Journal of Public Health

, Volume 24, Issue 4, pp 317–324 | Cite as

Lifestyle health risk factors and multiple non-communicable diseases among the adult population in India: a cross-sectional study

  • Gopal Agrawal
  • Sangram K. Patel
  • Ashok K. Agarwal
Original Article



This article investigated the relationship between lifestyle factors and the co-occurrence of multiple chronic non-communicable diseases (NCDs).

Subjects and methods

Cross-sectional analysis of results from the World Health Organization Study on Global Ageing and Adult Health (WHO SAGE) was conducted in India in 2007. Subjects were aged 18 years and older. Multiple NCD morbidity was measured by a simple count of self-reported chronic NCDs from a list of nine. Five lifestyle risk factors were evaluated: (1) tobacco use, (2) alcohol consumption, (3) fruit and vegetable consumption, (4) physical activity, and (5) body mass index (BMI). Each lifestyle risk factor was given a score of 1 (unhealthy) if the recommended behavioral targets were not achieved and 0 otherwise. The combined effect of unhealthy lifestyle was evaluated using the total sum of scores.


The overall mean number ± SD of unhealthy lifestyle factors in the study population was 2.3 ± 1.14. Individually, the likelihood of reporting multiple chronic NCDs was greater among adults with low or high BMI (1.35, p < 0.05), alcohol consumption (1.36, p < 0.10), low intake of fruits and vegetables (1.05, p < 0.10), and tobacco users (1.62, p < 0.01). When combined, the risk of reporting multiple NCDs increased significantly with the increased exposure to the number of unhealthy lifestyle factors.


The present study provides support to the association of lifestyle factors and multiple NCD morbidity. Accumulation of a greater number of unhealthy lifestyle factors progressively increased the likelihood of suffering from multiple NCDs among adults in India.


Non-communicable diseases Health risk factors Multiple diseases Lifestyle SAGE India 


Compliance with ethical standards


This study did not receive any fund.

Conflict of interest


Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study received human subjects testing and ethics council approval from research review boards local to each participating site and from the WHO Ethical Review Committee (RPC149). The study was approved by Institutional Ethical Committee, Indian Institute of Public Health-Bhubaneswar. Informed consent was obtained from each respondent prior to the interview and examination.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Gopal Agrawal
    • 1
  • Sangram K. Patel
    • 1
  • Ashok K. Agarwal
    • 2
  1. 1.India Habitat CentreNew DelhiIndia
  2. 2.Public Health Foundation of IndiaGurgaonIndia

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