Healthy lifestyle as a way to manage health risks: Components and factors. Analytical review

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613.7
DOI: 
10.21668/health.risk/2023.4.15.eng
Authors: 

Ji Kang, Rosalam Che Me, Khairul Manami Kamarudin, Ruhaizin Sulaiman

Organization: 

University Putra Malaysia, Selangor, 43400, Malaysia

Abstract: 

Healthy lifestyle promotion is a strategic task within health protection and healthcare worldwide. A prevailing contribution made by non-communicable diseases into premature death and a decrease in life expectancy makes it necessary to search for effective prevention and technologies able to persuade people to adhere to health protection behavior.

The review concentrates on approaches to defining, structuring and empirical study of persuasive design of healthy lifestyle. Substantiation is provided for including physical, mental and social health protection into healthy lifestyle. The review also discusses a possibility to use the Health-Promoting Lifestyle Profile (HPLP II) scale to analyze health behavior, including Asian countries. Structural components of healthy lifestyle are identified on the basis of the HPLP II scale.

Additionally, several mainstream health behavior theories and models have been selected and analyzed, which explain people’s health behavior. They provide a theoretical basis for exploring influential factors of a healthy lifestyle. Contributions made by sociodemographic and cognitive factors have also been outlines and substantiation has been provided for the necessity to consider such factors as self-efficacy and subjective health perception when developing individual prevention.
This research holds valuable reference and guiding significance for the design and implementation of strategies aimed at influencing people's healthy lifestyles in related fields.

Keywords: 
healthy lifestyle, health behavior, behavioral theories, healthy lifestyle factors, Health-Promoting Lifestyle Profile, self-efficacy, preventive programs
Ji Kang, Rosalam Che Me, Khairul Manami Kamarudin, Ruhaizin Sulaiman. Healthy lifestyle as a way to manage health risks: components and factors. Analytical review. Health Risk Analysis, 2023, no. 4, pp. 158–171. DOI: 10.21668/health.risk/2023.4.15.eng
References: 
  1. Regional Action Framework for Noncommunicable Disease Prevention and Control in the Western Pacific. WHO, 2023. Available at: https://iris.who.int/bitstream/handle/10665/369695/9789290620044-eng.pdf... (June 17, 2023).
  2. Elwood P., Galante J., Pickering J., Palmer S., Bayer A., Ben-Shlomo Y., Longley M.,
    Gallacher J. Healthy lifestyles reduce the incidence of chronic diseases and dementia: evidence
    from the Caerphilly cohort study. PLoS One, 2013, vol. 8, no. 12, pp. e81877. DOI: 10.1371/journal.pone.0081877
  3. Wang K., Ma W., Wu K., Ogino S., Chan A.T., Giovannucci E.L., Song M. Healthy life-style, endoscopic screening, and colorectal cancer incidence and mortality in the United States:
    A nationwide cohort study. PLoS Med., 2021, vol. 18, no. 2, pp. e1003522. DOI: 10.1371/journal.pmed.1003522
  4. Chen X., Ding J., Li H., Carr P.R., Hoffmeister M. Brenner H. The power of a healthy life-style for cancer prevention: the example of colorectal cancer. Cancer. Biol. Med., 2022, vol. 19, no. 11, pp. 1586–1597. DOI: 10.20892/j.issn.2095-3941.2022.0397
  5. Tsai M.-C., Yeh T.-L., Hsu H.-Y., Hsu L.-Y., Lee C.-C., Tseng P.-J., Chien K.-L. Compari-son of four healthy lifestyle scores for predicting cardiovascular events in a national cohort study. Sci. Rep., 2021, vol. 11, no. 1, pp. 22146. DOI: 10.1038/s41598-021-01213-6
  6. Wu Y., He X., Zhou J., Wang Y., Yu L., Li X., Liu T., Luo J. Impact of healthy lifestyle on the risk of type 2 diabetes mellitus in southwest China: A prospective cohort study. J. Diabetes Investig., 2022, vol. 13, no. 12, pp. 2091–2100. DOI: 10.1111/jdi.13909
  7. Rassy N., Van Straaten A., Carette C., Hamer M., Rives-Lange C., Czernichow S. Associa-tion of Healthy Lifestyle Factors and Obesity-Related Diseases in Adults in the UK. JAMA Netw. Open, 2023, vol. 6, no. 5, pp. e2314741. DOI: 10.1001/jamanetworkopen.2023.14741
  8. Dhana K., Evans D.A., Rajan K.B., Bennett D.A., Morris M.C. Healthy lifestyle and the risk of Alzheimer dementia: Findings from 2 longitudinal studies. Neurology, 2020, vol. 95, no. 4, pp. e374–e383. DOI: 10.1212/WNL.0000000000009816
  9. Garcia-Castillo F., Ramos I., García del Castillo J.A. Concept, Dimensions and Perception of Healthy Lifestyle. Psychol. Psychology Res. Int. J., 2023, vol. 8, no. 3, pp. 1–8. DOI: 10.23880/pprij-16000347
  10. Health for all in the twenty-first century. WHO. Available at: https://apps.who.int/gb/ebwha/pdf_files/WHA51/ra5.pdf (June 21, 2023) (in Russian).
