INTRODUCTION:

Being healthy should be part of your overall lifestyle. Living a healthy lifestyle can help prevent chronic diseases and long-term illnesses. Feeling good about yourself and taking care of your health are important for your self-esteem and self-image. Maintain a healthy lifestyle by doing what is right for your body. The concept of health and healthy lifestyle here does not only imply mere absence of disease or infirmity by a state of complete physical, mental and social wellbeing. According to Physical activity guidelines for Americans (2008) and WHO (2010), it is a concept emphasizing the eight aspects of wellbeing into one´s life namely: emotional; environmental; financial; intellectual; occupational; physical; social; and spiritual.

Following this broad definition, I use health and healthy lifestyle to encompass personal; psychological; social; and physical capabilities and as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Health is a resource for everyday life, not the object of living, and is a positive concept emphasizing social and personal recourses as well as physical capabilities. Health is a fundamental human right, essential for personal development and an essential component of development, vital to a nation`s economic growth and internal stability (WHO, 201O)¹

STATEMENT OF THE PROBLEM:

A descriptive study to assess the knowledge regarding healthy lifestyles among adults in Kerala state.

OBJECTIVES:

The Objectives of the study were:

To assess the knowledge regarding healthy lifestyles among adults.

To find out the association between knowledge regarding healthy lifestyles among adults and selected demographic variables such as age , gender, education, occupation, type of food,non communicable disease, exercise, height,weight.

ASSUMPTION:

There are certain demographic factors that influence the knowledge regarding healthy lifestyle among adult.

· The knowledge of the adult regarding healthy lifestyle will be minimal.

REVIEW OF LITERATURE:

1. Literature related to incidence and prevalence of lifestyle diseases.

A cross-sectional study was conducted in Riyadh city, Saudi Arabia to measure the prevalence and factors associated with an unhealthy lifestyle on 2021.An interview-based study was conducted with 968 males and 2029 females, aged 30‒75 years, covering 18 primary health care centers in Riyadh. Multivariate logistic regression analyses were conducted to identify the significant determinants associated with an unhealthy lifestyle. Results: Overall, men were 1.49(1.28, 1.74) times at higher risk of an unhealthy lifestyle compared to women. Men reporting unhealthy lifestyle were 2.1 (1.3, 3.4) and 1.5(1.0, 2.6) times more likely than men with healthy lifestyle to cite not enjoying physical activity, lack of social support, and not having enough information about a healthy diet [1.5(1.0, 2.0)], whereas those ≥ 45 years age group were 30 times less likely to report unhealthy lifestyle [0.7 (0.5, 0.9)]. In contrast, in women aged ≥ 45 years[1.3(1.1,1.7)], lack of motivation [1.3(1.1,1.7)], feelingconscious while exercising [2.0(1.4, 2.9)], not enjoying healthy food [1.6 (1.3, 2.1)], and no family support to prepare healthy food [1.4 (1.1, 1.8)] were significantly associated with an unhealthy lifestyle. The study concluded as in a Saudi sample, younger men and older women are at higher risk of an unhealthy lifestyle. In addition to self-motivation, combined strategies to promote physical activity and healthy eating are required to improve lifestyle. Bivariate analysis showing unadjusted odds ratio and 95% confidence interval for socio demographic factors associated with an unhealthy lifestyle in Saudi men and women in Riyadh, Saudi Arabia.²

A cross-sectional study was conducted in Amarkantak region, Anuppur district, Madhya Pradesh, India on 2017. Rural population of this locality consists of satellite residents (residents’ native of different regions but residing at Amarkantak due to service) as well as native residents of the villages in and around Amarkantak are listed. The data from sample size of 500 by random sampling was considered for the study and a well validated questionnaire was administered. Data collected relating to lifestyle risk factors and diseases were analyzed using SPSS. Rural population suffers less from lifestyle diseases when compared to urban population has a P-value of 0.000 with 0.056 standard error difference in independent sample T-test. Urban population has more appropriate nutritional habits when compared to rural population’ has a P-value of .000 with .066 standard error difference in chi- square and independent sample t-test. More than 50% of population prefers ethno-medicine’ has a P-value of 0.000 in chi-square test. Results obtained signify the adverse behavior of rural population regarding health necessities. Early detection and tracking of risk factors can reduce the occurrence of lifestylediseases.³

