Strategy against Obesity: How Government Policy Can Counter the Obesogenic Environment
Temple, N. J. (2023) · Nutrients · doi:10.3390/nu15132910 · Cited by 52
“These findings are similar to the low level of exercise reported around 1990 to 2004 [25].”
ResultLifestyle risk score and mortality in Korean adults: a population-based cohort study
Lee, D. H., Nam, J. Y., Kwon, S., Keum, N., Lee, J.-T., Shin, M., & Oh, H. (2020) · Scientific Reports · doi:10.1038/s41598-020-66742-y · Cited by 42
Altmeyer, M., Lessel, P., Jantwal, S., Müller, L., Daiber, F., & Krüger, A. (2021) · User Modeling and User-Adapted Interaction · doi:10.1007/s11257-021-09288-6 · Cited by 47
The Eating Identity Type Inventory (EITI). Development and associations with diet
Blake, C. E., Bell, B. A., Freedman, D. A., Colabianchi, N., & Liese, A. D. (2013) · Appetite · doi:10.1016/j.appet.2013.05.008 · Cited by 46
Neighbourhood Environment Correlates of Physical Activity: A Study of Eight Czech Regional Towns
Sigmundová, D., Ansari, W. E., & Sigmund, E. (2011) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph8020341 · Cited by 40
Vallis, M. (2015) · Canadian Journal of Diabetes · doi:10.1016/j.jcjd.2015.01.002 · Cited by 42
“Evidence suggests that health behaviours are strongly associated with health outcomes (6,43); that healthbehaviour change leads to improvements in health (5); and that the base rates of health behaviours are low (44).”
BackgroundLinking a Motivational Interviewing Curriculum to the Chronic Care Model
Abramowitz, S., Flattery, D., Franses, K., & Berry, L. (2010) · Journal of General Internal Medicine · doi:10.1007/s11606-010-1426-6 · Cited by 40
Turner, B. J., Navuluri, N., Winkler, P., Arismendez, S. V., & Finley, E. P. (2014) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2013.12.010 · Cited by 44
More Than Good Intentions: Advancing Adherence to Therapy Recommendations
Radomski, M. V. (2011) · American Journal of Occupational Therapy · doi:10.5014/ajot.2011.000885 · Cited by 39
Gayer, B., Avendano, E. E., Edelson, E., Nirmala, N., Johnson, E. J., & Raman, G. (2019) · Current Developments in Nutrition · doi:10.1093/cdn/nzz109 · Cited by 39
Hing, M., Hoffman, R. M., Seleman, J., Chibwana, F., Kahn, D. G., & Moucheraud, C. (2019) · Health Policy and Planning · doi:10.1093/heapol/czz112 · Cited by 39
“Though the initial adjustment period was difficult, echoing findings from previous studies (Mellen et al., 2008; King et al., 2009), many participants were ultimately optimistic in making dietary and lifestyle changes.”
ResultRobertson, A., Mullan, B. A., & Todd, J. (2014) · Appetite · doi:10.1016/j.appet.2014.01.006 · Cited by 39
Knowledge, Attitude and Practice on Cardiovascular Diseaseamong Women in North-Eastcoast Malaysia
Muhamad, R., Yahya, R., & Yusoff, H. M. (2012) · International journal of collaborative research on internal medicine & public health · Cited by 39
Palomaki, G. E., Melillo, S. N., Neveux, L. M., Douglas, M. P., Dotson, W. D., Janssens, A. C. J. W., Balkite, E. A., & Bradley, L. A. (2010) · Genetics in Medicine · doi:10.1097/gim.0b013e3181f8728d · Cited by 38
Correlates of Self-Care Behaviors among Low-Income Elderly Women with Hypertension in South Korea
Yang, S., Jeong, G. H., Kim, S., & Lee, S. H. (2013) · Journal of Obstetric, Gynecologic & Neonatal Nursing · doi:10.1111/1552-6909.12265 · Cited by 37
Microsatellite instability among individuals of Hispanic origin with colorectal cancer
Gupta, S. N., Ashfaq, R., Kapur, P., Afonso, B. B., Nguyen, T., Ansari, F., Boland, C. R., Goel, A., & Rockey, D. C. (2010) · Cancer · doi:10.1002/cncr.25486 · Cited by 38
Using a Mixed-Methods RE-AIM Framework to Evaluate Community Health Programs for Older Latinas
Schwingel, A., Gálvez, P., Linares, D. E., & Sebastião, É. (2016) · Journal of Aging and Health · doi:10.1177/0898264316641075 · Cited by 38
“Behavioral change programs such as AEA, however, utilize contemporary advances in behavioral science to help people identify positive lifestyle choices that are personally meaningful to them and that they can implement in their daily routines (Cress et al., 2005; King et al., 2009).”
