Objective: History of stroke or diabetes increases risk for cardiometabolic conditions, which can be exacerbated by the presence of modifiable lifestyle risk behaviors. The purpose of this study was to evaluate lifestyle risk behaviors among stroke survivors with and without diabetes to inform future research and healthcare intervention. Specifically, we compared the prevalence of three lifestyle risk behaviors (i.e., consuming ≤1 fruit and ≤1 vegetable daily, physical inactivity, and overweight/obesity) and total number of lifestyle risk behaviors among stroke survivors, stratified by diabetes status.

Methods: Cross-sectional data from the 2013 and 2015 Behavioral Risk Factor Surveillance System (BRFSS) were examined. Weighted and age-adjusted prevalence estimates and adjusted odds ratios (AOR, adjusted for sociodemographic characteristics) with 95% confidence intervals (CIs) were calculated to compare prevalence and odds of individual and total number of lifestyle risk behaviors between stroke survivors with and without diabetes.

Results: Prevalence and AORs were higher in stroke survivors with diabetes compared to stroke survivors without diabetes for consuming ≤1 fruit and ≤1 vegetable daily (58.8% vs. 53.7%; AOR: 1.14, CI: 1.02-1.28), physical inactivity (65.7% vs. 54.6%; AOR: 1.41, CI: 1.26-1.58), overweight/obesity (87.2% vs. 63.1%; AOR: 2.42, CI: 2.12-2.79), 2 lifestyle risk behaviors (41.1% vs. 36.7%; AOR: 1.16, CI: 1.03-1.30), and 3 lifestyle risk behaviors (35.7% vs. 21.8%; AOR: 1.54, CI: 1.36-1.74).

Conclusion: Individual and clustered lifestyle risk behaviors were present in greater proportions among stroke survivors with diabetes compared to those without diabetes. Because the co-occurrence of chronic conditions (i.e., multimorbidity) and multiple lifestyle risk behaviors increases risk for poor health and premature death, effective healthcare interventions and community programs are needed to promote health behavior change in stroke survivors.


R.R. Bailey: None. A. Phad: None. R. McGrath: None. A. Ford: None. R.G. Tabak: Other Relationship; Self; Envolve PeopleCare/Centene Corporation. N.H. Serrano: None. D. Haire-Joshu: Research Support; Self; Centene Corporation.


National Institutes of Health (P30DK092950, 5T32HL130357)

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