Lifestyle risk factors for chronic disease in a multiethnic population: an analysis of two prospective studies over a 20-year period.

This study investigated changes in risk factors in Hawaii over 20 years and compared health behaviors among ethnic groups with well-documented differences in disease risk.Comparison of scores of a Chronic Disease Risk Index (CDRI) in the population of two large population-based cohorts.The respective sample sizes for the two cohorts were 19,319 and 97,746 persons ages > or = 40 years of White, Chinese, Filipino, Japanese, and Native Hawaiian ancestry.The CDRI included smoking status, alcohol use, meat intake, fruit and vegetable consumption, and body mass index. Mean total and component scores were compared over time and by ethnic group after adjustment for age and education.We found a reduction in overall CDRI scores, ie, improved health profiles, for both men and women over time. Men, Native Hawaiians, and Whites had higher CDRI scores than women and Japanese, Chinese, and Filipinos due to their higher scores for smoking, alcohol use, and overweight, whereas nutritional intakes were similar in all ethnic categories. Smoking, alcohol use, and overweight increased over time in both men and women, whereas dietary composition appeared to improve.This analysis suggests an overall reduction in modifiable dietary and lifestyle risk factors in Hawaii over time. Persistent differences by sex and ethnic category indicate that interventions to modify lifestyle factors need to tailor messages to the groups at highest risk.