Poor adherence to healthy lifestyle habits in U.S. adults

Despite the well-known benefits of having a lifestyle that includes physical activity, eating a diet high in fruits and vegetables, maintaining a healthy weight, moderate alcohol use and not smoking, only a small proportion of adults follow this healthy lifestyle pattern, and in fact, the numbers are declining, according to an article published in the June 2009 issue of The American Journal of Medicine. Lifestyle choices are associated with the risk of cardiovascular disease as well as diabetes.

Investigators from the Department of Family Medicine, Medical University of South Carolina, Charleston compared the results of two large-scale studies of the US population in 1988-1994 and in 2001-2006. In the intervening 18 years, the percentage of adults aged 40-74 years with a body mass index greater than 30 has increased from 28% to 36%; physical activity 12 times a month or more has decreased from 53% to 43%; 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%; and moderate alcohol use has increased from 40% to 51%. The number of people adhering to all 5 healthy habits has decreased from 15% to 8%.

The National Health and Nutrition Examination Survey (NHANES) is a national survey of non-institutionalized persons in the US conducted regularly by the National Center for Health Statistics. The researchers used data from a sub sample of the NHANES surveys of 1988-1994 and 2001-2006, adults aged 40-74 years, because this age span is the primary time for initial diagnosis of cardiovascular risk factors and disease. In the NHANES 1988-1994, the number of respondents 40-74 years old was 7340, representing a weighted sample size of 78,794,217. For NHANES 2001-2006, the number of respondents was 7811, for a weighted sample size of 65,476,573.

Since people with diagnosed health conditions such as cardiovascular disease, diabetes, hypertension, or high cholesterol were part of the samples, the researchers sought to determine whether such individuals were adhering to the healthy habits to a greater or lesser degree than people without those conditions, and whether adherence had changed over time. The study also concluded that people with cardiovascular disease, diabetes, high blood pressure or high cholesterol, or risk factors for those conditions, were no more likely to adhere to a healthy lifestyle pattern than people without such risk factors.

Writing in the article, Dana E. King, MD, MS, states, "The potential public health benefits from promoting a healthier lifestyle at all ages, and especially ages 40-74 years, are substantial. Regular physical activity and a prudent diet can reduce the risk of premature death and disability from a variety of conditions including coronary heart disease, and are strongly related to the incidence of obesity. In the US, medical costs due to physical inactivity and its consequences are estimated at $76 billion in 2000 dollars. Research indicates that individuals are capable of adopting healthy habits in middle age, and making an impact on cardiovascular risk."