Prospective associations between stressful life course events and clusters of lifestyle behaviours

The adoption of health-damaging lifestyle behaviours may be a coping mechanism stemming from maladaptive behavioural stress response to stress exposure, but little is known about the influence of stressors on health-damaging lifestyle behaviour clusters. This study aimed to identify clusters of lifestyle behaviours based on six lifestyle-related behaviours and to examine the associations between childhood adversity, stressful and traumatic life events, and the clusters of lifestyle behaviours in community-dwelling Australian adults.

This prospective study comprises 1773 adults aged 40-44 years at baseline from the Personality and Total Health (PATH) Through Life Study. Data on childhood adversity, stressful life events, traumatic life events were obtained from Wave 1 in 2000/2001 to Wave 3 in 2008/2009 and lifestyle behaviours were obtained at Wave 4 in 2012/2013 using self-reported surveys. Latent class analysis was conducted to identify distinct clusters of lifestyle behaviours using data from physical activity, alcohol consumption, insomnia, fruit and vegetable intake, and smoking status. Multinomial logistic regression analysis examined the associations between stressors and lifestyle behaviour clusters.

Three clusters of lifestyle behaviours labelled 'Poor sleep quality, low vegetable intake' (58.8%), 'Inactive, risky alcohol use, smoker' (3.3%), and 'Inactive, low fruit and vegetable intake, poor sleep quality, smoker' (35.9%) were identified. Exposure to stressful life events was associated with higher likelihood of belonging to the 'inactive, low fruit and vegetable intakes, poor sleep quality, smoker' cluster as opposed to the 'poor sleep quality, low vegetable intake's cluster (RRR = 1.42, 95% CI=[1.12, 1.81]) after adjusting for age, sex, educational level and income.

Our findings revealed an association between exposure to stressful life events and clustering of being physically inactive, low fruit and vegetable intake, poor sleep quality and smoking. Consequently, implementing health promotion strategies to target multiple lifestyle behaviours may be beneficial in reducing the cumulative impact of stress on health.