title: The Clustering of Lifestyle Behaviours in New Zealand and their Relationship with Optimal Wellbeing.
abstract: The purpose of this research was to determine (1) associations between multiple lifestyle behaviours and optimal wellbeing and (2) the extent to which five lifestyle behaviours-sleep, physical activity, sedentary behaviour, sugary drink consumption, and fruit and vegetable intake-cluster in a national sample.
  
  
  
  A national sample of New Zealand adults participated in a web-based wellbeing survey. Five lifestyle behaviours-sleep, physical activity, sedentary behaviour, sugary drink consumption, and fruit and vegetable intake-were dichotomised into healthy (meets recommendations) and unhealthy (does not meet recommendations) categories. Optimal wellbeing was calculated using a multi-dimensional flourishing scale, and binary logistic regression analysis was used to calculate the relationship between multiple healthy behaviours and optimal wellbeing. Clustering was examined by comparing the observed and expected prevalence rates (O/E) of healthy and unhealthy two-, three-, four-, and five-behaviour combinations.
  
  
  
  Data from 9425 participants show those engaging in four to five healthy behaviours (23 %) were 4.7 (95 % confidence interval (CI) 3.8-5.7) times more likely to achieve optimal wellbeing compared to those engaging in zero to one healthy behaviour (21 %). Clustering was observed for healthy (5 %, O/E 2.0, 95 % CI 1.8-2.2) and unhealthy (5 %, O/E 2.1, 95 % CI 1.9-2.3) five-behaviour combinations and for four- and three-behaviour combinations. At the two-behaviour level, healthy fruit and vegetable intake clustered with all behaviours, except sleep which did not cluster with any behaviour.
  
  
  
  Multiple lifestyle behaviours were positively associated with optimal wellbeing. The results show lifestyle behaviours cluster, providing support for multiple behaviour lifestyle-based interventions for optimising wellbeing.
authors.affiliation: Human Potential Centre, Auckland University of Technology, Private Bag 92006, Auckland, 1142, New Zealand. kate.prendergast@aut.ac.nz.
authors.forename: Kate B
authors.initials: KB
authors.lastname: Prendergast
authors.affiliation: Human Potential Centre, Auckland University of Technology, Private Bag 92006, Auckland, 1142, New Zealand.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Mackay
authors.affiliation: Human Potential Centre, Auckland University of Technology, Private Bag 92006, Auckland, 1142, New Zealand.
authors.forename: Grant M
authors.initials: GM
authors.lastname: Schofield
mesh_terms: D000328:Adult; D016000:Cluster Analysis; D015444:Exercise; D005260:Female; D005638:Fruit; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D015995:Prevalence; D012890:Sleep
keywords: Flourishing; Lifestyle behaviours; Positive health; Wellbeing