Rx Nutrition Resource Center
Rx Nutrition Resource Center
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Disclosures: The authors report no relevant financial disclosures.
May 29, 2020
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Few US adults participate in all recommended healthy behaviors

Source/Disclosures
Disclosures: The authors report no relevant financial disclosures.
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Less than 7% of U.S. adults engaged in all five healthy behaviors recommended by public health institutions, including HHS, the CDC, the American Lung Association and the American Cancer Society, researchers reported. These behaviors include exercise, maintaining a healthy diet and normal BMI, and avoiding cigarette smoking and excessive alcohol consumption.

The analysis was based on 26,194 National Health and Nutrition Examination Survey responses from adults aged 20 to 79 years. The results were recently published in the American Journal of Preventive Medicine.

“The data may have relevance toward the current pandemic where underlying health has an impact regarding case fatality rates,” Eric M. Hecht, MD, PhD, associate professor in the department of public health sciences at the University of Miami Miller School of Medicine, told Healio Primary Care. “Individuals vulnerable to COVID-19 include those with obesity, smokers and illnesses tied to failure to perform healthy behaviors.”

Eric Hecht
Eric M. Hecht

Hecht and colleagues tracked respondents’ BMI over a 12-year period. They assessed other healthy behaviors — alcohol and cigarette use, healthy diet and exercise — using the following survey questions:

  • Do you now smoke cigarettes?
  • In the past 12 months, how often did you drink any type of alcoholic beverage?
  • In the past 12 months, on those days that you drank alcoholic beverages, on average, how many drinks did you have?
  • In a typical week, do you do any vigorous-intensity sports, fitness or recreational activities that cause large increases in breathing or heart rate like running or basketball for at least 10 minutes continuously?
  • In a typical week, on how many days do you do vigorous-intensity sports, fitness or recreational activities?
  • How much time do you spend doing vigorous-intensity sports, fitness or recreational activities on a typical day?
  • How healthy is your overall diet?

The researchers found that smoking rates (P = .01) and adherence to a healthy BMI declined over time (P = .03). The percentage of respondents who participated in all five healthy behaviors over time ranged from 4.4% to 6.3%. Engagement in at least four behaviors ranged from 20.2% to 22.8% and participation in two or fewer behaviors ranged from 45.4% to 48.3%. The average number of total behaviors for the study cohort was 2.6.

Reference: Hecht EM, et al. Am J Prev Med. 2020;doi:10.1016/j.amepre.2020.02.013.

According to Hecht, there is no easy way for physicians to help increase patient participation rates.

“Most practitioners and public health educators tend to focus on one behavior, like smoking,” he said. “If the focus were on a number of behaviors, more substantial claims could be made by practitioners and public educators regarding substantial health benefits.”

Primary care physicians can consider using the “five A’s” model — Ask, Advise, Assess, Assist and Arrange — to facilitate discussions with patients about changing unhealthy behaviors, according to research published in American Family Physician.

Sample talking points include asking patients about engagement in unhealthy behaviors, describing the risks of negative behaviors, providing resources and discussing the next steps toward healthy behavior.

When having discussions, “patients are likely to respond more favorably to ‘I’ statements (‘I recommend...’) rather than ‘You’ statements (‘You should...’),” H. Russell Seabright, PhD, MPH, professor of psychology at Lake Superior State University, wrote. – by Janel Miller

References:

Hecht EM, et al. Am J Prev Med. 2020;doi:10.1016/j.amepre.2020.02.013.

Larzelere M, et al. Am Fam Physician. 2012;85:591-598.

Meriwether RA, et al. Am Fam Physician. 2008;77:1129-1136.

Seabright HR. Am Fam Physician. 2018;98:719-728.

Disclosures: The authors report no relevant financial disclosures.