Health behaviours like smoking, nutrition, alcohol consumption and physical activity (SNAP) are often studied separately, while combinations can be particularly harmful. This study aims to contribute to a better understanding of lifestyle choices by studying the prevalence of (combinations of) unhealthy SNAP behaviours in relation to attitudinal factors (time orientation, risk attitude) and subjective health (self-rated health, life expectancy) among the adult Dutch population. In total 1006 respondents, representative of the Dutch adult population (18–75 years) in terms of sex, age, and education, were drawn from a panel in 2016. They completed an online questionnaire. Groups comparisons and logistic regression analyses (crude and adjusted) were applied to analyse (combinations of) SNAP behaviours in relation to time orientation (using the Consideration of Future Consequences scale comprising Immediate (CFC-I) and Future (CFC-F) scales) and risk attitude (Health-Risk Attitude Scale; HRAS-6), as well as subjective health (visual analogue scale and subjective life expectancy). In the analyses, 989 respondents (51% men, average 52 years, 22% low, 48% middle, and 30% high educated) were included. About 8% of respondents engaged in four unhealthy SNAP behaviours and 18% in none. Self-rated health varied from 5.5 to 7.6 in these groups, whilst subjective life expectancy ranged between 73.7 and 85.5 years. Logistic regression analyses, adjusted for socio-demographic variables, showed that smoking, excessive drinking and combining two or more unhealthy SNAP behaviours were significantly associated with CFC-I scores, which increased the odds by 30%, 18% and 19%, respectively. Only physical inactivity was significantly associated with CFC-F scores, which increased the odds by 20%. Three out of the four SNAP behaviours were significantly associated with HRAS-6, which increased the odds between 6% and 12%. An unhealthy diet, excessive drinking, and physical inactivity were significantly associated with SRH, which decreased the odds by 11%. Only smoking was significantly associated with subjective life expectancy, which decreased the odds by 3%. Our findings suggest that attitudinal factors and subjective health are relevant in the context of understanding unhealthy SNAP behaviours and their clustering. This emphasizes the relevance of a holistic approach to health prevention rather than focusing on a single unhealthy SNAP behaviour.

中文翻译：

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荷兰成年人口中不健康行为的组合与态度因素和主观健康之间的关系如何？

诸如吸烟，营养，饮酒和体育锻炼（SNAP）之类的健康行为经常被单独研究，而两者结合可能特别有害。这项研究旨在通过研究不健康的SNAP行为（组合）与态度因素（时间取向，风险态度）和主观健康（自我评估的健康，预期寿命）的相关性，从而有助于更好地理解生活方式。荷兰成年人口。2016年，共有1006名受访者从性别，年龄和教育方面代表了荷兰成年人口（18-75岁），他们完成了在线调查表。应用组比较和逻辑回归分析（粗略和调整后）来分析（组合）与时间方向相关的SNAP行为（使用包括“立即”（CFC-I）和“未来”（CFC-F）量表的“未来后果的考虑”量表）和风险态度（健康风险态度量表； HRAS-6），以及主观健康（视觉模拟量表和主观预期寿命）。在分析中，包括989名受访者（51％的男性，平均52岁，低22％，中级48％，高学历30％）。约8％的受访者进行了四种不健康的SNAP行为，而18％的受访者则没有。这些组的自我评价健康水平从5.5到7.6不等，而主观预期寿命在73.7至85.5岁之间。经社会人口统计学变量调整后的逻辑回归分析表明，吸烟，过量饮酒和两种或两种以上不健康的SNAP行为相结合与CFC-I得分显着相关，这使几率分别增加了30％，18％和19％。只有身体不活动与CFC-F分数显着相关，这才将几率提高20％。四种SNAP行为中有三项与HRAS-6显着相关，这增加了6％至12％的几率。不健康的饮食，过度饮酒和缺乏运动与SRH显着相关，这使患病率降低了11％。仅吸烟与主观预期寿命显着相关，这使几率降低了3％。我们的研究结果表明，态度因素和主观健康与理解不健康的SNAP行为及其成簇有关。