Abstract

Introduction: There was little information on heart-healthy behaviors, which are determined as recently updated lifestyle behavioral factors, in the associations with health-related quality of life (HRQOL) in the general population. Hypothesis: We hypothesized that either individual or combined heart-healthy behavior(s) would be significantly associated with HRQOL. Methods: A cross-sectional study was conducted using data from the 7th Korea National Health and Nutrition Examination Survey with 10,396 adults aged 19-64 years (4,412 men and 5,984 women). Seven heart-healthy behaviors were used, i.e., current non-smoking, non-binge drinking, sufficient physical activity, sufficient sedentary behavior, sufficient intake of fruits and vegetables, no-sugar-sweetened beverage intake, and sufficient sleep duration. EuroQOL-5 scores converted to 100 points (range: 0 - 100) were taken for HRQOL. The hypothesis was tested using multiple linear regression analysis with complex sampling designed to use weighted values after adjusting for age, gender, region, income, education, marital status, number of comorbidities, and the other healthy behaviors. Results: Of the participants (N = 10,396), 77.4% reported current non-smoking, 85.1% non-binge drinking, 50.4% sufficient physical activity, 54.1% sufficient sedentary behavior, 35.7% sufficient intake of fruits and vegetables, 42.2% no sugar-sweetened beverage intake, and 56.5% sufficient sleep duration. Women were significantly more likely to have higher percentages of heart-healthy behaviors than men. Among men, sufficient physical activity (p = 0.047) was significantly associated with EuroQOL-5 scores. Among women, non-sedentary behavior (p = 0.001) and sufficient intake of fruits and vegetables (p = 0.040) were significantly associated with EuroQOL-5 scores. Individuals with a greater number of heart-healthy behaviors showed significantly higher scores of EuroQOL-5 (p = 0.002) in a linear pattern among men, but not among women. The prevalence of having 0 - 2, 3 - 5, and 6 - 7 of the healthy behaviors was 12.8%, 74.4%, and 12.8%, respectively. Compared with the group with 0 - 2 of the healthy behaviors, the group with either 3 - 5 (p = 0.009) or 6 - 7 (p = 0.001) showed significantly higher scores of EuroQOL-5 among men, but not among women. Conclusions: Some individual and combined heart-Healthy behaviors were significantly associated with HRQOL; these associations differed by gender. Heart-healthy behaviors should be further emphasized and encouraged in men to elevate the levels of HRQOL, and may be paid attention in women to the efforts of identifying confounding factors in the associations between heart-healthy behaviors and HRQOL.

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