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Engaging in multiple healthy lifestyle behaviors is associated with better health outcomes than focusing on a single domain

In a cross-sectional study of 510 adults, four multibehavioral clusters were identified: unhealthy behavior, mixed behavior-healthy diet, mixed behavior-stable good mood, and healthy behavior. Compared to the unhealthy behavior cluster, the mixed behavior-stable good mood and healthy behavior clusters had significantly higher mental health-related quality of life (β=6.32, 95% CI 3.73-8.91 and β=5.61, 95% CI 2.47-8.75, respectively) and well-being (β=11.62, 95% CI 7.86-15.38 and β=9.63, 95% CI 5.17-14.10, respectively). Participants in these clusters and those in the mixed behavior-healthy diet cluster also reported better perceived health (OR 3.19, 95% CI 1.20-8.49; OR 9.85, 95% CI 3.54-27.40; OR 12.18, 95% CI 4.04-36.71, respectively).

Last updated: Aug 14, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score34/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Behavioral and Contextual Patterns Derived From Ecological Momentary Assessment and Wearable Sensors and Their Associations With Health-Related Outcomes: WEALTH Cross-Sectional Study.

observational

Kose J, Bouchan J, Fezeu LK, Gauffeny N, Buck C, Cimler R, Donnelly A, Elavsky S, Harrington J, Hayes G, Hebestreit A, Sigcha L, Vetrovsky T, Cardon G, Oppert JM · JMIR formative research (2026)

Participants: N/A
Duration: 7-day measurement period
Intervention: Multibehavioral patterns (clusters) derived from EMA and wearable sensors, including physical activity, sedentary behavior, sleep, eating behavior, and contextual factors
Outcome: Mental health-related quality of life (SF-36), well-being (WHO-5), handgrip strength, and self-rated health
Effect Size: β=6.32 and β=5.61 for mental health-related quality of life; β=11.62 and β=9.63 for well-being; ORs 3.19, 9.85, 12.18 for self-rated health
Population: Adults from Czechia, Germany, France, and Ireland (median age 35.5 years, 56.7% female)

Result:

PubMed: 42579880DOI: 10.2196/85991

Mechanism Graph

Multiple healthy lifestyle behaviors (e.g., physical activity, healthy diet, stable mood) may synergistically improve mental health and well-being.
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Engaging in multiple healthy behaviors may enhance overall health perception.
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The combination of behaviors may have additive or interactive effects on health outcomes.
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Result: Better health outcomes compared to focusing on a single domain.

Limitations

  • ⚠Cross-sectional design limits causal inference.
  • ⚠Self-reported measures (EMA, dietary intake, health outcomes) may introduce recall bias.
  • ⚠Sample may not be representative of all adult populations.
  • ⚠Clusters are data-driven and may not generalize to other settings.

Frequently Asked Questions

What are the four multibehavioral clusters identified in this study?▼

The clusters are: unhealthy behavior, mixed behavior-healthy diet, mixed behavior-stable good mood, and healthy behavior.

Which clusters showed significantly better mental health outcomes?▼

The mixed behavior-stable good mood and healthy behavior clusters had significantly higher mental health-related quality of life and well-being compared to the unhealthy behavior cluster.

How was the data collected in this study?▼

Data were collected over a 7-day free-living period using ecological momentary assessment (EMA) for contextual factors, activPAL for sedentary behavior, ActiGraph for physical activity, and a Food Frequency Questionnaire for dietary intake.

What is the main takeaway from this study?▼

Engaging in multiple healthy lifestyle behaviors is associated with better health outcomes than focusing on a single domain, highlighting the importance of a holistic approach to health.

Products

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References

  1. 1.Kose J, Bouchan J, Fezeu LK, Gauffeny N, Buck C, Cimler R, Donnelly A, Elavsky S, Harrington J, Hayes G, Hebestreit A, Sigcha L, Vetrovsky T, Cardon G, Oppert JM. "Behavioral and Contextual Patterns Derived From Ecological Momentary Assessment and Wearable Sensors and Their Associations With Health-Related Outcomes: WEALTH Cross-Sectional Study.." JMIR formative research, 2026. PMID: 42579880 DOI: 10.2196/85991
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.