Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
권호 표지
DOI QR코드

DOI QR Code

High Risk Groups in Health Behavior Defined by Clustering of Smoking, Alcohol, and Exercise Habits: National Heath and Nutrition Examination Survey

흡연, 음주와 운동습관의 군집현상을 통한 건강행태의 고위험군: 국민건강영양 조사

  • Kang, Ki-Won (Department of Preventive Medicine, School of Public Health, Seoul National University) ;
  • Sung, Joo-Hon (Department of Preventive Medicine, School of Public Health, Seoul National University) ;
  • Kim, Chang-Yup (Department of Preventive Medicine, School of Public Health, Seoul National University)
  • 강기원 (서울대학교 보건대학원 예방의학교실) ;
  • 성주헌 (서울대학교 보건대학원 예방의학교실) ;
  • 김창엽 (서울대학교 보건대학원 예방의학교실)
  • Published : 2010.01.31
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives: We investigated the clustering of selected lifestyle factors (cigarette smoking, heavy alcohol consumption, lack of physical exercise) and identified the population characteristics associated with increasing lifestyle risks. Methods: Data on lifestyle risk factors, sociodemographic characteristics, and history of chronic diseases were obtained from 7,694 individuals ${\geq}20$ years of age who participated in the 2005 Korea National Health and Nutrition Examination Survey (KNHANES). Clustering of lifestyle risks involved the observed prevalence of multiple risks and those expected from marginal exposure prevalence of the three selected risk factors. Prevalence odds ratio was adopted as a measurement of clustering. Multiple correspondence analysis, Kendall tau correlation, Man-Whitney analysis, and ordinal logistic regression analysis were conducted to identify variables increasing lifestyle risks. Results: In both men and women, increased lifestyle risks were associated with clustering of: (1) cigarette smoking and excessive alcohol consumption, and (2) smoking, excessive alcohol consumption, and lack of physical exercise. Patterns of clustering for physical exercise were different from those for cigarette smoking and alcohol consumption. The increased unhealthy clustering was found among men 20-64 years of age with mild or moderate stress, and among women 35-49 years of age who were never-married, with mild stress, and increased body mass index (>$30\;kg/m^2$). Conclusions: Addressing a lack of physical exercise considering individual characteristics including gender, age, employment activity, and stress levels should be a focus of health promotion efforts.

