More than 70% of worldwide deaths each year are the result of noncommunicable diseases such as cardiovascular disease, cancers, chronic respiratory diseases and diabetes. These four groups account for more than 80% of all premature deaths from noncommunicable diseases.

The worse news is that conditions leading to these premature deaths are often related to lifestyle choices that involve long-term risks that are often not apparent to children and adolescents. One in three adolescents reported at least three of six risk factors that contribute to the development of a noncommunicable disease later in life.

That’s the top-line conclusion reached from a new analysis of data collected between 2007 and 2016 from 304,779 adolescents aged 11 to 17 years (52.2% females) from 89 countries as part of the Global School-based Student Health Survey. The researchers compared the observed to expected prevalence ratios of 64 possible combinations of the six risk factors to determine clustering patterns.

More than four in five adolescents (82.4%) had at least two risk factors, and just over a third (34.9%) had at least three. More than half (56%) of adolescents in the Americas had at least three risk factors, the most of any region in the world.

Associate Professor Asaduzzaman Khan of the University of Queensland School of Health and Rehabilitation Sciences and one of the study’s authors commented, “Many of these behaviours acquired during adolescence tend to remain in adulthood, and exposure to each additional risk factor increases the future risk of poor health and premature death.” Globally, adolescents generally exhibit multiple modifiable risk factors for future development of noncommunicable diseases.

The clustering, or co-occurrence, of smoking, drinking alcohol, physical inactivity, and low fruit and vegetable intake was observed in roughly the same proportion in both females and males. The co-occurrence of these four risk factors were 165% greater than expected among females, compared to 110% greater than expected among males. Overall, however, boys reported more lifestyle risk factors than girls. Some conditions and diseases people have for some time — completely unaware — and it would be good to pay better attention to potential signs and symptoms — biting your nails and other habits that could be a sign of a serious problem.

Along with the periodic collection of similar risk factor data, Dr. Khan also makes this recommendation: “Early gender-specific prevention strategies targeting clusters of modifiable risk factors, customised for WHO [World Health Organization] regions, should be prioritised to help mitigate current and future burden of non-communicable diseases globally.”

Smoking and alcohol use clustered in both sexes across all regions of the world. Smoking, alcohol use, physical inactivity and poor diet clustered in males while physical inactivity, sedentary behavior and poor diet clustered in females. Although certain foods like dairy, eggs, and fats are contentious topics in the nutrition world — often with conflicting scientific evidence of their health benefits versus dangers — there is a consensus around the health of foods — find out what healthy eating habits will change your life for the better.

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