School of Kinesiology and Health Studies, Queen's University, 28 Division Street Kingston, Ontario, Canada K7L 3 N6.
Prev Sci. 2012 Apr;13(2):183-95. doi: 10.1007/s11121-011-0255-0.
Clustering of unhealthy behaviors has been reported in previous studies; however the link with all-cause mortality and differences between those with and without chronic disease requires further investigation.
To observe the clustering effects of unhealthy diet, fitness, smoking, and excessive alcohol consumption in adults with and without chronic disease and to assess all-cause mortality risk according to the clustering of unhealthy behaviors.
Participants were 13,621 adults (aged 20-84) from the Aerobics Center Longitudinal Study. Four health behaviors were observed (diet, fitness, smoking, and drinking). Baseline characteristics of the study population and bivariate relations between pairs of the health behaviors were evaluated separately for those with and without chronic disease using cross-tabulation and a chi-square test. The odds of partaking in unhealthy behaviors were also calculated. Latent class analysis (LCA) was used to assess clustering. Cox regression was used to assess the relationship between the behaviors and mortality.
The four health behaviors were related to each other. LCA results suggested that two classes existed. Participants in class 1 had a higher probability of partaking in each of the four unhealthy behaviors than participants in class 2. No differences in health behavior clustering were found between participants with and without chronic disease. Mortality risk increased relative to the number of unhealthy behaviors participants engaged in.
Unhealthy behaviors cluster together irrespective of chronic disease status. Such findings suggest that multi-behavioral intervention strategies can be similar in those with and without chronic disease.
之前的研究报告了不健康行为的聚类现象；然而，这种聚类与全因死亡率之间的联系，以及患有和不患有慢性疾病的人群之间的差异，还需要进一步研究。
观察患有和不患有慢性疾病的成年人中不健康饮食、健身、吸烟和过量饮酒行为的聚类效应，并根据不健康行为的聚类评估全因死亡率风险。
参与者为来自有氧运动中心纵向研究的 13621 名成年人（年龄 20-84 岁）。观察了四项健康行为（饮食、健身、吸烟和饮酒）。使用交叉表和卡方检验分别评估患有和不患有慢性疾病的研究人群的基线特征以及健康行为之间的两两关系。还计算了参与不健康行为的几率。潜在类别分析（LCA）用于评估聚类。Cox 回归用于评估行为与死亡率之间的关系。
四项健康行为相互关联。LCA 结果表明存在两个类别。与类别 2 相比，类别 1 的参与者更有可能参与四项不健康行为中的每一项。患有和不患有慢性疾病的参与者之间，健康行为聚类没有差异。死亡率随着参与者参与的不健康行为数量的增加而增加。
无论是否患有慢性疾病，不健康行为都会聚集在一起。这些发现表明，多行为干预策略在患有和不患有慢性疾病的人群中可能是相似的。
