title: Multiple healthy behaviors and optimal self-rated health: findings from the 2007 Behavioral Risk Factor Surveillance System Survey.
abstract: OBJECTIVE
  The aim of this study was to examine the association between the number of healthy behaviors (i.e., not currently smoking, not currently drinking excessively, physically active, and consuming fruits and vegetables five or more times per day) and optimal self-rated health (SRH) among U.S. adults or adults with cardiovascular diseases (CVDs) or diabetes.
  
  
  METHODS
  We estimated the age-standardized prevalence of optimal SRH among a total of 430,912 adults who participated in the 2007 Behavioral Risk Factor Surveillance System (BRFSS). Prevalence ratios were produced with multivariate Cox regression models using number of healthy behaviors as a predictor; status of optimal SRH was used as an outcome variable while controlling for sociodemographic and health risk factors.
  
  
  RESULTS
  The age-standardized prevalence of reporting optimal SRH was 83.5%, 55.6%, and 56.3% among adults overall, and adults with CVDs or diabetes, respectively. Also in the aforementioned order, adults who reported having four healthy behaviors had 33%, 85%, and 87% increased likelihoods of reporting optimal SRH, when compared to their counterparts who reported none of these behaviors.
  
  
  CONCLUSIONS
  The findings of this study indicate that number of healthy behaviors is associated with optimal SRH among adults, especially adults with CVDs or diabetes. These findings reinforce the support for identifying and implementing clinical and population-based intervention strategies that effectively promote multiple healthier lifestyle behaviors among adults.
authors.affiliation: Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention, Atlanta, GA 30341, USA. jxt9@cdc.gov
authors.forename: James
authors.initials: J
authors.lastname: Tsai
authors.forename: Earl S
authors.initials: ES
authors.lastname: Ford
authors.forename: Chaoyang
authors.initials: C
authors.lastname: Li
authors.forename: Guixiang
authors.initials: G
authors.lastname: Zhao
authors.forename: William S
authors.initials: WS
authors.lastname: Pearson
authors.forename: Lina S
authors.initials: LS
authors.lastname: Balluz
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D040343:Behavioral Risk Factor Surveillance System; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000523:psychology; D016009:Chi-Square Distribution; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000523:psychology; D059026:Diagnostic Self Evaluation; D004032:Diet / Q000706:statistics & numerical data; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D016016:Proportional Hazards Models; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult