Interrelationships between self reported physical health and health behaviors among healthy US adults: From the NHANES 2009–2016

OBJECTIVES: Individuals who engage in regular physical activity, consume a healthy diet, have a normal body mass index (BMI), as well as avoid smoking and heavy alcohol consumption have lower risks of morbidity and mortality. While self-reported health is a strong predictor of morbidity and mortality, data are sparse about the interrelationship of concurrent healthy behaviors and self-reported health. STUDY DESIGN: Cross-sectional study design. METHODS: The sample included 7,267 individuals aged 30–50 years without diabetes, heart failure, cancer, myocardial infarction, stroke and emphysema from 2009 to 2016 of the National Health and Nutrition Examination Survey (NHANES). We used latent class analyses to identify concurrent healthy behaviors and explore interrelationships of class membership with self-reported health after adjusting for covariates using SAS® 9.4 software. RESULTS: Two mutually exclusive classes were found, “fewer healthy behaviors” and “more healthy behaviors”. “Fewer healthy behaviors” class members were less adherent to healthy guidelines while “more healthy behaviors” class members were more adherent. The two classes varied by smoking status, diet, and physical activity but not by BMI or alcohol consumption. Individuals in the “more healthy behaviors” class were associated with self-assessments of good (OR: 2.08; 95% CI: 1.15–3.79), very good (OR: 3.22; 95% CI: 1.78–3.79) and excellent (OR: 4.09; 95% CI: 2.11–7.94) health compared to those in the “fewer healthy behavior” class. CONCLUSIONS: We revealed two mutual exclusive classes with differing patterns of healthy behavior adherence. The class of individuals with more concurrent healthy behavior recommendations were more likely to self-assess their health more favorably.