<![CDATA[Type 2 Diabetes Mellitus (DMT2) prevalence is rising among adolescents globally. Unhealthy lifestyle behaviors including low physical activity, poor dietary patterns, negative attitudes, and inadequate family support are primary risk factors for early-onset DMT2. This study examines the relationships between these modifiable lifestyle factors and healthy lifestyle implementation among adolescents in Bandar Lampung, Indonesia. A quantitative cross-sectional study was conducted at Puskesmas Sumur Batu and Labuhan Ratu, Bandar Lampung City (2026). A total of 363 adolescents aged 12–14 years were selected using proportional random sampling (Slovin formula, 10% margin of error). Structured and validated questionnaires (Pearson r>0.361; Cronbach's alpha>0.70) measured physical activity, dietary pattern, attitude, and family support. Data were analyzed using univariate, bivariate (Chi-square), and multivariate (logistic regression) analyses. Statistically significant associations were found for all four independent variables with healthy lifestyle implementation: physical activity (OR=1.801, 95% CI: 1.083–2.997; p=0.031), dietary pattern (OR=2.333, 95% CI: 1.417–3.842; p=0.001), attitude (OR=1.927, 95% CI: 1.168–3.178; p=0.014), and family support (OR=1.739, 95% CI: 1.061–2.851; p=0.037). Multivariate logistic regression identified dietary pattern as the strongest determinant (adjusted OR=2.179; 95% CI: 1.338–3.547; p=0.002). Dietary pattern is the dominant factor influencing healthy lifestyle implementation among adolescents. All four lifestyle factors were independently and significantly associated with healthy lifestyle behavior. Evidence-based health promotion strategies, particularly nutrition education and multidisciplinary interventions targeting adolescents and their families, are essential for DMT2 prevention. Study limitations include self-reported data and two-site sampling, which may limit generalizability.]]>
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