BackgroundDieteren, C. M., Brouwer, W. B. F., & van Exel, J. N. A. (2020) · BMC Public Health · doi:10.1186/s12889-020-8429-y · Cited by 37
“However, contrary to what would be desirable from a public health perspective, studies have shown that adherence to a healthy lifestyle (making healthy choices) has decreased over the past decade [5, 6].”
ResultJeon, Y., Pyo, J., Park, Y.-K., & Ock, M. (2020) · BMC Public Health · doi:10.1186/s12889-020-09940-7 · Cited by 37
Increasing Stair Use in an Office Worksite through an Interactive Environmental Intervention
Swenson, T., & Siegel, M. (2013) · American Journal of Health Promotion · doi:10.4278/ajhp.120221-quan-104 · Cited by 36
“Although there are many nationwide initiatives to promote physical activity, little progress has been made over the past two decades.(4) Widespread awareness campaigns extolling the importance of exercise have not made a significant impact and Americans have become less physically active overall between 1955 and 2005,…”
BackgroundCarstens, M. T., Goedecke, J. H., Dugas, L., Evans, J., Kroff, J., Levitt, N. S., & Lambert, E. V. (2013) · Nutrition & Metabolism · doi:10.1186/1743-7075-10-8 · Cited by 34
“This trend in obesity may be linked to changes in population levels of physical activity [5], along with a changing food”
BackgroundFitness, fatness, and systolic blood pressure: Data from the Cooper Center Longitudinal Study
Chen, J., Das, S. R., Barlow, C. E., Grundy, S. M., & Gilchrist, S. C. (2010) · American Heart Journal · doi:10.1016/j.ahj.2010.04.014 · Cited by 36
Troost, J. P., Rafferty, A. P., Luo, Z., & Reeves, M. J. (2011) · American Journal of Public Health · doi:10.2105/ajph.2011.300326 · Cited by 34
Metadata
- Authors
- King, D. E., Mainous, A. G., Carnemolla, M., & Everett, C. J.
- Affiliations
- Medical University of South Carolina (US)
- Corresponding author
- King, Dana E.
- Venue
- The American Journal of Medicine
- Publisher
- Elsevier BV
- Published
- 2009-06
- Volume
- 122
- Issue
- 6
- Pages
- 528-534
- ISSN
- 0002-9343 (ISSN-L)
- OpenAlex
- W2089229405
- Cited by
- 336
- References
- 39
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 9 · 2023: 16 · 2022: 1 · 2021: 16 · 2020: 11 · 2019: 15 · 2018: 29 · 2017: 24 · 2016: 17 · 2015: 19 · 2014: 18 · 2013: 25 · 2012: 37
- FWCI
- 75.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Public Health Service (5 D55HP05150)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health and Lifestyle Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- healthy lifestyle adherence, lifestyle trends, fruit and vegetable intake, physical activity, body mass index, obesity, alcohol consumption, smoking, cardiovascular risk, temporal trends, racial and ethnic disparities, hypertension, diabetes mellitus
- MeSH terms
- Activities of Daily Living, Adult, Aged, Alcohol Drinking, Cardiovascular Diseases, Choice Behavior, Diabetes Mellitus, Type 2, Feeding Behavior, Female, Health Status, Health Surveys, Humans, Life Style, Male, Middle Aged, Obesity, Patient Compliance, Risk Factors, Smoking, United States, Health Behavior, Body Mass Index, Cluster Analysis, Practice Guidelines as Topic
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