Background: Reaching national health objectives depends upon our ability to encourage the performance of multiple good health behaviors. There are cognitive, social, and biological reasons for expecting health behaviors to cluster. However, few studies have found significant associations among health behaviors, with the exception of the documented link between smoking and alcohol consumption.
Methods: We used cluster analysis to identify population subgroups with similar patterns of diet quality, physical activity, alcohol consumption, and cigarette smoking. This is the first study of health behavior interrelationships to include a measure of overall diet quality and a large sample from a nationally representative survey of U.S. adults.
Results: We identified seven health behavior typologies: 10% of the sample (health promoting lifestyle) had an overall healthy lifestyle, 25% had a good diet but sedentary activity level, 18% had fair diet but high activity level (fitness lifestyle). Individuals in the passive lifestyle cluster (25%) had no active health promoting activities but did avoid risk taking health behaviors. Six percent of the sample were in a drinking cluster, 15% in a smoking cluster, and 2% had a hedonic lifestyle characterized by heavy drinking and smoking. These lifestyle clusters could be characterized by demographic and socioeconomic factors.
Conclusions: This research indicates that it is possible to identify a discrete number of health lifestyles in a population sample of U.S. adults. Understanding past, present, and changing health lifestyles may provide insights for health behavior research and information for the development and targeting of public health programs that can impact on multifactorial chronic diseases.