2. Literature related to knowledge regarding healthy lifestyle among adults:

A descriptive – analytical study conducted among 480 elderly people over 60 years old referred to Islamshahr Health Center of Tehran University of Medical Sciences in the period in 2014– 2015. Data were collected through at two-part questionnaire including socio-demographic and health-related characteristics and healthy lifestyle instrument. Healthy lifestyle of the elderly was assessed using a 46 items self-report standard instrument with five subscales reflecting domains including exercise, nutrition, prevention, stress management, and social relationship. the Finally, the data obtained were analyzed using an independent t-test, analysis of variance and ordinal logistic regression test at a significant level of P < 0.05. A sample size with a confidence interval of 0.95, power of 0.8 and considering 20% sample size reduction, determined 480 elderly. Mean score of total healthy lifestyle was 148.56±11.5. Men and women scored 151.95±11.15 and 145±10.32, respectively (P < 0.001). 76.2% of participants had moderately healthy lifestyle, and 23.8% had desirable healthy lifestyle. Marital status and gender were important factors in elderly healthy lifestyle. Furthermore, most the elderly had moderate score of lifestyle, should try that affecting factors in lifestyle and its domains be as an important educational priority forelderly.⁴

A cross sectional study was conducted in the Netherlands designed to analyses the relationship between use of mobile application and physical activity, health and lifestyle of recreational runners. On September 21^st 2016 the 30th, was organized in Amsterdam, the Netherlands. The organization of the running event randomly selected and invited 15,000runners out of 54,410 participants (16 and 6.4 km) to participate in an online survey. Runners of all levels were invited to participate. Participation in the run was either onanindividualbasis, with a company or for acharity. Inclusion criteria were (a)≥18 years and(b) signed in-formed consent. Exclusion criteria were (a) participating in both distances or (b) leaving all questions unanswered after informed consent. Of the 15,000 invited runners, 28% responded. For both distances, use of mobile application was positively related to running physical activity and feeling healthier (p<0.05). Also, app use was positively related to feeling better about them, feeling like an athlete, motivating others to participate in running, and losing weight (p< 0.01). Furthermore, for 16km runners app use was positively related to eating healthier, feeling more energetic and reporting a higher chance to maintain sport behavior (p<0.05). These results suggest that use of mobile apps has a beneficial role in the preparation of a running event, as it promotes health and physical activity. Further research is now needed to determine a causal relationship between app use and physical and health related behavior.⁵

3. Literature related to association between knowledge regarding healthy lifestyle anddemographic variables.

A cross sectional study ‘Relation between lifestyle and socio-demographic factors and body composition among elderly was conducted at Tehran, Iran. A total of 380 elderly people aged 60 and above were selected using systematic sampling. The objective of the study was to examine the relationship between lifestyle and socio demographic factors and body composition. The demographic variables were gender, age, physical activity, energy intake, percentage of macronutrients, educational level, job status, TV watching time, smoking, diseases, and taking medicine. Their body composition was measured by Bioelectrical Impedance Analysis and the Acti graph device was used for assessing physical activity patterns. A three-day food recall was conducted to measure their intake of energy and macronutrients. Lifestyle and socio- demographic information were collected by interview using a pretested questionnaire. The result were overweight, obesity and central obesity were more prevalent in women than in men. Moreover, 57.1% and 18.7% of participants had high and very high fat mass index, respectively. High fat mass index was seen in 47% of men and 37.5% of women who had normal body mass index (BMI). Meanwhile, age, gender, physical activity, energy intake, the percentage of energy from fat and protein, educational level, job, television watching time, smoking, chronic diseases, and taking medicine were significantly associated with anthropometric measurements. Overweight, obesity and high body fat percentage were common among the aged. Considering the factors that are significantly associated with body composition, programs that can increase their awareness about the dietary balance and suitable physical activity should be organized to address these problems.⁶

