Healthy Lifestyle Characteristics Among Adults in the United States, 2000 Mathew J. Reeves, PhD; Ann P. Rafferty, PhD
Background: Many public health recommendations and clinical guidelines emphasize the importance of healthy lifestyles. Recent epidemiologic studies demonstrate that following a healthy lifestyle has substantial health benefits. The objectives of this study were to report on the prevalence of healthy lifestyle characteristics (HLCs) and to generate a single indicator of a healthy lifestyle. Methods: National data for the year 2000 were ob-
port prevalences of each HLC and the indicator by major demographic subgroups. Results: By using data from more than 153 000 adults, the prevalence (95% confidence interval) of the individual HLCs was as follows: nonsmoking, 76.0% (75.6%76.4%); healthy weight, 40.1% (39.7%-40.5%); 5 fruits and vegetables per day, 23.3% (22.9%-23.7%); and regular physical activity, 22.2% (21.8%-22.6%). The overall prevalence of the healthy lifestyle indicator (ie, having all 4 HLCs) was only 3.0% (95% confidence interval, 2.8%-3.2%), with little variation among subgroups (range, 0.8%-5.7%). Conclusion: These data illustrate that a healthy lifestyle—
tained from the Behavioral Risk Factor Surveillance System, which consists of annual, statewide, random digit– dialed household telephone surveys. We defined the following 4 HLCs: nonsmoking, healthy weight (body mass index [calculated as weight in kilograms divided by the square of height in meters] of 18.5-25.0), consuming 5 or more fruits and vegetables per day, and regular physical activity ( 30 minutes for 5 times per week). The 4 HLCs were summed to create a healthy lifestyle index (range, 0-4), and the pattern of following all 4 HLCs was defined as a single healthy lifestyle indicator. We re-
defined as a combination of 4 HLCs—was undertaken by very few adults in the United States, and that no subgroup followed this combination to a level remotely consistent with clinical or public health recommendations. Arch Intern Med. 2005;165:854-857 style.15,16 For example, the Nurses’ Health Study found that the risk of coronary heart disease15 and type 2 diabetes mellitus16 was reduced 5- and 10-fold, respectively, among those who engaged in 5 modifiable healthy behaviors. However, only 3% of the nurses actually engaged in this lifestyle. We chose to estimate the prevalence of 4 healthy lifestyle characteristics (HLCs) (ie, nonsmoking, healthy weight, fruit and vegetable consumption, and leisure time physical activity [LTPA]) using a nationally representative sample of US adults, and to generate a single indicator of a healthy lifestyle defined by undertaking all 4 HLCs. METHODS The Behavioral Risk Factor Surveillance System (BRFSS) is composed of annual, statewide, random digit–dialed household telephone surveys of adults.17,18 We pooled the 2000 BRFSS responses from all 50 states and the District of Columbia, and restricted the sample to respondents aged 18 to 74 years. The median
Author Affiliations: Department of Epidemiology, College of Human Medicine, Michigan State University, East Lansing (Dr Reeves); and Bureau of Epidemiology, Michigan Department of Community Health, Lansing (Dr Rafferty). Financial Disclosure: None.
N THE UNITED STATES AND worldwide, chronic diseases account for the greatest overall population disease burden in terms of mortality, morbidity, and decreased quality of life.1 Most people with major chronic diseases share multiple common lifestyle characteristics or behaviors, particularly smoking, poor diet, physical inactivity, and obesity.2 Tobacco, poor diet, and physical inactivity have been identified as leading contributors to overall mortality in the United States.3 The public health importance of these lifestyle characteristics can also be gauged by their inclusion in major public health reports on smoking,4,5 physical activity,6 and diet,7 and in clinical guidelines...