Clustering of lifestyle characteristics and their association with cardio-metabolic health: the Lifestyles and Endothelial Dysfunction (EVIDENT) study

Br J Nutr. 2015 Sep 28;114(6):943-51. doi: 10.1017/S0007114515002500. Epub 2015 Aug 13.

Abstract

Little is known about the clustering patterns of lifestyle behaviours in adult populations. We explored clusters in multiple lifestyle behaviours including physical activity (PA), smoking, alcohol use and eating habits in a sample of adult population. A cross-sectional and multi-centre study was performed with six participating groups distributed throughout Spain. Participants (n 1327) were part of the Lifestyles and Endothelial Dysfunction (EVIDENT) study and were aged between 20 and 80 years. The lifestyle and cardiovascular risk (CVR) factors were analysed using a clustering method based on the HJ-biplot coordinates to understand the variables underlying these groupings. The following three clusters were identified. Cluster 1: unhealthy, 677 subjects (51%), with a slight majority of men (58.7%), who were more sedentary and smokers with higher consumption of whole-fat dairy products, bigger waist circumference as well as higher TAG levels, systolic blood pressure (SBP) and CVR. Cluster 2: healthy/PA, 265 subjects (20%), including 24.0% of males with high PA. Cluster 3: healthy/diet, including 29% of the participants, with a higher consumption of olive oil, fish, fruits, nuts, vegetables and lower alcohol consumption. Using the unhealthy cluster as a reference, and after adjusting for age and sex, the multiple regression analysis showed that belonging to the healthy/PA cluster was associated with a lower waist circumference, body fat percentage, SBP and CVR. In summary, the three clusters were identified according to lifestyles. The 'unhealthy' cluster had the least favourable clinical parameters, the 'healthy/PA' cluster had good HDL-cholesterol levels and low SBP and the 'healthy/diet' cluster had lower LDL-cholesterol levels and clinical blood pressure.

Trial registration: ClinicalTrials.gov NCT01083082.

Keywords: BP blood pressure; CVR cardiovascular risk; Cardiovascular risk; Clustering; EVIDENT Lifestyles and Endothelial Dysfunction; Lifestyle; Multi-centre studies; PA physical activity; PAIx peripheral augmentation index; Risk factors; SBP systolic BP.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Alcohol Drinking / adverse effects
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / physiopathology
  • Cardiovascular Diseases / prevention & control*
  • Cluster Analysis
  • Cross-Sectional Studies
  • Endothelium, Vascular / physiology*
  • Endothelium, Vascular / physiopathology
  • Female
  • Humans
  • Life Style*
  • Male
  • Middle Aged
  • Motor Activity*
  • Nutrition Policy*
  • Overweight / physiopathology
  • Patient Compliance*
  • Risk Factors
  • Sedentary Behavior
  • Sex Factors
  • Smoking / adverse effects
  • Spain / epidemiology
  • Young Adult

Associated data

  • ClinicalTrials.gov/NCT01083082