A cross sectional study to find the association between socio-demographic characteristics and preventable lifestyle related risk factors of non–communicable diseases among adolescents: a school-based study in Berhampur, Odisha. A total of 400 school children were included in the study using simple random sampling. Data was collected by pretested, structured, close ended, self-administered questionnaires. Data collection was done in January 2017. Objectives of the study was to study the socio-demographic characteristics of study population, to ascertain the association of lifestyle related risk factors for non- communicable diseases among study population socio demographic characteristics, to assess the relative contribution of educational and working status of parents on life style related risk factors for non- communicable diseases. The result of the study was out of 400 students included in the study, 69.5% were males, the mean age of the study subject was 15.77 with standard deviation 2.81. On multiple regression analysis, it was found that male respondents parents job had strong association with unhealthy dietary practices and educational status of respondents had strongest association with passive smoking and addiction habits. This study showed a poor practice of healthy life style with a high burden of life style related risk factors of non- communicable diseases among students. Therefore, the school should emphasizes on including topic related to leading of a healthy life style in the curriculum. Frequent campaigns and educational seminar can be conducted for the adoption of healthy life styles.⁷

MATERIAL AND METHODS:

Research approach:

Quantitative research approach was adopted for the study.

Research design:

Descriptive research design.

Sampling technique:

Conveniencesampling technique was used for this study.

Sample:

The sample selected for this study consisted of 100 adults who where about18 to 60 years old in various districts of Kerala.

Tool:

Tool 1: Structured Knowledge questionnaire

Section A: Socio-demographic Performa

Section B: Structured knowledge questionnaire on bacterial infection.

Data collection process:

Data collection was done through Google forms in Kerala state by using self-structured questionnaires based on the knowledge regarding healthy lifestyles among adults. The data was collected on 2/3/2021 after obtaining consent from the samples to participate in the study. The samples were selected based on inclusion and exclusion criteria. A total of 100 samples were selected based on convenience sampling technique and the knowledge of the adult regarding healthy lifestyle was assessed by providing self-structured questionnaires through Google forms.

Data analysis:

The collected data were organized, tabulated and analyzed. The data analysis was done according to the objectives of the study. The researcher used descriptive and inferential statistics for data analysis.

RESULT:

In this study it shows that 04% of adults had poor knowledge on healthy lifestyle, 23% had average knowledge and 73% had good knowledge when tested by using a structured questionnaire.

Table 1: Scoring of Structured Knowledge Questionnaire

Knowledge score level	Score
Poor	0-8
Average	9-16
Good	17-25

Table 2: Association between knowledge regarding healthy lifestyles among adult and selected demographic variables

Sl. No	Demographic variables	Knowledge			df	Chi Square	Level of Significance
		Poor	Average	Good
1.	Age
	19-20	2	7	10	6	17.74	S
	21-30	0	9	55
	31-40 Above 40	1 1	3 4	3 5
2.	Gender
	Male	3	7	20	2	4.095	NS
	Female	1	16	54
3.	Education
	Primary	0	2	20	6	9.158	NS
	Higher secondary Graduate Post graduate and above	2 2 0	5 15 1	16 50 7
4.	Occupation
	Un employee	1	15	45	6	5.919	NS
	Government employee	1	3	4
	Private employee	1	4	18
	Self employee	1	1	6
5.	Type of food
	Vegetarian	0	2	8	2	0.563	NS
	Non vegetarian	4	15	46
6.	Non communicable disease
	Yes	1	7	6	2	7.588	S
	No	3	16	67
7. 8. 9.	Exercise
	Yes	0	8	27	2 6 6	2.281 14.076 7.005	NS NS NS
	No	4	15	46
	Height 140-150 151-160 161-170 Above170 Weight 40-50 51-60 61-70 Above 70	0 1 1 3 0 2 1 1	4 14 4 1 10 4 7 2	13 29 26 5 23 29 16 5

S- Significant NS- Non-significant