The purpose of this paper is to add to the growing body of knowledge r
egarding the clustering or covariation of health behaviors in adolesce
nts. Patterns of smoking, healthy eating and activity levels were exam
ined through a self-report survey using serial cross-sectional samples
of students over 7 years (sixth to 12th grade). The students represen
ted were participants in the Class of 89 study, a component of the Min
nesota Heart Health Program. Comparisons are made between males and fe
males as well as by reference and intervention communities. Bi-variate
and multivariate results suggest that not only do associations exist
between health behaviors, but the associations strengthen over time, A
fter the eighth grade, students reporting lower activity patterns as w
ell as those making fewer healthy food choices also exhibit a higher w
eekly smoking prevalence. The multivariate analyses point to a risk pr
ofile where smoking, poor food choices and lower activity patterns clu
ster. The results point to the importance of early health education in
order to foster the development of a positive health profile prior to
consolidation of unhealthful behaviors. Comprehensive school-based he
alth education is also recommended as a way to promote the importance
and development of a healthy lifestyle across multiple behaviors.