JMIR Publications

ABSTRACT

Background:

Practicing healthy lifestyles can reduce the risk to develop non-communicable diseases and the related mortality. However, engagement in healthy lifestyle behavior was suboptimal.

Objective:

To define individuals’ lifestyle characteristics before and during COVID-19 and determine the factors associated with practicing a healthy lifestyle. This cross-sectional study was conducted using data from the 2019 and 2021 Behavioural Risk Factor Surveillance System surveys.

Methods:

US individuals aged ≥ 18 years were interviewed via phone call. Healthy lifestyles were assessed through corresponding questions regarding the maintenance of optimal body weight, physical activity, daily consumption of five portions of fruits and vegetables, current smoking status and alcohol consumption. Missing data were imputed using the R statistical package. The effects of practicing a healthy lifestyle on cases without missing data and those with imputation were reported.

Results:

The rates of practicing a healthy lifestyle were 4.0% and 3.6% in 2019 and 2021, respectively. Although 36.6% of all the 2021 respondents had missing data, the results of the logistic regression analysis for cases without missing data and those with imputation were similar. Of the cases with imputation, women (odds ratio [OR] 1.87) residing in urban areas (OR 1.24) with high education levels (OR 1.73) and good or better health status (OR 1.59) were more likely to practice healthier lifestyles than young individuals (OR 0.51¬¬¬–0.67) with low household income (OR 0.74–0.78) and chronic health conditions (OR 0.48–0.74).

Conclusions:

A healthy lifestyle should be strongly promoted at the community level. In particular factors associated with a low rate of practice of healthy lifestyles should be targeted.