  11. Mollborn S., Lawrence E.M., Saint Onge J.M. Contributions and Challenges in Health Lifestyles Research. J. Health Soc. Behav., 2021, vol. 62, no. 3, pp. 388–403. DOI: 10.1177/0022146521997813
  12. Cockerham W.C. Health lifestyle theory and the convergence of agency and structure. J. Health Soc. Behav., 2005, vol. 46, no. 1, pp. 51–67. DOI: 10.1177/002214650504600105
  13. Brivio F., Viganò A., Paterna A., Palena N., Greco A. Narrative Review and Analysis of the Use of "Lifestyle" in Health Psychology. Int. J. Environ. Res. Public Health, 2023, vol. 20, no. 5, pp. 4427. DOI: 10.3390/ijerph20054427
  14. Paweł F., Nowak P.F., Blukacz M. The relationship between spirituality, health-related behavior, and psychological well-being. Front. Psychol., 2020, vol. 11, pp. 1997. DOI: 10.3389/fpsyg.2020.01997
  15. Abdou R.A., Helal H.A. Health promoting lifestyle, perceived health competence, barriers and benefits among nursing students in Alexandria. Journal of Education and Practice, 2018, vol. 9, no. 16, pp. 50–62.
  16. Lewallen T.C., Hunt H., Potts-Datema W., Zaza S., Giles W. The Whole School, Whole Community, Whole Child model: a new approach for improving educational attainment and healthy development for students. J. Sch. Health, 2015, vol. 85, no. 11, pp. 729–739. DOI: 10.1111/josh.12310
  17. US Preventive Services Task Force, Grossman D.C., Bibbins-Domingo K., Curry S.J., Barry M.J., Davidson K.W., Doubeni C.A., Epling J.W. Jr. [et al.]. Behavioural counseling to pro-mote a healthful diet and physical activity for cardiovascular disease prevention in adults without cardiovascular risk factors: US Preventive Services Task Force recommendation statement. JAMA, 2017, vol. 318, no. 2, pp. 167–174. DOI: 10.1001/jama.2017.7171
  18. Dhana K., Franco O.H., Ritz E.M., Ford C.N., Desai P., Krueger K.R., Holland T.M., Dhana A. [et al.]. Healthy lifestyle and life expectancy with and without Alzheimer's dementia: population based cohort study. BMJ, 2022, vol. 377, pp. e068390. DOI: 10.1136/bmj-2021-068390
  19. Jandackova V.K., Scholes S., Britton A., Steptoe A. Healthy Lifestyle and Cardiac Vagal Modulation Over 10 Years: Whitehall II Cohort Study. J. Am. Heart Assoc., 2019, vol. 8, no. 19, pp. e012420. DOI: 10.1161/JAHA.119.012420
  20. Tu Z.-Z., Lu Q., Zhang Y.-B., Shu Z., Lai Y.-W., Ma M.-N., Xia P.-F., Geng T.-T. [et al.]. Associations of Combined Healthy Lifestyle Factors with Risks of Diabetes, Cardiovascular
    Disease, Cancer, and Mortality Among Adults with Prediabetes: Four Prospective Cohort Studies in China, the United Kingdom, and the United States. Engineering, 2023, vol. 22, no. 3, pp. 141–148. DOI: 10.1016/j.eng.2022.04.010
  21. Stiglic N., Viner R.M. Effects of screentime on the health and well-being of children and adolescents: a systematic review of reviews. BMJ Open, 2019, vol. 9, no. 1, pp. e023191. DOI: 10.1136/ bmjopen-2018-023191
  22. Byrne M.K., Miellet S., McGlinn A., Fish J., Meedya S., Reynolds N., van Oijen A.M. The drivers of antibiotic use and misuse: the development and investigation of a theory driven community measure. BMC Public Health, 2019, vol. 19, no. 1, pp. 1425. DOI: 10.1186/s12889-019-7796-8
