Racial Differences in Maintaining Optimal Health Behaviors Into Middle Age

John N. Booth*, Norrina Bai Allen, David Calhoun, April P. Carson, Luqin Deng, David C. Goff, David T. Redden, Jared P. Reis, Daichi Shimbo, James M. Shikany, Stephen Sidney, Bonnie Spring, Cora E. Lewis, Paul Muntner

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Introduction: Earlier development of cardiovascular disease risk factors in blacks versus whites may result from differences in maintaining health behaviors. Age-specific racial differences in maintaining health behaviors from ages 18 to 50 years were determined. Methods: In 1985–1986, the population-based Coronary Artery Risk Development in Young Adults study enrolled 5,115 participants aged 18–30 years. In 2017, a total of 2,485 blacks and 2,407 whites with one or more optimal health behaviors at baseline who attended one or more of seven follow-up exams over 25 years (i.e., through 2010–2011) were analyzed. The primary outcome, maintaining four or more optimal health behaviors, included BMI <25; never smoking; ≥150 minutes/week of moderate to vigorous physical activity; no/moderate alcohol intake (women/men: zero to seven/zero to 14 drinks per week); and Dietary Approaches to Stop Hypertension diet adherence score ≥15 (i.e., baseline highest quartile). Hazard ratios comparing blacks with whites for maintaining optimal health behaviors were calculated among participants with each optimal behavior at baseline. Results: From ages 18 to 50 years, 2.6% of blacks and 9.2% of whites maintained four or more optimal health behaviors (for optimal BMI: 16.0% and 30.1%, smoking status: 74.6% and 78.4%, physical activity: 17.7% and 21.4%, alcohol intake: 68.4% and 64.6%, diet adherence: 3.9% and 10.3%, respectively). The multivariable adjusted hazard ratio comparing blacks with whites was 0.63 (95% CI=0.56, 0.72) for maintaining four or more optimal health behaviors (for optimal BMI: 0.82 [95% CI=0.66, 1.01], smoking status: 0.57 [95% CI=0.52, 0.62], physical activity: 0.83 [95% CI=0.75, 0.91], alcohol intake: 1.19 [95% CI=1.03, 1.37], diet adherence: 0.71 [95% CI=0.61, 0.82]). Conclusions: Fewer blacks than whites maintained four or more optimal health behaviors until age 50 years, but maintenance was low among both races.

Original languageEnglish (US)
Pages (from-to)368-375
Number of pages8
JournalAmerican Journal of Preventive Medicine
Volume56
Issue number3
DOIs
StatePublished - Mar 1 2019

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Health Behavior
Smoking
Alcohols
Exercise
Diet
Young Adult
Coronary Vessels
Cardiovascular Diseases
Maintenance
hydroquinone
Hypertension
Population

