Kristin Manz

Körperlich-sportliche Aktivität und Nutzung elektronischer Medien im Kindes- und Jugendalter

Physical activity during childhood and adolescence has numerous health benefits, while sedentary behavior, especially electronic media use, is associated with the development of overweight. Therefore, the promotion of physical activity during childhood and adolescence is an integral part of national public health efforts. The aim of this article is to describe the physical activity behavior of German children and adolescents based on the nationwide data of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS wave 1). Furthermore, the association between physical activity and sports participation and use of screen-based media in youth aged 11 to 17 years was analyzed. The analyses included data from 10,426 children and adolescents aged 3-17 years collected by telephone interviews. Children older than 11 years answered the questions by themselves, whereas a parent was interviewed for younger children. The descriptive analyses were performed under consideration of social and demographic factors. According to the results of KiGGS wave 1 a total of 77.5% (95% Cl 76.0-78.9 %) of the children and adolescents participated in sports activities, and 59.7% (58.1-61.3 %) were members of a sports club. The recommendation of the World Health Organization (WHO) to be physically active at least 60 min per day was achieved by 27.5% (26.0-28.9 %). Children and adolescents with a low socioeconomic status (SES) participated less in sports activities than children of higher SES groups. Excessive use of screen-based media was more likely to be associated with lack of sports participation than with a lack of physical activity. In the future, preventive measures should promote the daily physical activity of children and adolescents and additionally encourage children and adolescents with low SES to participate in sports activities.

Recommendations for Promoting Physical Activity for Children and Adolescents in Germany. A Consensus Statement

Increasing physical activity and reduction of sedentary behaviour play important roles in health promotion and prevention of lifestyle-related diseases in children and adolescents. However, the question of how much physical activity is useful for which target group is still a matter of debate. International guidelines (World Health Organization; European Association for the Study of Obesity), which are mainly based on expert opinions, recommend 60 min of physical activity every day. Age- and sex-specific features and regional differences are not taken into account. Therefore, expert consensus recommendations for promoting physical activity of children and adolescents in Germany were developed with special respect to national data, but also with respect to aspects of specific target groups, e.g., children with a lower socio-economic status (SES) or with migration background. They propose 90 min/day of physical activity, or at least 12,000 steps daily. Additionally, lifestyle factors, especially restriction of media consumption, were integrated. The recommendations provide orientation for parents and caregivers, for institutions such as schools and kindergartens as well as for communities and stakeholders.

[Physical activity and electronic media use in children and adolescents: results of the KiGGS study: first follow-up (KiGGS wave 1)].

Physical activity during childhood and adolescence has numerous health benefits, while sedentary behavior, especially electronic media use, is associated with the development of overweight. Therefore, the promotion of physical activity during childhood and adolescence is an integral part of national public health efforts. The aim of this article is to describe the physical activity behavior of German children and adolescents based on the nationwide data of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS wave 1). Furthermore, the association between physical activity and sports participation and use of screen-based media in youth aged 11 to 17 years was analyzed. The analyses included data from 10,426 children and adolescents aged 3-17 years collected by telephone interviews. Children older than 11 years answered the questions by themselves, whereas a parent was interviewed for younger children. The descriptive analyses were performed under consideration of social and demographic factors. According to the results of KiGGS wave 1 a total of 77.5% (95% Cl 76.0-78.9 %) of the children and adolescents participated in sports activities, and 59.7% (58.1-61.3 %) were members of a sports club. The recommendation of the World Health Organization (WHO) to be physically active at least 60 min per day was achieved by 27.5% (26.0-28.9 %). Children and adolescents with a low socioeconomic status (SES) participated less in sports activities than children of higher SES groups. Excessive use of screen-based media was more likely to be associated with lack of sports participation than with a lack of physical activity. In the future, preventive measures should promote the daily physical activity of children and adolescents and additionally encourage children and adolescents with low SES to participate in sports activities.

Predictors of physical activity among older adults in Germany: a nationwide cohort study

Objectives To investigate individual, interpersonal and environmental baseline factors predicting regular aerobic physical activity (PA) participation among older adults in Germany at follow-up 12 years later. Design Population-based cohort study. Setting Cluster-randomised general population sample selected based on population registry address information from 130 nationally distributed sample points collected from 1997 to 1999 and re-evaluated 12 years later from 2008 to 2011. Participants 1184 adults, aged 65 years or older at follow-up with complete data at baseline and follow-up, were included in the final study sample. Outcome measure Regular ‘aerobic PA ≥1 day/week’ assessed based on self-reported information. Results At follow-up, 53.2% of the participants engaged in aerobic PA ≥1 day/week. Participants aged 50 to 60 years at baseline were more likely to engage in aerobic PA ≥1 day/week than participants aged 61 to 78 years; OR 1.88, 95% CI 1.46 to 2.40. Participants with middle and high socioeconomic status (SES) were more likely to engage in aerobic PA ≥1 day/week than participants with low SES; OR middle SES 2.08, 1.33 to 3.25; high SES 3.44, 2.11 to 5.60. Participants with high social support were more likely to engage in aerobic PA ≥1 day/week at follow-up than participants with low social support; OR 1.98, 1.26 to 3.12. Furthermore, participants who engaged in leisure time PA at least once per week at baseline were more likely to engage in aerobic PA ≥1 day/week at follow-up than those who engaged less than once per week; OR 1.95, 1.46 to 2.60. Conclusions Several influencing factors assessed at baseline predicted regular aerobic PA participation 12 years later. These factors should be considered when planning interventions to prevent physical inactivity in older adults. There is great potential to increase aerobic PA participation in older adults in Germany, in particular among those with low SES and low social support.