Keywords

References

  1. World Health Organisation. The World Health Report 2002- Reducing Risks. Promoting Healthy Life. Geneva: WHO; 2002.
  2. Lee JJ, Yang JH, Hwang TY. Clustering of lifestyle risk factors in urban poor and rural adults. J Korean Soc Health Educ Promot 2005; 22(4): 167-177. (Korean)
  3. Institute of Medicine. Health and Behavior: The Interplay of Biological, Behavioral and Social Influences. Washingron DC: National Academy Press.; 2001.
  4. Schuit AJ, van Loon AJ, Tijhuis M, Ocke M. Clustering of lifestyle risk factors in a general adult population. Prev Med 2002; 35(3): 219-224. https://doi.org/10.1006/pmed.2002.1064
  5. Berrigan D, Dodd K, Troiano RP, Krebs-Smith SM, Barbash RB. Patterns of health behavior in U.S. adults. Prev Med 2003; 36(5): 615-623. https://doi.org/10.1016/S0091-7435(02)00067-1
  6. Slattery ML, Potter JD. Physical activity and colon cancer: Confounding or interaction?. Med Sci Sports Exerc 2002; 34(6): 913-919. https://doi.org/10.1097/00005768-200206000-00002
  7. Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, et al. Effect of potentially modifible risk associated with myocardial infarction in 52 countries(the INTERHEART study): Case- control study. Lancet 2004; 364(9438): 937- 952. https://doi.org/10.1016/S0140-6736(04)17018-9
  8. American Heart Association. Heart and Stroke Statistical Update. Dallas, Texas: American Heart Association; 1997.
  9. Johansson SE, Sundquist J. Change in lifestyle factors and their influence on health status and all-cause mortality. Int J Epidemiol 1999; 28(6): 1073-1080. https://doi.org/10.1093/ije/28.6.1073
  10. Prochaska JO. Multiple health behavior research represents the future of preventive medicine. Prev Med 2008; 46(3): 281-285. https://doi.org/10.1016/j.ypmed.2008.01.015
  11. Prochaska JJ, Velicer WF, Nigg CR, Prochaska JO. Methods of quantifying change in multiple risk factor interventions. Prev Med 2008; 46(3): 260-265. https://doi.org/10.1016/j.ypmed.2007.07.035
  12. Poortinga W. Prevalence and clustering of four major lifestyle risk factors in an English adult population. Prev Med 2007; 44(2): 124-128. https://doi.org/10.1016/j.ypmed.2006.10.006
  13. Chiolero A, Wietlisbach V, Ruffieux C, Paccaud F, Cornuz J. Clustering of risk behaviors with cigarrette consumption; A population-based survey. Prev Med 2006; 42(5): 348-353. https://doi.org/10.1016/j.ypmed.2006.01.011
  14. Mistry R, McCarthy WJ, Yancey AK, Lu Y, Patel M. Resilience and patterns of health risk behaviors in California adoloscents. Prev Med 2009; 48(3): 291-297. https://doi.org/10.1016/j.ypmed.2008.12.013
  15. Raitakari OT, Leino M, Rakkonen K, Porkka KV, Taimela S, Rasanen L, et al. Clustering of risk habits in young adults. The Cardiovascular Risk in Young Finns Study. Am J Epidemiol 1995; 142(1): 36-44. https://doi.org/10.1093/oxfordjournals.aje.a117543
  16. Keller S, Maddock JE, Hannover W, Thyrian JR, Basler HD. Multiple health risk behaviors in German first year university students. Prev Med 2008; 46(3): 189-195. https://doi.org/10.1016/j.ypmed.2007.09.008
  17. Emmons KM, Marcus BH, Linnan L, Rossi JS, Abrams DB. Mechanisms in multiple risk factor interventions: Smoking, physical activity, and dietary fat intake among manufacturing workers. Working Well Research Group. Prev Med 1994; 23(4): 481-489. https://doi.org/10.1006/pmed.1994.1066
