http://www.amjmed.com/webfiles/images/journals/ajm/AJMJune09King.pdf

ABSTRACT 

BACKGROUND: Lifestyle choices are associated with cardiovascular disease and mortality. The purpose of 

this study was to compare adherence to healthy lifestyle habits in adults between 1988 and 2006. 

METHODS: Analysis of adherence to 5 healthy lifestyle trends (5 fruits and vegetables/day, regular 

exercise 12 times/month, maintaining healthy weight [body mass index 18.5-29.9 kg/m2], moderate 

alcohol consumption [up to 1 drink/day for women, 2/day for men] and not smoking) in the National 

Health and Nutrition Examination Survey 1988-1994 were compared with results from the National Health 

and Nutrition Examination Survey 2001-2006 among adults aged 40-74 years. 

RESULTS: Over the last 18 years, the percent of adults aged 40-74 years with a body mass index 30 kg/m2 

has increased from 28% to 36% (P .05); physical activity 12 times a month or more has decreased from 

53% to 43% (P .05); smoking rates have not changed (26.9% to 26.1%); eating 5 or more fruits and 

vegetables a day has decreased from 42% to 26% (P .05), and moderate alcohol use has increased from 

40% to 51% (P .05). Adherence to all 5 healthy habits has gone from 15% to 8% (P .05). Although 

adherence to a healthy lifestyle was lower among minorities, adherence decreased more among non- 

Hispanic Whites over the period. Individuals with a history of hypertension/diabetes/cardiovascular disease 

were no more likely to be adherent to a healthy lifestyle than people without these conditions. 

CONCLUSIONS: Generally, adherence to a healthy lifestyle pattern has decreased during the last 18 years, 

with decreases documented in 3 of 5 healthy lifestyle habits. These findings have broad implications for 

the future risk of cardiovascular disease in adults. 

© 2009 Elsevier Inc. All rights reserved. 

• The American Journal of Medicine (2009) 122, 528-534