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health

Cite this

Booth, John N. ; Allen, Norrina Bai ; Calhoun, David ; Carson, April P. ; Deng, Luqin ; Goff, David C. ; Redden, David T. ; Reis, Jared P. ; Shimbo, Daichi ; Shikany, James M. ; Sidney, Stephen ; Spring, Bonnie ; Lewis, Cora E. ; Muntner, Paul. / Racial Differences in Maintaining Optimal Health Behaviors Into Middle Age. In: American Journal of Preventive Medicine. 2019 ; Vol. 56, No. 3. pp. 368-375.
@article{6f34fd74d0b04a2fbd4c8690a819189b,
title = "Racial Differences in Maintaining Optimal Health Behaviors Into Middle Age",
abstract = "Introduction: Earlier development of cardiovascular disease risk factors in blacks versus whites may result from differences in maintaining health behaviors. Age-specific racial differences in maintaining health behaviors from ages 18 to 50 years were determined. Methods: In 1985–1986, the population-based Coronary Artery Risk Development in Young Adults study enrolled 5,115 participants aged 18–30 years. In 2017, a total of 2,485 blacks and 2,407 whites with one or more optimal health behaviors at baseline who attended one or more of seven follow-up exams over 25 years (i.e., through 2010–2011) were analyzed. The primary outcome, maintaining four or more optimal health behaviors, included BMI <25; never smoking; ≥150 minutes/week of moderate to vigorous physical activity; no/moderate alcohol intake (women/men: zero to seven/zero to 14 drinks per week); and Dietary Approaches to Stop Hypertension diet adherence score ≥15 (i.e., baseline highest quartile). Hazard ratios comparing blacks with whites for maintaining optimal health behaviors were calculated among participants with each optimal behavior at baseline. Results: From ages 18 to 50 years, 2.6{\%} of blacks and 9.2{\%} of whites maintained four or more optimal health behaviors (for optimal BMI: 16.0{\%} and 30.1{\%}, smoking status: 74.6{\%} and 78.4{\%}, physical activity: 17.7{\%} and 21.4{\%}, alcohol intake: 68.4{\%} and 64.6{\%}, diet adherence: 3.9{\%} and 10.3{\%}, respectively). The multivariable adjusted hazard ratio comparing blacks with whites was 0.63 (95{\%} CI=0.56, 0.72) for maintaining four or more optimal health behaviors (for optimal BMI: 0.82 [95{\%} CI=0.66, 1.01], smoking status: 0.57 [95{\%} CI=0.52, 0.62], physical activity: 0.83 [95{\%} CI=0.75, 0.91], alcohol intake: 1.19 [95{\%} CI=1.03, 1.37], diet adherence: 0.71 [95{\%} CI=0.61, 0.82]). Conclusions: Fewer blacks than whites maintained four or more optimal health behaviors until age 50 years, but maintenance was low among both races.",
author = "Booth, {John N.} and Allen, {Norrina Bai} and David Calhoun and Carson, {April P.} and Luqin Deng and Goff, {David C.} and Redden, {David T.} and Reis, {Jared P.} and Daichi Shimbo and Shikany, {James M.} and Stephen Sidney and Bonnie Spring and Lewis, {Cora E.} and Paul Muntner",
year = "2019",
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language = "English (US)",
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}

Booth, JN, Allen, NB, Calhoun, D, Carson, AP, Deng, L, Goff, DC, Redden, DT, Reis, JP, Shimbo, D, Shikany, JM, Sidney, S, Spring, B, Lewis, CE & Muntner, P 2019, 'Racial Differences in Maintaining Optimal Health Behaviors Into Middle Age', American Journal of Preventive Medicine, vol. 56, no. 3, pp. 368-375. https://doi.org/10.1016/j.amepre.2018.10.020

Racial Differences in Maintaining Optimal Health Behaviors Into Middle Age. / Booth, John N.; Allen, Norrina Bai; Calhoun, David; Carson, April P.; Deng, Luqin; Goff, David C.; Redden, David T.; Reis, Jared P.; Shimbo, Daichi; Shikany, James M.; Sidney, Stephen; Spring, Bonnie; Lewis, Cora E.; Muntner, Paul.

In: American Journal of Preventive Medicine, Vol. 56, No. 3, 01.03.2019, p. 368-375.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Racial Differences in Maintaining Optimal Health Behaviors Into Middle Age

AU - Booth, John N.

AU - Allen, Norrina Bai

AU - Calhoun, David

AU - Carson, April P.

AU - Deng, Luqin

AU - Goff, David C.

AU - Redden, David T.

AU - Reis, Jared P.

AU - Shimbo, Daichi

AU - Shikany, James M.

AU - Sidney, Stephen

AU - Spring, Bonnie

AU - Lewis, Cora E.