  18. Pronk NP, Anderson LH, Crain AL, Martinson BC, O'Connor PJ, Sherwood NE, et al. Meeting recommendations for multiple healthy lifestyle factors: Prevalence, clustering and predictors among adolescent, adult and senior health plan members. Am J Prev Med 2005; 27(2): 25-33.
  19. Chou KL. Prevalence and clustering of four major lifestyle risk factors in Hong Kong Chinease older adults. J Aging Health 2008; 20(7): 788-803. https://doi.org/10.1177/0898264308321082
  20. Laaksonen M, Prattala R, Karisto A. Patterns of unhealthy behaviour in Finland. Eur J Public Health 2001; 11(3): 294-300. https://doi.org/10.1093/eurpub/11.3.294
  21. Fine LJ, Philogene GS, Gramling R, Coups EJ, Sinha S. Prevalence of multiple chronic disease risk factors: 2001 national health interview survey. Am J Prev Med 2004; 27(2 Suppl): 18-24. https://doi.org/10.1016/j.amepre.2004.04.017
  22. Rhee D, Yun SC, Khang YH. Co-occurrence of problem behaviors in South Korean adolescents: Findings from Korea Youth Panel Survey. J Adolesc Health 2007; 40(2): 195-197. https://doi.org/10.1016/j.jadohealth.2006.08.007
  23. Kang EJ. Clustering of lifestyle behaviors of Korean adults using smoking, drinking, and physical activity. Health Soc Welf Rev 2007; 27(2): 44-66. (Korean) https://doi.org/10.15709/hswr.2007.27.2.44
  24. Kim HC. Characteristic and Strategy of National Health and Nutrition Survey. Preventive Medicine Winter Symposium; 2007 Feb 13: Seoul, Korea. [cited 2009 Oct 28]; Available from: URL: http://web.richis.org/~prevent/ what/20070213a/ a02.pdf. (Korean)
  25. Ministry of Health and Social Welfare. The Report of the 2005 Korean National Health and Nutrition Survey. Kwachon: Ministry of Health and Social Welfare; 2007.(Korean)
  26. World Health Organization Regional Office for the Western Pacific (WPRO). The Asia-pacific perspective: Redefining obesity and its treatment. The International Association for the Study of Obesity (IASO) and the International Obesity Task Force (IOTF); 2000 [cited 2009 Oct 28]. Available from: URL: http://www.wpro.who.int/internet/resources.ashx/NUT/Redefining+obesity.pdf.
  27. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure: The JNC 7 report. JAMA 2003; 289(19): 2560-2572. https://doi.org/10.1001/jama.289.19.2560
  28. Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care 2003; 26(Suppl 1): S5-S20. https://doi.org/10.2337/diacare.26.2007.S5
  29. National Cholesterol Education Program(NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 2002; 106(25): 3143-3421.
  30. Guo XH, Zhang PH, Zeng ZC, Wang W, Li C, Shi Y et al. Combination patterns of cardiovascular risks and sequelase at different stage of hypertension in natural hypertensive population in Beijing. Clin Exp Hypertens 2009; 31(2): 142-155. https://doi.org/10.1080/10641960802621309
  31. Bezecri JP. Correspondence Analysis Handbook. New York: Marcel Dekker Inc.; 1992.
  32. Bae MK, Lee WK, Song CH, Lee KM, Jung SP. The factors associated with body mass index of adults. J Korean Acad Fam Med 1999; 20(7): 906-917. (Korean)
  33. Unger JB. Stages of change of smoking cessation: Relationships with other health behaviors. Am J Prev Med 1996; 12(2): 134-138.
  34. Lee SY, Kim SW, Park JW. Health behavior patterns of Korean. Korean J Prev Med 1997; 30(1): 181-194.
  35. Oh JD, Lee SY, Lee GL, Kim YJ, Kim YJ, Cho BM. Health behavior and metabolic syndrome. J Korean Acad Fam Med 2009; 30(2): 120-128. (Korean) https://doi.org/10.4082/kjfm.2009.30.2.120
  36. Lee KH, Chung WJ, Lee SM. Association of stress level with smoking. J Korean Acad Fam Med 2006; 27(1): 42- 48. (Korean)