  23. Farhud D.D. Impact of Lifestyle on Health. Iran. J. Public Health, 2015, vol. 44, no. 11, pp. 1442–1444.
  24. 20 health tips for 2020. WHO, 2019. Available at: https://www.who.int/philippines/news/feature-stories/detail/20-health-ti... (June 18, 2023).
  25. Batista P., Neves-Amado J., Pereira A., Amado J. FANTASTIC lifestyle questionnaire from 1983 until 2022: A review. Health Promot. Perspect., 2023, vol. 13, no. 2, pp. 88–98. DOI: 10.34172/hpp.2023.11
  26. Darviri C., Alexopoulos E.C., Artemiadis A.K., Tigani X., Kraniotou C., Darvyri P., Chrousos G.P. The Healthy Lifestyle and Personal Control Questionnaire (HLPCQ): a novel tool for assessing self-empowerment through a constellation of daily activities. BMC Public Health, 2014, vol. 14, pp. 995. DOI: 10.1186/1471-2458-14-995
  27. Woynarowska-Sołdan M., Panczyk M., Iwanow L., Zarzeka A., Gotlib J. Validation of the positive health behaviours scale: a nationwide survey of nurses in Poland. Int. J. Occup. Saf. Ergon., 2019, vol. 25, no. 1, pp. 76–85. DOI: 10.1080/10803548.2018.1436124
  28. Savarese G., Carpinelli L., Cavallo P., Vitale M. Italian Psychometric Validation of the Multidimensional Students’ Health-Promoting Lifestyle Profile Scale. Health, 2018, vol. 10, no. 11, pp. 1554–1575. DOI: 10.4236/health.2018.1011118
  29. Petrash M.D., Strizhitskaya O.Y., Murtazina I.R. Validation of the Questionnaire «Health-Promoting Lifestyle Profile» in the Russian Sample. Konsul'tativnaya psikhologiya i psikhoterapiya, 2018, vol. 26, no. 3, pp. 164–190. DOI: 10.17759/cpp.2018260309 (in Russian).
