Current public health reports emphasize lifestyle modification, particularly quitting smoking, improved diet, increased physical activity and weight control, as the key to prevention and control of chronic diseases, according to background information in the article. Even though chronic diseases account for the greatest burden in terms of illness, diminished quality of life, and death, few Americans undertake the modifications that would result in a healthy lifestyle, the researchers found.

Mathew J. Reeves, Ph.D., of Michigan State University, East Lansing, and Ann P. Rafferty, Ph.D., of the Michigan Department of Community Health, Lansing, analyzed data from the 2000 Behavioral Risk Factor Surveillance System, annual statewide random-dialed telephone surveys, to determine the prevalence of four healthy lifestyle characteristics (HLCs): nonsmoking; healthy weight; consuming five or more fruits and vegetables a day; and regular physical activity. The researchers combined these four characteristics to generate a single indicator for a healthy lifestyle, scored by the number of healthy lifestyle characteristics were followed. A healthy lifestyle would be defined as following all four.

Using data from more than 153,000 adults from all 50 states, the researchers found that only three percent of U.S. adults maintain a healthy lifestyle with all four healthy lifestyle characteristics. Seventy-six percent of are nonsmoking. People were less likely to smoke if they were older, had more education, higher incomes and were in general better health. The 40.1 percent maintaining a healthy weight were likely to be younger, better educated and also in general better health. Only 23.3 percent of people reported consuming five or more fruits and vegetables a day and only 22.2 percent reported undertaking regular physical activity (at least 30 minutes of moderate physical activity at least five times a week).

"These data illustrate that a healthy lifestyle--defined as a combination of four HLCs--was undertaken by very few adults in the United States, and that no subgroup followed this combination to a level remotely consistent with clinical or public health recommendations," the authors conclude. "These data, along with those that illustrate the benefit of following a healthy lifestyle, support the need for comprehensive primary prevention activities to increase healthy lifestyles and to reduce the prevalence of chronic risk factors at the population level."

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