The Clustering of Lifestyle Risk Factors in the Serbian Adult Population and Association with Self-Rated Health

Variables	n (%)	weighted %
Socio-demographic characteristics
Gender
women	4138 (52.5)	53.2
men	3747 (47.5)	46.8
Age (years)
18–34	1696 (21.5)	24.7
35–54	2578 (32.7)	35.4
55 and over	3611 (45.8)	39.9
Marital status
married	4975 (63.2)	61.3
single	2896 (36.8)	38.7
Region of Serbia
Belgrade	1534 (19.5)	20.6
Vojvodina	2109 (26.7)	31.0
Sumadija and Western Serbia	2831 (35.9)	30.4
Southern and Eastern Serbia	1411 (17.9)	18.0
Education level
postsecondary	1598 (20.3)	22.4
secondary	4513 (57.2)	57.3
primary	1773 (22.5)	20.4
Lifestyle risk factors¹
Smoking	2540 (32.2)	33.1
Risky alcohol drinking	758 (9.6)	10.5
Physical inactivity	2960 (37.5)	38.2
Low fruit and vegetable intake	4982 (63.2)	63.1
Self-rated health
very good	1928 (24.5)	26.7
good	3120 (39.6)	40.2
fair	2002 (25.4)	23.7
bad	696 (8.8)	7.9
very bad	136 (1.7)	1.5
Total²	7885 (100.0)	100.0

Legend:

1 Prevalence of lifestyle risk factors;

2 The total sample included participants who provided data for all four lifestyle risk factors

Table 2.

Distribution of lifestyle risk factors in the clusters.

Lifestyle risk factors	Cluster 2. Low fruit and vegetable intake (n=1847)	Cluster 3. Physical inactivity (n=1931)	Cluster 4. Smoking and other LRFs (n=2147)	Cluster 5. Risky drinking and other LRFs (n=758)	Total (n=7885)
Smoking (%)	0.0	0.0	100.0	52.5	33.1
Physical inactivity (%)	0.0	100.0	37.7	30.3	38.2
Risky drinking (%)	0.0	0.0	0.0	100.0	10.5
Low fruit and vegetable intake (%)	100.0	59.6	68.7	67.4	63.1

[i] Values in the table are weighted.

Table 3.

Multinomial logistic regression model estimating the association between cluster membership and socio-demographic characteristics.

Lifestyle risk factors	Cluster 2. Low fruit and vegetable intake; OR (95% CI)	Cluster 3. Physical inactivity; OR (95% CI)	Cluster 4. Smoking and other LRFs; OR (95% CI)	Cluster 5. Risky drinking and other LRFs; OR (95% CI)
Gender
women	1	1	1	1
men	1.33 (1.32–1.33)^*	0.78 (0.77–0.78)^*	1.01 (1.01–1.02)^*	4.99 (4.95–5.04)^*
Age (years)
18–34	1.88 (1.86–1.90)^*	1.04 (1.03–1.05)^*	1.42 (1.40–1.43)^*	3.53 (3.48–3.57)^*
35–54	1.51 (1.50–1.52)^*	0.99 (0.98–1.00)^*	2.01 (1.99–2.02)^*	2.37 (2.34–2.39)^*
55 and over	1	1	1	1
Marital status
married	1	1	1	1
single	1.01 (1.00–1.01)	1.38(1.37–1.39)^*	1.21 (1.21–1.22)^*	1.22 (1.21–1.23)^*
Region of Serbia
Belgrade	1	1	1	1
Vojvodina	1.76 (1.74–1.77)^*	0.97 (0.97–0.98)^*	1.28 (1.27–1.29)^*	1.58 (1.56–1.60)^*
Sumadija and Western Serbia	3.00 (2.97–3.03)^*	0.99 (0.98–0.99)^*	1.27 (1.26–1.28)^*	1.22 (1.20–1.24)^*
Southern and Eastern Serbia	1.60 (1.58–1.61)^*	1.06 (1.05–1.07)^*	1.03 (1.02–1.05)^*	2.42 (2.39–2.48)^*
Education level
postsecondary	1	1	1	1
secondary	1.44 (1.43–1.45)^*	0.83 (0.82–0.83)^*	1.49(1.48–1.50)^*	1.45 (1.44–1.47)^*
primary	1.95 (1.93–1.97)^*	1.11(1.10–1.12)^*	1.79 (1.77–1.81)^*	1.19 (1.17–1.21)^*

Legend: The reference category for the dependent variable in a multinomial logistic regression model is Cluster 1 (Healthy lifestyle) ; OR=odds ratio; CI=confidence interval;

* p<0.01

Table 4.

Association between poor SRH and lifestyle clusters.

Lifestyle clusters	Unadjusted model; OR (95% CI)	Model 1; OR (95% CI)	Model 2 OR (95% CI)
Cluster 1 (Healthy lifestyle)	1	1	1
Cluster 2 (Low fruit and vegetable intake)	0.95 (0.94–0.96)^*	1.16 (1.14–1.17)^*	0.99 (0.97–1.00)
Cluster 3 (Physical inactivity)	2.88 (2.84–2.91)^*	3.07 (3.04–3.11)^*	2.97 (2.93–3.01)^*
Cluster 4 (Smoking and other LRFs)	1.49 (1.48–1.51)^*	1.88 (1.85–1.90)^*	1.82 (1.80–1.85)^*
Cluster 5 (Risky drinking and other LRFs)	0.61 (0.60–0.63)^*	1.13 (1.11–1.16)^*	1.09 (1.07–1.11)^*

Legend: Model 1 was adjusted for gender and age; Model 2 was adjusted for all socio-demographic variables (gender, age, marital status, region, education); OR=odds ratio; CI=confidence interval;

* p<0.01

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DOI: https://doi.org/10.2478/sjph-2025-0027 | Journal eISSN: 1854-2476 | Journal ISSN: 0351-0026

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Language: English, Slovenian

Page range: 208 - 217

Submitted on: May 23, 2025

Accepted on: Oct 23, 2025

Published on: Dec 1, 2025

Published by: National Institute of Public Health, Slovenia

In partnership with: Paradigm Publishing Services

Keywords:

Related subjects:

Hygiene and environmental medicine

© 2025 Nataša Dragnić, Sanja Harhaji, Vesna Mijatović Jovanović, Sonja Čanković, Snežana Ukropina, Ivana Radić, published by National Institute of Public Health, Slovenia
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Volume 64 (2025): Issue 4 (December 2025)