  30. Chang L.C. Health literacy, self-reported status and health promoting behaviors for adolescents in Taiwan. J. Clin. Nurs., 2011, vol. 20, no. 1–2, pp. 190–196. DOI: 10.1111/j.1365-2702.2009.03181.x
  31. Cao W.-J., Chen C.-S., Hua Y., Li Y.-M., Xu Y.-Y., Hua Q.-Z. Factor analysis of a health-promoting lifestyle profile (HPLP): application to older adults in Mainland China. Arch. Gerontol. Geriatr., 2012, vol. 55, no. 3, pp. 632–638. DOI: 10.1016/j.archger.2012.07.003
  32. Teng H.L., Yen M., Fetzer S. Health promotion lifestyle profile-II: Chinese version short form. J. Adv. Nurs., 2010, vol. 66, no. 8, pp. 1864–1873. DOI: 10.1111/j.1365-2648.2010.05353.x
  33. Zhang L., Liao J., Pan X., Liang D., Zeng J., Sun M., Luo X., Ma X. [et al.]. How to make more people adopt healthy behaviors? Assessing health literacy, health promoting lifestyle and their association of community residents in Shenzhen, China. Front. Public Health, 2022, vol. 10, pp. 900883. DOI: 10.3389/fpubh.2022.900883
  34. Bandura A. Toward a Psychology of Human Agency. Perspect. Psychol. Sci., 2006, vol. 1, no. 2, pp. 164–180. DOI: 10.1111/j.1745-6916.2006.00011.x
  35. Ryan R.M., Deci E.L. Self-determination theory and the facilitation of intrinsic motiva-tion, social development, and well-being. Am. Psychol., 2000, vol. 55, no. 1, pp. 68–78. DOI: 10.1037/0003-066X.55.1.68
  36. Sellami M., Gasmi M., Denham J., Hayes L.D., Stratton D., Padulo J., Bragazzi N. Effects of Acute and Chronic Exercise on Immunological Parameters in the Elderly Aged: Can Physical
    Activity Counteract the Effects of Aging? Front. Immunol., 2018, vol. 9, pp. 2187. DOI: 10.3389/fimmu.2018.02187
  37. Graves L.E., Ridgers N.D., Williams K., Stratton G., Atkinson G., Cable N.T. The physiological cost and enjoyment of Wii Fit in adolescents, young adults, and older adults. J. Phys. Act. Health, 2010, vol. 7, no. 3, pp. 393–401. DOI: 10.1123/jpah.7.3.393
  38. Lucini D., Pagani E., Capria F., Galiano M., Marchese M., Cribellati S., Parati G. Age In-fluences on Lifestyle and Stress Perception in the Working Population. Nutrients, 2023, vol. 15, no. 2, pp. 399. DOI: 10.3390/nu15020399
  39. Nagai M. Relationships among Lifestyle Awareness, Age, and Lifestyle-related Diseases in Healthy Japanese Community Residents. Asian Pac. Isl. Nurs. J., 2020, vol. 5, no. 2, pp. 103–110. DOI: 10.31372/20200502.1092
  40. Hailemariam A., Yew S.L., Appau S. Gender health gaps: the role of risky addictive be-haviors. Journal of Economic Behavior and Organization, 2021, vol. 191, pp. 639–660. DOI: 10.1016/j.jebo.2021.09.026
  41. Lipsky M.S., Su S., Crespo C.J., Hung M. Men and Oral Health: A Review of Sex and Gender Differences. Am. J. Mens Health, 2021, vol. 15, no. 3, pp. 15579883211016361. DOI: 10.1177/15579883211016361
  42. van Uffelen J.G.Z., Khan A., Burton N.W. Gender differences in physical activity motivators and context preferences: a population-based study in people in their sixties. BMC Public Health, 2017, vol. 17, no. 1, pp. 624. DOI: 10.1186/s12889-017-4540-0
  43. Munt A.E., Partridge S.R., Allman-Farinelli M. The barriers and enablers of healthy eating among young adults: a missing piece of the obesity puzzle: A scoping review. Obes. Rev., 2017, vol. 18, no. 1, pp. 1–17. DOI: 10.1111/obr.12472
  44. Varì R., Scazzocchio B., D'Amore A., Giovannini C., Gessani S., Masella R. Gender-related differences in lifestyle may affect health status. Ann. Ist. Super. Sanita, 2016, vol. 52, no. 2, pp. 158–166. DOI: 10.4415/ANN_16_02_06
