Health lifestyles across the transition to adulthood: implications for health

May combine two claims.

Health lifestyles are diverse across adolescence, early adulthood, and young adulthood, but few individuals had a consistently healthy lifestyle at any stage.

“We uncover diverse health lifestyles among adolescents, early adults, and young adults; however, few individuals engaged in a consistently salubrious lifestyle at any developmental stage.”

May combine two claims.

Health lifestyles are an important and meaningful construct that differs across life stages.

“Results from the latent class analyses for the three waves provide evidence that health lifestyles are an important and meaningful construct that differs across life stages.”

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While some individuals in each life stage engage in a lifestyle that can be described as consistently positive or negative, most individuals have a lifestyle characterized by a mix of salubrious and insalubrious behaviors.

“The results demonstrate that while some individuals in each life stage engage in a lifestyle that can be described as consistently positive or negative, most individuals have a lifestyle that is characterized by a mix of salubrious and insalubrious behaviors.”

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The mostly negative, especially substance use early adult group (11%) generally exhibited insalubrious behavior, with particularly problematic levels of tobacco, marijuana, and alcohol use.

“The mostly negative, especially substance use group (11%) generally exhibited insalubrious behavior, with particularly problematic levels of tobacco, marijuana, and alcohol use”

May combine two claims.

The largest early adult group was poor diet and no health care (35%), distinguished by high rates of fast food and disordered behaviors and low rates of breakfast and dental exams.

“At about one third of the population, the largest group was poor diet and no health care (35%), distinguished by high rates of fast food and disordered behaviors and low rates of breakfast and dental exams.”

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Adolescent health lifestyles consist of many patterns of health behavior, and most adolescents belong to groups that include some health-compromising behaviors.

“Overall, adolescent health lifestyles comprise many patterns of health behavior, with most individuals belonging to groups with some health compromising behaviors.”

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The mid, sleep problems adolescent group (15%) had the lowest rates of getting enough sleep and of getting nine or more hours of sleep.

“Mid, sleep problems (15%) demonstrated the lowest rates of getting enough sleep and getting nine or more hours of sleep.”

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Early adult health lifestyles show diverse mixes of health behavior, with substance use and activity levels appearing particularly salient for distinguishing early adulthood health lifestyles.

“Like adolescent health lifestyles, these classes demonstrate diverse mixes of health behavior, with substance use and activity levels appearing particularly salient for distinguishing early adulthood health lifestyles.”

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Both the unsafe, no substance use adolescent group (16%) and the substance users and unsafe adolescent group (8%) demonstrated poor rates of safety behaviors.

“Both the unsafe, no substance use group (16%) and the substance users and unsafe group (8%) demonstrated poor rates of safety behaviors”

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The mostly negative adolescent group (9%) had mostly unhealthy behaviors, including the lowest rates of eating fruits and vegetables and of health care use.

“The mostly negative group (9%) had mostly unhealthy behaviors, including the lowest rates of eating fruits and vegetables and health care use.”

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Lifestyles were both directly associated with young adult self-rated health and partially accounted for when considering health lifestyles from other stages, but only young adult health lifestyles were significantly associated with young adult cardiovascular risk.

“Lifestyles were both directly associated with young adult self-rated health and partially accounted for when considering health lifestyles from other stages, but only young adult health lifestyles were significantly associated with young adult cardiovascular risk.”

May combine two claims.

The inactive, poor diet, poor sleep young adult group showed quite unhealthy behavior across several domains, but also had little substance use, fighting, or sex risk.

“The next group, inactive, poor diet, poor sleep showed quite unhealthy behavior across several domains, but also had little substance use, fighting, or sex risk.”

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When all three life course stages were considered in the self-rated health model (Model 4), the coefficients were slightly smaller and some groups that showed significant relationships no longer remained significant.

“When all three life course stages were considered in the self-rated health model (Model 4), the coefficients were slightly smaller and some groups that showed significant relationships no longer remained significant.”

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The healthiest early adult group was the consistently positive group (27%), which generally exhibited healthier behaviors than average.

“The healthiest group was the consistently positive group (27%), which generally exhibited healthier behaviors than average.”

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Among early adults in the mostly positive, seated time and problem drinking group, 25% adopted a consistently positive lifestyle in young adulthood, a similar percentage took on an inactive, poor diet, poor sleep lifestyle, and 12% belonged to the young adult consistently negative group.

“Among early adults in that class, 25% adopted a consistently positive lifestyle in young adulthood, with a similar percentage taking on an inactive, poor diet, poor sleep lifestyle and 12% belonging to the young adult consistently negative group.”

