Health Behavior Combinations and Their Association With Inflammation

Abstract

Purpose: Studies have examined the independent and additive effects of health behaviors (e.g., physical activity, diet, sleep, and smoking) on systemic inflammation, but we know little about whether different pairs of these behaviors differentially influence inflammation, which was the purpose of this study. Design: Cross-sectional. Setting: The National Health and Nutrition Examination Survey (NHANES) 2005–2006. Subjects: A total of 2051 adults (≥20 years). Measures: A questionnaire/interview was used to assess sleep and dietary behavior; physical activity was assessed via accelerometry; smoking was assessed via cotinine levels; and a blood sample was taken to assess systemic inflammation (C-reactive protein; [CRP]). Analysis: Multivariable linear regression analysis. Results: Six health behavior pairs were evaluated: (1) active and healthy diet, (2) active and adequate sleep, (3) active and nonsmoker, (4) healthy diet and adequate sleep, (5) healthy diet and nonsmoker, and (6) adequate sleep and nonsmoker. After adjusting for age, gender, race-ethnicity, poverty level, and chronic disease, only active and nonsmoker (β = −.15) and healthy diet and adequate sleep (β = −.16) were associated with CRP. Conclusion: Regular physical activity and smoking avoidance and healthy eating and adequate sleep were the two health behavior pairs associated with less inflammation. This suggests that certain health behaviors may act synergistically on reducing systemic inflammation, whereas other health behavior combinations may not. Such knowledge may help to develop and implement tailored health behavior interventions.