  45. Friis K., Lasgaard M., Rowlands G., Osborne R.H., Maindal H.T. Health Literacy Mediates the Relationship Between Educational Attainment and Health Behavior: A Danish Population-Based Study. J. Health Commun., 2016, vol. 21, suppl. 2, pp. 54–60. DOI: 10.1080/10810730.2016.1201175
  46. Hahn R.A., Truman B.I. Education Improves Public Health and Promotes Health Equity. Int. J. Health Serv., 2015, vol. 45, no. 4, pp. 657–678. DOI: 10.1177/0020731415585986
  47. Chan Y.Y., Lim K.K., Lim K.H., Teh C.H., Kee C.C., Cheong S.M., Khoo Y.Y., Baharudin A. [et al.]. Physical activity and overweight/obesity among Malaysian adults: findings from the 2015 National Health and morbidity survey (NHMS). BMC Public Health, 2017, vol. 17, no. 1, pp. 733. DOI: 10.1186/s12889-017-4772-z
  48. Lago S., Cantarero D., Rivera B., Pascual M., Blázquez-Fernández C., Casal B., Reyes F. Socioeconomic status, health inequalities and non-communicable diseases: a systematic review. Z. Gesundh. Wiss., 2018, vol. 26, no. 1, pp. 1–14. DOI: 10.1007/s10389-017-0850-z
  49. Bor J., Cohen G.H., Galea S. Population health in an era of rising income inequality: USA, 1980–2015. Lancet, 2017, vol. 389, no. 10077, pp. 1475–1490. DOI: 10.1016/S0140-6736(17)30571-8
  50. French S.A., Tangney C.C., Crane M.M., Wang Y., Appelhans B.M. Nutrition quality of food purchases varies by household income: the SHoPPER study. BMC Public Health, 2019, vol. 19, no. 1, pp. 231. DOI: 10.1186/s12889-019-6546-2
  51. Lee H., Lee B.G., La I.S. Differential patterns of lifestyle behaviors among low- and high-income postmenopausal women in Korea: a latent class analysis. BMC Womens Health, 2023, vol. 23, no. 1, pp. 617. DOI: 10.1186/s12905-023-02767-5
  52. Ahn Y.-C., Park H.-S., Ra G.-W. Perceived Health Status and Health Promoting Behaviors among University Students. J. Korean Med., 2014, vol. 35, no. 4, pp. 52–64. DOI: 10.13048/jkm.14043
  53. Wang D., Xing X.-H., Wu X.-B. Healthy lifestyles of university students in China and in-fluential factors. Scientific World Journal, 2013, vol. 2013, pp. 412950. DOI: 10.1155/2013/412950
  54. Daskalopoulou C., Stubbs B., Kralj C., Koukounari A., Prince M., Prina A.M. Physical activity and healthy ageing: A systematic review and meta-analysis of longitudinal cohort studies. Ageing Res. Rev., 2017, vol. 38, pp. 6–17. DOI: 10.1016/j.arr.2017.06.003
  55. Lin Y.-C., Latner J.D., Fung X.C.C., Lin C.-Y. Poor Health and Experiences of Being Bul-lied in Adolescents: Self-Perceived Overweight and Frustration with Appearance Matter. Obesity (Silver Spring), 2018, vol. 26, no. 2, pp. 397–404. DOI: 10.1002/oby.22041
  56. Ram T., Laxmi. Health-related Self-efficacy of Indian Female Employees. Asia-Pacific Journal of Management Research and Innovation, 2016, vol. 12, no. 2, pp. 169–176. DOI: 10.1177/2319510X16680657
  57. Chen N., Zhang J., Wang Z. Effects of middle-aged and elderly people's self-efficacy on health promotion behaviors: Mediating effects of sports participation. Front. Psychol., 2023, vol. 13, pp. 889063. DOI: 10.3389/fpsyg.2022.889063
  58. McAuley E., Szabo A., Gothe N., Olson E.A. Self-efficacy: Implications for Physical Ac-tivity, Function, and Functional Limitations in Older Adults. Am. J. Lifestyle Med., 2011, vol. 5, no. 4. DOI: 10.1177/1559827610392704
  59. Allison K.R., Dwyer J.J., Makin S. Self-efficacy and participation in vigorous physical activity by high school students. Health Educ. Behav., 1999, vol. 26, no. 1, pp. 12–24. DOI: 10.1177/109019819902600103
  60. Haegele J.A., Kirk T.N., Zhu X. Self-efficacy and physical activity among adults with vis-ual impairments. Disabil. Health J., 2018, vol. 11, no. 2, pp. 324–329. DOI: 10.1016/j.dhjo.2017.10.012
