Achieving a healthy lifestyle among United States adults: a long way to go

The United States population has been advised to engage in various healthy lifestyle factors known to be associated with reduced morbidity and mortality from various chronic conditions. These include not smoking, adequate fruit and vegetable intake, adequate physical activity, and normal body weight. Little is known about the prevalence of United States adults who engage in all four of these behaviors, however.

Cross-sectional analysis.

The third National Health and Nutrition Examination Survey (1988-1994).

16,176 participants aged > or = 21 years.

Percentage of participants engaging in four healthy lifestyle factors.

Overall, 6.8% of the US population engaged in all four healthy lifestyle factors. Women were more likely than men (P = .001), and Whites and participants of "other race or ethnicity" were more likely than African Americans and Mexican Americans to engage in all four healthy lifestyle factors. A significant positive educational gradient was also evident (P for linear trend <.001). The highest percentages of participants engaging in all four lifestyle factors occurred among men (15.8%) and women (18.4%) of "other" race who had at least 13 years of education. The lowest percentages were observed for White men (1.1%) and African-American women (0.9%) with little education.

The small proportion of US adults engaging in four healthy lifestyle factors demonstrates the enormity of the task that awaits the public health community in persuading Americans to adopt a multidimensional healthy lifestyle.