Background and Aims: Adherence to an optimal lifestyle, defined as adequate physical activity, no use of tobacco, moderate alcohol use, and eating five servings of fruits and vegetables per day, has been associated with as much as 14 years of increased longevity and improved functional health status. Unfortunately, adherence to these optimal lifestyle behaviors is relatively low among the population. Furthermore, the extent to which adherence to multiple lifestyle behaviors is associated with specific disease incidence is unclear. Improved understanding of this association may hold significant potential for population health improvement strategies. The purpose of this investigation was to study the association of adherence to varying levels of an optimal lifestyle with the incidence of chronic disease among employed adults (N=35,684).
Methods: All baseline data were collected as part of a health assessment process during the year 2007. Participants were followed for two years. Descriptive statistics were calculated and reported as the proportion of the sample reporting a newly diagnosed chronic disease (diabetes, heart disease, hyperlipidemia, hypertension, back pain, or cancer) by the number of lifestyle behaviors that they practiced.
Results: Compared with individuals who practiced no or only 1 optimal lifestyle behavior, the risk of developing a condition for individuals practicing 3 or 4 behaviors was 66% lower for diabetes, 45% lower for heart disease, 17% lower for hyperlipidemia, 15% lower for hypertension, 43% lower for back pain, and 24% lower for cancer.
Conclusions: Adherence to optimal lifestyle is associated with lower 2-year incidence rates of several chronic conditions. Attention to population-based strategies that improve adherence to these four behaviors appears to positively affect risk of chronic diseases and their risk factors. To the extent that social marketing strategies and systematic measurement and feedback to individual members, patients, and groups (e.g., employer-based) increases adherence to multiple health behaviors, risk of chronic disease may be reduced.