  61. Rajani N.B., Mastellos N., Filippidis F.T. Self-Efficacy and Motivation to Quit of Smokers Seeking to Quit: Quantitative Assessment of Smoking Cessation Mobile Apps. JMIR Mhealth Uhealth, 2021, vol. 9, no. 4, pp. e25030. DOI: 10.2196/25030
  62. DiBello A.M., Miller M.B., Carey K.B. Self-Efficacy to Limit Drinking Mediates the Association between Attitudes and Alcohol-Related Outcomes. Subst. Use Misuse, 2019, vol. 54, no. 14, pp. 2400–2408. DOI: 10.1080/10826084.2019.1653322
  63. van Herpen-Meeuwissen L.J.M., van Onzenoort H.A.W., van den Bemt P.M.L.A., Maat B., van den Bemt B.J.F. The Effect of Self-Administration of Medication During Hospitalization on Patient's Self-Efficacy and Medication Adherence After Discharge. Patient Prefer. Adherence, 2022, vol. 16, pp. 2683–2693. DOI: 10.2147/PPA.S375295
  64. Zhou C., Yue X.D., Zhang X., Shangguan F., Zhang X.Y. Self-efficacy and mental health problems during COVID-19 pandemic: A multiple mediation model based on the Health Belief Model. Pers. Individ. Dif., 2021, vol. 179, pp. 110893. DOI: 10.1016/j.paid.2021.110893
  65. Mo Y., Deng L., Zhang L., Lang Q., Pang H., Liao C., Wang N., Tao P., Huang H. Anxi-ety of Nurses to support Wuhan in fighting against COVID-19 Epidemic and its Correlation With Work Stress and Self-efficacy. J. Clin. Nurs., 2021, vol. 30, no. 3–4, pp. 397–405. DOI: 10.1111/jocn.15549
  66. Castillo-Mayén R., Cano-Espejo C., Luque B., Cuadrado E., Gutiérrez-Domingo T., Arenas A., Rubio S.J., Delgado-Lista J. [et al.]. Influence of Self-Efficacy and Motivation to Follow a Healthy Diet on Life Satisfaction of Patients with Cardiovascular Disease: A Longitudinal Study. Nutrients, 2020, vol. 12, no. 7, pp. 1903. DOI: 10.3390/nu12071903
  67. Kusol K., Kaewpawong P. Perceived Self-Efficacy, Preventive Health Behaviors and Quality of Life Among Nursing Students in Nakhon Si Thammarat Province, Thailand During the COVID-19 Pandemic. Patient Prefer. Adherence, 2023, vol. 17, pp. 1989–1997. DOI: 10.2147/PPA.S424611
  68. Montgomery G.H. Cognitive factors in health psychology and behavioral medicine. J. Clin. Psychol., 2004, vol. 60, no. 4, pp. 405–413. DOI: 10.1002/jclp.10254
  69. Conner M., Norman P. Predicting Health Behaviour: Research and Practice with Social Cognition Models, 2nd ed. Maidenhead, Open University Press, 2005, 385 p.
  70. Mäntyselkä P., Kautiainen H., Miettola J. Beliefs and attitudes towards lifestyle change and risks in primary care – a community-based study. BMC Public Health, 2019, vol. 19, no. 1, pp. 1049. DOI: 10.1186/s12889-019-7377-x
  71. Melnyk B.M., Kelly S., Tan A. Psychometric Properties of the Healthy Lifestyle Beliefs Scale for Adolescents. J. Pediatr. Health Care, 2021, vol. 35, no. 3, pp. 285–291. DOI: 10.1016/j.pedhc.2020.11.002
  72. Akdeniz Kudubes A., Ayar D., Bektas İ., Bektas M. Predicting the effect of healthy life-style belief on attitude toward nutrition, exercise, physical activity, and weight-related self-efficacy in Turkish adolescents. Arch. Pediatr., 2022, vol. 29, no. 1, pp. 44–50. DOI: 10.1016/j.
    arcped.2021.11.001
  73. Langari M.N.M., Lindström J., Absetz P., Laatikainen T., Pihlajamäki J., Tilles-Tirkkonen T., Turunen H. Immigrants’ perspectives on healthy life and healthy lifestyle counseling: a focus group study. Scand. J. Public Health, 2023, vol. 51, no. 3, pp. 371–380. DOI: 10.1177/14034948221075021
Received: 
03.10.2023
Approved: 
13.12.2023
Accepted for publication: 
20.12.2023

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