Prevalence and co-occurrence of behavioral risk factors for noncommunicable diseases among working-age adults attending primary care in Bosnia and Herzegovina: a multicenter cross-sectional study.

AIM: To assess the prevalence and co-occurrence of established behavioral risk factors for noncommunicable diseases (NCDs) among the working-age population attending family medicine clinics across Bosnia and Herzegovina (BiH). METHODS: This cross-sectional study enrolled clinically stable individuals aged 18 to 65 years attending family medicine clinics across BiH. We assessed the prevalence and distribution of behavioral risk factors for NCDs using a standardized questionnaire and compared them by sex, socio-economic status, age groups, place of residence, and NCD status. RESULTS: The study included 2112 participants, of whom 584 (28%) had an NCD. The most prevalent behavioral risk factors were insufficient daily intake of fruit (85%), fiber (71%), and water (69%), followed by high salt consumption (66%) and physical inactivity (65%). The prevalence of overweight was 57% and it was significantly higher in men than in women. Men reported higher smoking rates but had higher levels of physical activity and greater water intake. Women demonstrated healthier dietary patterns and significantly higher fruit and fiber intake. Participants with NCDs had a better diet than those without NCDs, but reported worse stress management and sleep quality, which might reflect behavioral changes following disease onset. CONCLUSION: Behavioral risk factors for NCDs are widespread among the working-age population in BiH, with suboptimal diet, physical inactivity, and smoking being the most prevalent ones. Public health policies should be focused on disease prevention, such as health-promoting infrastructure and education for health care professionals and patients.