AU - Muntner, Paul

PY - 2019/3/1

Y1 - 2019/3/1

N2 - Introduction: Earlier development of cardiovascular disease risk factors in blacks versus whites may result from differences in maintaining health behaviors. Age-specific racial differences in maintaining health behaviors from ages 18 to 50 years were determined. Methods: In 1985–1986, the population-based Coronary Artery Risk Development in Young Adults study enrolled 5,115 participants aged 18–30 years. In 2017, a total of 2,485 blacks and 2,407 whites with one or more optimal health behaviors at baseline who attended one or more of seven follow-up exams over 25 years (i.e., through 2010–2011) were analyzed. The primary outcome, maintaining four or more optimal health behaviors, included BMI <25; never smoking; ≥150 minutes/week of moderate to vigorous physical activity; no/moderate alcohol intake (women/men: zero to seven/zero to 14 drinks per week); and Dietary Approaches to Stop Hypertension diet adherence score ≥15 (i.e., baseline highest quartile). Hazard ratios comparing blacks with whites for maintaining optimal health behaviors were calculated among participants with each optimal behavior at baseline. Results: From ages 18 to 50 years, 2.6% of blacks and 9.2% of whites maintained four or more optimal health behaviors (for optimal BMI: 16.0% and 30.1%, smoking status: 74.6% and 78.4%, physical activity: 17.7% and 21.4%, alcohol intake: 68.4% and 64.6%, diet adherence: 3.9% and 10.3%, respectively). The multivariable adjusted hazard ratio comparing blacks with whites was 0.63 (95% CI=0.56, 0.72) for maintaining four or more optimal health behaviors (for optimal BMI: 0.82 [95% CI=0.66, 1.01], smoking status: 0.57 [95% CI=0.52, 0.62], physical activity: 0.83 [95% CI=0.75, 0.91], alcohol intake: 1.19 [95% CI=1.03, 1.37], diet adherence: 0.71 [95% CI=0.61, 0.82]). Conclusions: Fewer blacks than whites maintained four or more optimal health behaviors until age 50 years, but maintenance was low among both races.

AB - Introduction: Earlier development of cardiovascular disease risk factors in blacks versus whites may result from differences in maintaining health behaviors. Age-specific racial differences in maintaining health behaviors from ages 18 to 50 years were determined. Methods: In 1985–1986, the population-based Coronary Artery Risk Development in Young Adults study enrolled 5,115 participants aged 18–30 years. In 2017, a total of 2,485 blacks and 2,407 whites with one or more optimal health behaviors at baseline who attended one or more of seven follow-up exams over 25 years (i.e., through 2010–2011) were analyzed. The primary outcome, maintaining four or more optimal health behaviors, included BMI <25; never smoking; ≥150 minutes/week of moderate to vigorous physical activity; no/moderate alcohol intake (women/men: zero to seven/zero to 14 drinks per week); and Dietary Approaches to Stop Hypertension diet adherence score ≥15 (i.e., baseline highest quartile). Hazard ratios comparing blacks with whites for maintaining optimal health behaviors were calculated among participants with each optimal behavior at baseline. Results: From ages 18 to 50 years, 2.6% of blacks and 9.2% of whites maintained four or more optimal health behaviors (for optimal BMI: 16.0% and 30.1%, smoking status: 74.6% and 78.4%, physical activity: 17.7% and 21.4%, alcohol intake: 68.4% and 64.6%, diet adherence: 3.9% and 10.3%, respectively). The multivariable adjusted hazard ratio comparing blacks with whites was 0.63 (95% CI=0.56, 0.72) for maintaining four or more optimal health behaviors (for optimal BMI: 0.82 [95% CI=0.66, 1.01], smoking status: 0.57 [95% CI=0.52, 0.62], physical activity: 0.83 [95% CI=0.75, 0.91], alcohol intake: 1.19 [95% CI=1.03, 1.37], diet adherence: 0.71 [95% CI=0.61, 0.82]). Conclusions: Fewer blacks than whites maintained four or more optimal health behaviors until age 50 years, but maintenance was low among both races.

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JF - American Journal of Preventive Medicine

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