Lifestyle behavior patterns and mortality among adults in the NHANES 1988–1994 population: A latent profile analysis

Jennifer S. Davis, Emilyn Banfield, Hwa Young Lee, Ho Lan Peng, Shine Chang, Alexis C. Wood

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Evidence suggests interdependent associations of individual modifiable behaviors with health outcomes. However, such interrelations have not been accounted for in previous behavior-outcome associations. We conducted latent profile analysis (LPA) on self-reported levels of alcohol consumption, restaurant dining, vitamin/mineral supplement use, physical activity (PA) and smoke exposure (first- and second-hand smoke) separately for smokers (N = 4530) and non-smokers (N = 13,421) using data from the third National Health and Nutrition Examination Survey (NHANES III) to identify subgroups with similar levels within and across behaviors. Cox-proportional hazards models were used to compare mortality rates between subgroups from cancer, cardiovascular disease (CVD) and all-causes at an average of 16.4 (±6.1) years follow-up. Five behavioral typologies were identified in non-smokers (“Moderates”, “Low Risk Factors”, “Restaurant Diners”, “Moderate Passive Smokers” and “Heavy Passive Smokers”), and four in smokers (“Moderates”, “Low Risk Factors”, “Heavy Smokers” and “Physically Active”). As a group, “Moderates” had levels of each behavior that were not significantly different from at least one other group. Compared to “Moderates”, in non-smokers “Restaurant Diners” had lower hazard from all-cause (hazard ratio (HR):0.84, 95% CI:0.74–0.97) and CVD (HR:0.59, 0.43–0.82) mortality, while “Low Risk Factors” had higher cancer mortality (HR:1.38,1.03–1.84). In smokers, compared to “Moderates”, higher hazards for mortality were found for “Heavy Smokers” (all cause: HR:1.34, 1.12–1.60; CVD: HR:1.52, 1.04–2.23; cancer: HR:1.41 1.02–1.96) and “Low Risk Factors” (all-cause: HR:1.58, 1.14–2.17). Taken together, when restaurant dining, PA and smoking exposures are grouped together, novel predictions for mortality occur, suggesting data on multiple behaviors may be informative for risk stratification.

Original languageEnglish (US)
Pages (from-to)131-139
Number of pages9
JournalPreventive Medicine
Volume120
DOIs
StatePublished - Mar 2019

Keywords

  • Latent profile analysis
  • Lifestyle patterns
  • Mortality
  • NHANES

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health

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