Cited by

  1. 대규모 사업장 남녀 근로자의 직무스트레스 수준에 따른 건강행태 vol.40, pp.6, 2010, https://doi.org/10.4040/jkan.2010.40.6.852
  2. Five-Year Incidence of Periodontal Disease Is Related to Body Mass Index vol.90, pp.2, 2010, https://doi.org/10.1177/0022034510382548
  3. 당뇨 환자의 관리행태에 대한 군집 분류 vol.12, pp.2, 2010, https://doi.org/10.5762/kais.2011.12.2.765
  4. Smoking Prevalence and the Association between Smoking and Sociodemographic Factors Using the Korea National Health and Nutrition Examination Survey Data, 2008 to 2010 vol.5, pp.None, 2010, https://doi.org/10.4137/tui.s9841
  5. Habitual physical exercise has beneficial effects on telomere length in postmenopausal women vol.19, pp.10, 2012, https://doi.org/10.1097/gme.0b013e3182503e97
  6. Laryngeal pathologies in older Korean adults and their association with smoking and alcohol consumption vol.123, pp.2, 2010, https://doi.org/10.1002/lary.23603
  7. 사무직 남성 근로자의 이상지질혈증과 고혈압 영향 요인 vol.25, pp.4, 2010, https://doi.org/10.7475/kjan.2013.25.4.432
  8. 우리나라 성인의 건강행태군집 유형과 관련요인 vol.12, pp.8, 2010, https://doi.org/10.14400/jdc.2014.12.8.397
  9. 심뇌혈관질환자의 소득과 교육수준에 따른 건강행태 비교 - 2010-2011년도 국민건강영양조사 자료를 이용하여 - vol.15, pp.10, 2010, https://doi.org/10.5762/kais.2014.15.10.6223
  10. Clustering of lifestyle characteristics and their association with cardio-metabolic health: the Lifestyles and Endothelial Dysfunction (EVIDENT) study vol.114, pp.6, 2015, https://doi.org/10.1017/s0007114515002500
  11. 잠재계층분석을 활용한 결혼이주여성의 건강관련행동 군집유형과 영향요인 vol.32, pp.5, 2010, https://doi.org/10.14367/kjhep.2015.32.5.17
  12. Evaluation of the dermatologic life quality among cleanroom workers in a secondary battery factory vol.28, pp.None, 2010, https://doi.org/10.1186/s40557-016-0125-0
  13. 한국인 남녀에서 이상지질혈증 관련 건강생활 실천 규명 -국민건강영양조사 2012년 자료 이용- vol.14, pp.1, 2016, https://doi.org/10.14400/jdc.2016.14.1.327
  14. 성별에 따른 한국 중고령자의 건강 생활양식의 군집현상 및 우울감과의 관계 vol.33, pp.1, 2016, https://doi.org/10.14367/kjhep.2016.33.1.1
  15. The Effect of Non-regular Employment on the Health Behaviors, Mental Health and Quality of Life: Data from the Korea National Health and Nutrition Examination Survey 2013 vol.24, pp.3, 2016, https://doi.org/10.17547/kjsr.2016.24.3.127
  16. Prevalence and behavioural risk factors of light or moderate and heavy cigarette smoking in 32 countries vol.26, pp.6, 2010, https://doi.org/10.1080/14330237.2016.1250424
  17. 광주지역 제조업 근로자의 근무형태가 식습관에 미치는 영향 vol.49, pp.6, 2010, https://doi.org/10.4163/jnh.2016.49.6.495
  18. 한국 성인의 음주와 흡연 동시행위가 자살생각과 자살시도에 미치는 영향: 국민건강영양조사 자료 활용 vol.28, pp.6, 2010, https://doi.org/10.7475/kjan.2016.28.6.609
  19. Clustering of four major lifestyle risk factors among Korean adults with metabolic syndrome vol.12, pp.3, 2010, https://doi.org/10.1371/journal.pone.0174567
  20. Obesity Markers as Predictors for Colorectal Neoplasia vol.26, pp.1, 2010, https://doi.org/10.7570/jomes.2017.26.1.28
  21. 관상동맥질환자의 규칙적 운동이행 영향요인의 성별 비교: 국민건강영양조사 자료(2013~2015년) 활용 vol.25, pp.2, 2018, https://doi.org/10.7739/jkafn.2018.25.2.134
  22. Physical activity status by pain severity in patients with knee osteoarthritis: a nationwide study in Korea vol.19, pp.None, 2010, https://doi.org/10.1186/s12891-018-2301-6
  23. Adult Cancer Survivors’ Patterns of Smoking and Current Smoking-related Factors: Analysis on 2007-2011 Korea Medical Institute (KMI) Data vol.10, pp.1, 2010, https://doi.org/10.25055/jksrnt.2019.10.1.23
  24. Awareness and Utilization of Mobile Health and Preventive Health Behavior according to Cardiovascular Risk Factor Cluster Type in Early Middle-aged Male Workers vol.31, pp.5, 2010, https://doi.org/10.7475/kjan.2019.31.5.562
  25. Impact of Stress on Subway Station Workers’ Health Concern and Dietary Behavior in the Seoul Metro vol.29, pp.6, 2019, https://doi.org/10.17495/easdl.2019.12.29.6.482
  26. Association between Clustering of Lifestyle and Chronic Disease Using Healthcare Big Data vol.45, pp.2, 2010, https://doi.org/10.21032/jhis.2020.45.2.113
  27. Intergenerational Coresidential Patterns by Young Adult’s and Their Mother’s Mental Health and Substance Use vol.41, pp.9, 2010, https://doi.org/10.1177/0192513x19894348
  28. A study on the health effects of residents in Namhae and Hadong - Centered on health insurance data vol.19, pp.3, 2010, https://doi.org/10.15250/joie.2020.19.3.268
  29. Evaluation of Health-Habits with the S.M.A.R.T. Questionnaire: An Observational Study vol.10, pp.10, 2010, https://doi.org/10.3390/educsci10100285
  30. Factors related to the regular exercise participation of middle-aged and older people vol.37, pp.5, 2020, https://doi.org/10.14367/kjhep.2020.37.5.23
  31. 최근 한 달 이내 전자담배 흡연율 및 관련요인 vol.11, pp.2, 2010, https://doi.org/10.22156/cs4smb.2021.11.02.153
  32. Cross-Sectional Association between Hypercholesterolemia and Knee Pain in the Elderly with Radiographic Knee Osteoarthritis: Data from the Korean National Health and Nutritional Examination Survey vol.10, pp.5, 2010, https://doi.org/10.3390/jcm10050933
  33. An Association Rule Mining Analysis of Lifestyle Behavioral Risk Factors in Cancer Survivors with High Cardiovascular Disease Risk vol.11, pp.5, 2021, https://doi.org/10.3390/jpm11050366
  34. Development of a Nomogram for Predicting Depression in the Elderly Using Patient Health Questionnaire-9 among a Nationwide Sample of Korean Elderly vol.11, pp.7, 2010, https://doi.org/10.3390/jpm11070645
  35. Combined Effects of Unhealthy Lifestyle Behaviors on Metabolic Syndrome among Postmenopausal Women vol.9, pp.7, 2021, https://doi.org/10.3390/healthcare9070848
  36. Clustering of Healthy Behaviors and Related Factors among 19-64 Aged Korean Adults vol.46, pp.3, 2010, https://doi.org/10.21032/jhis.2021.46.3.267