title: The prevalence and clustering of four major lifestyle risk factors in an English adult population.
abstract: BACKGROUND
  The aim of this study was to examine the clustering of four major lifestyle risk factors (smoking, heavy drinking, lack of fruit and vegetables consumption, and lack of physical activity), and to examine the variation across different socio-demographic groups in the English adult population.
  
  
  METHODS
  The study population was derived from the 2003 Health Survey for England (n=11,492). Clustering was examined by comparing the observed and expected prevalence of the different possible combinations. A multinomial multilevel regression model was conducted to examine the socio-demographic variation in the clustering of the four risk factors.
  
  
  RESULTS
  The study found that, when using British health recommendations, a majority of the English population have multiple lifestyle risk factors at the same time. Clustering was found at both ends of the lifestyle spectrum and was more pronounced for women than for men. Overall, multiple risk factors were more prevalent among men, lower social class households, singles, and people who are economically inactive, but less prevalent among home owners and older age groups.
  
  
  CONCLUSIONS
  The clustering of multiple risk factors provides support for multiple-behavior interventions as opposed to single-behavior interventions.
authors.affiliation: Cardiff University, UK. poortingaw@cardiff.ac.uk
authors.forename: Wouter
authors.initials: W
authors.lastname: Poortinga
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking; D016000:Cluster Analysis; D004739:England; D005260:Female; D015438:Health Behavior; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D015995:Prevalence; D012307:Risk Factors; D012309:Risk-Taking; D012907:Smoking