For example, a positive state of health seems to be correlated with low or no consumption of alcohol and tobacco, as well as with healthy nutrition and intense physical activity. The Korean National Health and Nutrition Examination Survey (KNHANES) is a nationally representative cross-sectional survey carried out since 1998 by the Korea Centers for Disease Control and Prevention (KCDC) to monitor the health and nutrition status of Korean citizens25. Individual lifestyle risk factors, such as obesity, physical inactivity, smoking, excessive alcohol consumption and poor diet, have been associated with an increased risk of various chronic diseases and premature death1,2,3,4.People who were single were at greater risk of showing a drinking lifestyle, a lifestyle that smokes, or a lifestyle with cumulative risk factors compared to married people. In addition, people in the lifestyle class who drink were more likely to have symptoms of depression or PTSD (table). Interventions and strategies that promote multiple healthy lifestyle behaviors can have substantial implications for reducing chronic diseases and premature death among Korean adults.
The justification of lifestyle-related risk factors taking into account physical activity and nutrition was based on the guidelines. However, we observed a greater attenuation of the association when smoking was excluded from the score, indicating that smoking is more harmful than other lifestyle-related risk behaviors. The present study also analyzed associations between lifestyle-related risk classes and mental health problems, something that had not been done before with a nationally representative sample in Germany. In a sensitivity analysis that excluded deaths that occurred during the first 3 years of follow-up, the association between lifestyle risk score and all-cause and cause-specific mortality did not change substantially (supplementary table).
Although the results indicate that more than half of the German population lived a relatively healthy lifestyle when it came to the consumption of alcohol, tobacco or illicit drugs, even people in the healthy lifestyle class showed low physical activity and an unhealthy diet. Men were more likely to follow a drinking lifestyle (24.4%) or to accumulate risk factors (1.7%) compared to women.