May combine two claims.

Young adults in the consistently negative class exhibited the worst self-rated health, followed by young adults in the inactive, poor diet, poor sleep, early adults in the mostly negative, especially substance use, and adolescents in the mostly negative groups.

“Young adults in the consistently negative class exhibited the worst self-rated health, followed by young adults in the inactive, poor diet, poor sleep, early adults in the mostly negative, especially substance use, and adolescents in the mostly negative groups.”

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The mixed adolescent group (10%) had positive activity, diet, health care, and sleep, but negative substance use and safety.

“The mixed group (10%) had positive activity, diet, health care, and sleep, but negative substance use and safety.”

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Health lifestyles in adolescence, early adulthood, and young adulthood (compared to the most positive group) were each associated with young adult self-rated health when separately considered, but these associations were attenuated in models that incorporated all life stages.

“That is, health lifestyles in adolescence, early adulthood, and young adulthood (compared to the most positive group) were each associated with young adult self-rated health when separately considered, but these associations were attenuated in models that incorporated all life stages.”

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Adolescent and early adult lifestyles do not appear salient for young adult cardiovascular health; none of those lifestyles demonstrated a strong relationship, net of controls which include adolescent weight status.

“Interestingly, the adolescent and early adult lifestyles do not appear salient for young adult cardiovascular health; none of those lifestyles demonstrated a strong relationship, net of controls which include adolescent weight status.”

May combine two claims.

The mostly positive with problem drinking young adult group (21%) appeared active and had favorable diet, health care, and sleep, but also exhibited high rates of problem drinking.

“The mostly positive with problem drinking group (21%) appeared active and had favorable diet, health care, and sleep, but also exhibited high rates of problem drinking.”

May combine two claims.

Model 4 for cardiovascular risk demonstrates that the health lifestyle coefficients were somewhat smaller compared to their counterparts in Models 1-3, but young adult inactive, poor diet, and poor sleep had significantly increased risk compared to consistently positive.

“Model 4 for cardiovascular risk demonstrates that the health lifestyle coefficients were somewhat smaller compared to their counterparts in Models 1 – 3, but young adult inactive, poor diet, and poor sleep had significantly increased risk compared to consistently positive.”

May combine two claims.

The next early adult group demonstrated mostly positive behaviors, but also had the highest rates of seated time and very high rates of problem drinking.

“The next group demonstrated mostly positive behaviors, but also had the highest rates of seated time and very high rates of problem drinking.”

Classified as probably not a substantial claim.

Sociological research has long identified health behaviors as components of broader lifestyles that develop over time in social contexts.

“even though sociological research has long identified health behaviors as components of broader lifestyles that develop over time in social contexts (Cockerham, 2005).”

• cites Cockerham, 2005 sourceNot checked yet

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Probably not a substantial claim: may not pass S2 (checkable).

Health behaviors are not isolated phenomena; they comprise routines and habits that make up a lifestyle.

“Health behaviors are not isolated phenomena but comprise routines and habits that make up a lifestyle (Bourdieu, 1984).”

• cites Bourdieu, 1984Not checked yet

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Classified as probably not a substantial claim.

Health behaviors are important for longevity.

“Research has long established the importance of health behaviors for longevity (Rogers et al., 2000).”

• cites Rogers et al., 2000Not checked yet

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Classified as probably not a substantial claim.

Theory has highlighted the potential importance of health lifestyles in understanding patterns of health-promoting or health-endangering behaviors.

“Theory has highlighted the potential importance of health lifestyles in understanding how and why there are patterns to behaviors that promote or endanger health (Cockerham, 2005)”

• cites Cockerham, 2005 sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

Smoking, poor nutrition, inadequate exercise, and excessive drinking contribute to the less healthy profile of U.S. adults compared to adults in similarly wealthy countries.

“In addition, smoking, poor nutrition and inadequate exercise, and excessive drinking all contribute to the less healthy profile of U.S. adults compared to adults living in similarly wealthy countries (Danaei et al., 2011; NRC and IOM, 2013).”

• cites Danaei et al., 2011Not checked yet

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• cites NRC and IOM, 2013Not checked yet

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Classified as probably not a substantial claim.

Health lifestyles may be part of an overall trajectory of exposures which affect health (a "pathway" model).

“Or health lifestyles may be part an overall trajectory of exposures which affect health (“pathway”) (Goosby et al., 2016; Montez and Hayward, 2011).”

