Clustering of multiple healthy lifestyle habits and health-related quality of life among US adults with diabetes

OBJECTIVE - We sought to examine the association between clustering of multiple healthy lifestyle habits (HLHs) and health-related quality of life (HRQOL) among adults with diabetes. RESEARCH DESIGN AND METHODS - We analyzed the representative sample of the civilian, noninstitutionalized U.S. population aged >= 18 years with diabetes using data from the 2005 Behavioral Risk Factor Surveillance System (n = 16,428). Four HRQOL measures were general health rating, physically unhealthy days, mentally unhealthy days, and impaired activity days. Three HLHs included not smoking, engaging in adequate leisure time physical activity, and consuming five or more servings of fruits and vegetables per day. RESULTS - The proportion of having 0, 1, 2, and 3 HLHs was 10.5, 44.7, 32.9, and 119% respectively. The age-adjusted prevalence rates of poor or fair health, >= 14 physically unhealthy days, >= 14 mentally unhealthy days, and >= 14 impaired activity days were 43.07, 27.61, 17.22, and 18.87%, respectively. After adjustment for potential confounders and comparison with none of the three HLHs, people with all three HLHs were less likely to report poor or fair health (adjusted odds ratio 0.49 [95% CI 0.33-0.711), >= 14 physically unhealthy days (0.56 [0.39-0.80]), >= 14 mentally unhealthy days (0.35 [0.23-0.55]), or >= 14 impaired activity days (0.35 [0.23-0.56]). CONCLUSIONS - Accumulation of multiple HLHs was significantly associated with better HRQOL among people with diabetes.