Clustering patterns of physical activity, sedentary and dietary behavior among European adolescents: The HELENA study

<p>Abstract</p> <p>Background</p> <p>Evidence suggests possible synergetic effects of multiple lifestyle behaviors on health risks like obesity and other health outcomes. A better insight in the clustering of those behaviors, could help to identify groups who are at risk in developing chronic diseases. This study examines the prevalence and clustering of physical activity, sedentary and dietary patterns among European adolescents and investigates if the identified clusters could be characterized by socio-demographic factors.</p> <p>Methods</p> <p>The study comprised a total of 2084 adolescents (45.6% male), from eight European cities participating in the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) study. Physical activity and sedentary behavior were measured using self-reported questionnaires and diet quality was assessed based on dietary recall. Based on the results of those three indices, cluster analyses were performed. To identify gender differences and associations with socio-demographic variables, chi-square tests were executed.</p> <p>Results</p> <p>Five stable and meaningful clusters were found. Only 18% of the adolescents showed healthy and 21% unhealthy scores on all three included indices. Males were highly presented in the cluster with high levels of moderate to vigorous physical activity (MVPA) and low quality diets. The clusters with low levels of MVPA and high quality diets comprised more female adolescents. Adolescents with low educated parents had diets of lower quality and spent more time in sedentary activities. In addition, the clusters with high levels of MVPA comprised more adolescents of the younger age category.</p> <p>Conclusion</p> <p>In order to develop effective primary prevention strategies, it would be important to consider multiple health indices when identifying high risk groups.</p

A cluster-analytic approach towards multidimensional health-related behaviors in adolescents: the MoMo-Study

<p>Abstract</p> <p>Background</p> <p>Although knowledge on single health-related behaviors and their association with health parameters is available, research on multiple health-related behaviors is needed to understand the interactions among these behaviors. The aims of the study were (a) to identify typical health-related behavior patterns in German adolescents focusing on physical activity, media use and dietary behavior; (b) to describe the socio-demographic correlates of the identified clusters and (c) to study their association with overweight.</p> <p>Methods</p> <p>Within the framework of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) and the “Motorik-Modul” (MoMo), 1,643 German adolescents (11–17 years) completed a questionnaire assessing the amount and type of weekly physical activity in sports clubs and during leisure time, weekly use of television, computer and console games and the frequency and amount of food consumption. From this data the three indices ‘physical activity’, ‘media use’ and ‘healthy nutrition’ were derived and included in a cluster analysis conducted with Ward’s Method and K-means analysis. Chi-square tests were performed to identify socio-demographic correlates of the clusters as well as their association with overweight.</p> <p>Results</p> <p>Four stable clusters representing typical health-related behavior patterns were identified: Cluster 1 (16.2%)—high scores in physical activity index and average scores in media use index and healthy nutrition index; cluster 2 (34.6%)—high healthy nutrition score and below average scores in the other two indices; cluster 3 (18.4%)—low physical activity score, low healthy nutrition score and very high media use score; cluster 4 (30.5%)—below average scores on all three indices. Boys were overrepresented in the clusters 1 and 3, and the relative number of adolescents with low socio-economic status as well as overweight was significantly higher than average in cluster 3.</p> <p>Conclusions</p> <p>Meaningful and stable clusters of health-related behavior were identified. These results confirm findings of another youth study hence supporting the assumption that these clusters represent typical behavior patterns of adolescents. These results are particularly relevant for the characterization of target groups for primary prevention of lifestyle diseases.</p