• cites Goosby et al., 2016 sourceNot checked yet

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• cites Montez and Hayward, 2011Not checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

Other important developmental changes occur, such as an increased need for sleep.

“Other important developmental changes occur as well, such as an increased need for sleep (Hirshkowitz et al., 2015).”

• cites Hirshkowitz et al., 2015 sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

Sleeping less than the recommended duration is associated with increased mortality risk.

“Sleeping less than the recommended duration is associated with increased mortality risk (Cappuccio et al., 2010).”

• cites Cappuccio et al., 2010 sourceNot checked yet

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Classified as probably not a substantial claim.

This nascent literature suggests that U.S. children, adolescents, and adults exhibit coherent patterns of behavior consistent with health lifestyles.

“This nascent literature suggests that U.S. children, adolescents, and adults exhibit coherent patterns of behavior, consistent with their conceptualization as health lifestyles.”

• cites Cockerham et al., 2017 sourceNot checked yet

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• cites Mize, 2017 sourceNot checked yet

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• cites Mollborn et al., 2014 sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

Safety measures are associated with likelihood of injury.

“comprised available indicators associated with likelihood of injury (Olivier and Creighton, 2015; Perneger and Smith, 1991; Pickett et al., 2005).”

• cites Olivier and Creighton, 2015Not checked yet

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• cites Perneger and Smith, 1991 sourceNot checked yet

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• cites Pickett et al., 2005 sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

Adult health behaviors are important for adult mortality and morbidity.

“Research has established that adult health behaviors are important for adult mortality and morbidity (Danaei et al., 2011; NRC and IOM, 2013; Rogers et al., 2000)”

• cites Danaei et al., 2011Not checked yet

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• cites NRC and IOM, 2013Not checked yet

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• cites Rogers et al., 2000Not checked yet

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May combine two claims.

Most health conditions are more prevalent in middle and older adulthood compared with young adulthood, but the consequences of unhealthy practices sometimes appear in younger adulthood.

“Most health conditions are more prevalent in middle and older adulthood compared with young adulthood, but the consequences of unhealthy practices sometimes appear in younger adulthood (Harris, 2010).”

• cites Harris, 2010 sourceNot checked yet

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Only one study has examined health lifestyles as they develop from adolescence to young adulthood, but it limited behaviors to smoking, drinking, obesity, and physical activity.

“To our knowledge, though, only one study has examined health lifestyles as they develop from adolescence to young adulthood, but this study limited behaviors to smoking, drinking, obesity, and physical activity (Daw et al., 2017).”

• cites Daw et al., 2017 sourceNot checked yet

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Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

Eating breakfast is a habit that many believe to be important for health.

“a habit that many believe to be important for health (Spence, 2017).”

• cites Spence, 2017 sourceNot checked yet

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Classified as probably not a substantial claim. May combine two claims.

Life course literature suggests that different life phases all matter for health, and that they sometimes operate through "imprint" processes and sometimes "pathway" processes depending on the phenomenon being studied.

“Life course literature suggests that different life phases all matter for health, and that they sometimes operate through “imprint” processes and sometimes “pathway” processes depending on the phenomenon being studied (Berkman, 2009; Montez and Hayward, 2011).”

• cites Berkman, 2009 sourceNot checked yet

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• cites Montez and Hayward, 2011Not checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

Sexual behavior variables are associated with risk of contracting sexually transmitted infections.

“Sexual behavior was assessed with developmentally appropriate variables that are associated with risk of contracting sexually transmitted infections (Steiner and Cates, 2006).”

• cites Steiner and Cates, 2006 sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

Individuals generally perceive regular examinations to be important for health.

“Individuals generally perceive regular examinations to be important for health (Oboler et al., 2002).”

• cites Oboler et al., 2002 sourceNot checked yet

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Classified as probably not a substantial claim.

Recently, researchers have begun to tie theoretical literature on health lifestyles to empirical examinations of clusters of a wide range of behaviors.

“Recently, researchers have begun to tie the theoretical literature on health lifestyles to empirical examinations of clusters of a wide range of behaviors (Cockerham et al., 2017; Mize, 2017; Mollborn et al., 2014; Saint Onge and Krueger, 2017; Skalamera and Hummer, 2016).”

• cites Cockerham et al., 2017 sourceNot checked yet

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• cites Mize, 2017 sourceNot checked yet

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• cites Mollborn et al., 2014 sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

Tobacco, marijuana, alcohol, and drugs have important health implications.

“all of which have important health implications (Chen and Lin, 2009; Shield et al., 2014; U.S. DHHS, 2014).”

