An examination of temporal trends in health behaviors among United States children, adolescents, and adults from 2005 to 2016

Introduction: Lifestyle-related health behaviors are major contributors to preventable chronic diseases. We aimed to characterize temporal trends in health behaviors of US children, adolescents, and adults and examine the association of sociodemographic characteristics with clustering of unhealthy behaviors. Methods: The study population included 46,793 participants from the 2005 to 2016 National Health and Nutrition Examination Survey from three age groups: children (aged 2-11), adolescents (aged 12-19), and adults (aged >= 20). We calculated weighted prevalences of unhealthy behaviors-poor diet quality, low physical activity, screentime, fast food consumption, smoking (adolescents and adults), alcohol use, and short sleep duration (adults)-for each survey wave to examine temporal trends across age groups. Multivariable logistic regression estimated associations of sociodemographic characteristics with unhealthy behavior clustering (>= 2 behaviors), stratified by age. Results: Results of the study demonstrated that between 2005 and 2016, the proportion of children and adolescents not meeting the physical activity guidelines increased and screentime increased among all ages. Dietary quality improved and smoking prevalence declined among adolescents and adults, while fast food consumption declined among adolescents. Unhealthy behavior clustering among children increased by 13%. The odds of unhealthy behavior clustering were higher among children and adolescents that were older, non-Hispanic Black, or lived in unmarried households, and among adults who were younger, non-Hispanic black, had lower educational attainment, were uninsured or had public insurance, and had lower poverty-to-income ratios. Conclusion: The findings suggest that screentime and physical inactivity are growing areas of concern in the U.S. population, and that disparities in adherence to multiple healthy behaviors may contribute to disparities in chronic diseases.