Participants reported on a range of lifestyle risk behaviors in the questionnaire. Smoking status was derived from two questions: “Have you ever been a regular smoker?” and “Are you a regular smoker now?” Participants were asked, “About how many alcoholic drinks do you have each week?” with one drink defined as one glass of wine, one half pint of beer, or one shot of spirits. Dietary behavior was measured by a previously used index [18 (link)] of five food items (vegetable, fruit, fish, processed meat, and types of milk) based on the Dietary Guidelines for Australians [22 ], as an indicator for overall dietary behavior. Physical activity was measured using the Active Australia Survey [23 ], which has acceptable reliability (Spearman’s rho for test–retest reliability was 0.56–0.64, with 76% agreement on meeting the recommended physical activity level) and validity (Spearman’s rho for total minutes/week of moderate-to-vigorous physical activity was 0.52 against accelerometer measures) [24 (link)]. This instrument asked the total time one spent on walking, moderate-intensity, and vigorous-intensity physical activity (bouts of at least 10 min) in the previous week. Sedentary behavior was assessed using a single-item measure: hours spent sitting in a typical 24-h day. This question was adapted from the widely used International Physical Activity Questionnaire [25 (link)] and had acceptable reliability and validity [26 (link)]. A similar question was also asked about sleep duration in a 24-h day, and this question was comparable with single-item instruments of self-reported sleep duration used by previous studies [27 (link),28 (link)]. The specific coding of these lifestyle risk behaviors is presented in Table 1 .
Each behavior was coded as 1 (at risk) or 0 (not at risk) and was summed as an index (total score range 0–6). Obesity was not included in the index because it was not considered a behavior, but rather an intermediate health outcome influenced by several of the included lifestyle behaviors.
Each behavior was coded as 1 (at risk) or 0 (not at risk) and was summed as an index (total score range 0–6). Obesity was not included in the index because it was not considered a behavior, but rather an intermediate health outcome influenced by several of the included lifestyle behaviors.
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