• cites Chen and Lin, 2009 sourceNot checked yet

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• cites Shield et al., 2014 sourceNot checked yet

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• cites U.S. DHHS, 2014Not checked yet

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Classified as probably not a substantial claim.

LCA is best suited for our aims because it allows lifestyles to be categorical and emerge from the data.

“LCA is best suited for our aims because it allows lifestyles to be categorical and emerge from the data (Abel, 1991).”

• cites Abel, 1991 sourceNot checked yet

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Classified as probably not a substantial claim.

Physical activity and sedentary time are associated with health outcomes.

“both physical activity and sedentary time are associated with health outcomes (Kesaniemi et al., 2001; Thorp et al., 2011).”

• cites Kesaniemi et al., 2001Not checked yet

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• cites Thorp et al., 2011 sourceNot checked yet

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Classified as probably not a substantial claim.

Health risk behaviors at critical periods in the life course can result in exposures that leave an imprint on health, years later or concurrently.

“Health risk behaviors at critical periods in the life course can result in exposures that leave an imprint on health, years later or concurrently.”

• cites Goosby et al., 2016 sourceNot checked yet

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• cites Montez and Hayward, 2011Not checked yet

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May combine two claims.

Overall, this study suggests a portrait of problematic health lifestyles among a nationally representative cohort of young Americans, with associated patterns of relatively poor physical health among those with poor health lifestyles.

“Overall, this study suggests a portrait of problematic health lifestyles among a nationally representative cohort of young Americans, with associated patterns of relatively poor physical health among those with poor health lifestyles.”

Probably not a substantial claim: may not pass S2 (checkable).

The differences in lifestyles across these development stages reinforce the need to examine them as independent predictors of young adult health.

“The differences in lifestyles across these development stages reinforce the need to examine them as independent predictors of young adult health.”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

Another explanation is that cardiovascular consequences of earlier exposures may yet manifest in later life, as related health conditions decline over age.

“Another explanation is that cardiovascular consequences of earlier exposures may yet manifest in later life, as related health conditions decline over age.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Supplemental models using ordered logit models for self-rated health produced similar results.

“Supplemental models using ordered logit models for self-rated health produced similar results.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The study controlled for background characteristics including adolescent self-rated health and weight status, but there may be other confounders.

“We control for background characteristics including adolescent self-rated health and weight status, but there may be other confounders.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

One explanation is that cardiovascular health is somewhat resilient in these earlier years, but unhealthy lifestyles have lasting effects on other aspects of physical and mental well-being.

“One explanation is that cardiovascular health is somewhat resilient in these earlier years, but unhealthy lifestyles have lasting effects on other aspects of physical and mental well-being.”

Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.

Some of the effect sizes were small, but small differences at these younger ages may translate into larger differences as these individuals enter middle and late adulthood.

“Some of the effect sizes were small, but small differences at these younger ages may translate into larger differences as these individuals enter middle and late adulthood.”

Classified as probably not a substantial claim.

The analysis included control variables (gender, race/ethnicity, age, family SES, adolescent health) to reduce spurious relationships.

“To minimize the risk of identifying spurious relationships, we included control variables in multivariate regression models: gender, race/ethnicity, age at the Wave IV interview, family of origin SES, and adolescent health.”

Classified as probably not a substantial claim. May combine two claims.

The number of latent classes was chosen based on substantive interpretation and fit statistics (G2, AIC, BIC), with the lowest BIC indicating best fit.

“We chose the number of classes based on substantive interpretation and fit statistics (including the G2, Akaike Information Criterion [AIC], and Bayesian Information Criterion [BIC]; see Appendix A for fit statistics for all waves); the best-fitting results represented the lowest BIC.”

Probably not a substantial claim: may not pass S2 (checkable).

Identifying the specific pattern of the health lifestyle-health relationship can shed light on the production of health as it unfolds across the life course.

“Thus, identifying the specific pattern of the health lifestyle-health relationship can shed light on the production of health as it unfolds across the life course.”

May combine two claims.

Our tests were conservative, and associations were likely attenuated.

“Therefore, our tests were conservative, and associations were likely attenuated.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The study was unable to consider these diverse groups and their behavioral patterns in this paper.

“but we were unable to consider these diverse groups and their behavioral patterns in this paper.”

May combine two claims.

Our results supported both the pathway and imprint models to describe outcome-specific processes through which health lifestyles shape health across the transition to adulthood.

“Our results supported both the pathway and imprint models to describe outcome-specific processes through which health lifestyles shape health across the transition to adulthood.”