Patterns of multiple lifestyle risk factors and their link to mental health in the German adult population: a cross-sectional study

Objectives Lifestyle risk factors, such as drinking or unhealthy diet, can expotentiate detrimental health effects. Therefore, it is important to investigate multiple lifestyle risk factors instead of single ones. The study aims at: (1) identifying patterns of lifestyle risk factors within the adult general population in Germany and (2) examining associations between the extracted patterns and external factors. Design Cross-sectional study. Setting General German adult population (aged 18-64 years). Participants Participants of the 2015 Epidemiological Survey of Substance Abuse (n=9204). Primary outcome measures Lifestyle risk factors (daily smoking, at-risk alcohol consumption, unhealthy diet, low physical activity, weekly use of pharmaceuticals, as well as consumption of cannabis and other illicit drugs). Results A latent class analysis was applied to identify patterns of lifestyle risk factors, and a multinomial logistic regression was carried out to examine associations between the extracted classes and external factors. A total of four classes were extracted which can be described as healthy lifestyle (58.5%), drinking lifestyle (24.4%), smoking lifestyle (15.4%) and a cumulate risk factors lifestyle (1.7%). Individuals who were male, at younger age and single as well as individuals with various mental health problems were more likely to show multiple lifestyle risk factors. Conclusions Healthcare professionals should be aware of correlations between different lifestyle risk factors as well as between lifestyle risk groups and mental health. Health promotion strategies should further focus especially on younger and single men

Impact of reducing alcohol consumption through price‐based policies on cancer incidence in Germany 2020–50—a simulation study

Background and Aims Alcohol is a major cancer risk factor and contributes considerably to the cancer burden in Germany. We aimed to provide projections of preventable cancer cases under different price-based alcohol policy scenarios. Design A macro-simulation approach was used to estimate numbers and proportions of cancer cases prevented under different price-based alcohol policy scenarios. Setting and participants Published price elasticities for main alcoholic beverages were applied to the mean daily intake of pure alcohol in the German population calculated from the German Health Interview and Examination Survey for Adults 2008-11 (DEGS1) to obtain hypothetical exposure distributions of alcohol consumption under different scenarios of changing price for alcoholic beverages. Measurements Age, sex and cancer site-specific potential impact fractions were calculated for different scenarios of changing the price of alcohol (single price increases, repeated price increases, volumetric price increase) for each year of a 30-year study period (2020-50). Findings Over a 30-year horizon, an estimated 4.7% (men = 10.1%, women = 1.4%) of alcohol-related cancer cases could be prevented in Germany, if alcohol intake above risk thresholds were reduced to levels below risk thresholds. Accordingly, the burden of new cancers would be reduced by approximately 244 000 cases (men = 200 000, women = 44 000). Of all price-based alcohol policy scenarios, a 100% price increase on alcoholic beverages was estimated to be most effective with approximately 213 000 (4.1%; men = 167 000; women = 47 000) preventable alcohol-related cancer cases, followed by 5-yearly 25% price increases (2.8%; men = 115 000, women = 29 000) and a volumetric price increase according to the beverage-specific alcohol content (1.9%; men = 72 000, women = 24 000). Conclusions Simulations suggest that a substantial number of alcohol-related cancer cases could be avoided in Germany by applying price-based policies to reduce consumption of alcoholic beverages