Health-enhancing physical activity during leisure time amongadults in Germany

Self-reported data from the GEDA 2014/2015-EHIS study was used to calculate the level of compliance among adults in Germany with the World Health Organization’s (WHO) recommendations on physical activity. The WHO’s recommendations distinguish between ‘aerobic activity’ and ‘muscle-strengthening activity’. In Germany, 42.6% of women and 48.0% of men reported that they conduct at least 2.5 hours of aerobic physical activity per week, and therefore meet the WHO’s recommendation on this form of activity. A higher level of education among women and men of all ages is associated with a higher frequency of meeting the WHO’s recommendations on aerobic activity. In addition, 27.6% of women and 31.2% of men conduct muscle-strengthening activity at least twice a week, thereby meeting the WHO’s recommendations on this form of activity. About one fifth of women (20.5%) and one quarter of men in Germany (24.7%) meet both of these recommendations. In summary, the results point to the value of encouraging people to conduct more physical activity during their leisure time. In fact, inactive people who begin to follow the WHO’s recommendations can significantly reduce their long-term risk of premature mortality. PHYSICAL ACTIVITY · PHYSICAL ACTIVITY RECOMMENDATIONS · ADULTS · GERMANY · HEALTH MONITORING Introduction Physical activity is defined as any bodily movement generated by the skeletal muscles that requires more energy to be consumed than the basal metabolic rate [1]. Health-enhancing physical activity includes aerobic activity (endurance activity) such as cycling, jogging, playing football or swimming that increases breathing and heart rate and is undertaken without interruption for at least 10 minutes [2]. Aerobic activity provides an important contribution to the maintenance and recovery of the health of the cardiovascular and metabolic system [3, 4]. Muscle-strengthening activity such as strength training, Pilates and yoga is also beneficial to health, as it increases the performance and health of the human musculoskeletal system, skeletal muscles, joints, bones, tendons and ligaments [2, 4]. In contrast, a lack of physical activity increases the risks of developing the most important non-communicable diseases such as heart disease, type 2 diabetes mellitus, and breast and colorectal cancer, and it also reduces life expectancy [5]. According to the 2015 Global Burden of Disease Study, physical inactivity in Germany contributes to a significant reduction in life expectancy and quality of life. Specifically, physical inactivity was found to be linked to 10% of the years lost due to coronary heart disease, 17% of the years lost due to diabetes mellitus, 15% of the years lost due to colorectal Journal of Health Monitoring Health-enhancing physical activity during leisure time among adults in Germany Journal of Health Monitoring 2017 2(2) FACT SHEET 36 cancer and 10% of the years lost due to breast cancer [6]. As insufficient levels of physical activity are associated with disease, the World Health Organization (WHO) formulated the goal of reducing the prevalence of insufficient physical activity (defined as less than 2.5 hours of moderateto vigorous-intensity physical activity per week) as part of the Global Action Plan for the Prevention and Control of Non-Communicable Diseases 20132020. The aim is to ensure that levels of insufficient physical activity are 10% lower than 2010 levels by 2025 [7]. Indicator The WHO’s recommendations on physical activity differentiate between ‘aerobic activity’ and ‘muscle-strengthening activity’ [2, 8]. Adherence to these recommendations among the population in Germany [8] was assessed with the validated German version of the European Health Interview Survey – Physical Activity Questionnaire (EHIS-PAQ) used for the German Health Update (GEDA 2014/2015-EHIS) survey [9, 10]. As part of this study, respondents were asked about the duration of the physical activity they undertake during a typical week, in the form of both moderate-intensity aerobic physical activity conducted during leisure time and cycling used for transportation, as well as the number of days a week during which they undertake muscle-strengthening activities. Details about the way in which these indicators were constructed have been published elsewhere [10]. The following describes the proportion of respondents who conduct at least moderate-intensity aerobic activities for at least 2.5 hours a week (the first part of the WHO’s recommendations on physical activity), as well as those who conduct muscle-strengthening activities on at least two days a week (the second part of the WHO’s recommendations), and the proportion of those who meet both parts of the WHO’s recommendations (2.5 hours of aerobic activity, as well as muscle-strengthening activities twice a week). The figures are stratified according to gender, age, level of education and federal state. A difference between these groups is interpreted as statistically significant where confidence intervals do not overlap. The analyses are based on data from 22,959 participants aged 18 years and above (12,511 women, and 10,448 men) with valid EHIS-PAQ data. The calculations were carried out using a weighting factor that corrects for deviations within the sample from the structure of the German population (as of 31 December 2014) with regard to gender, age, community type and education. The community type reflects the degree of urbanisation and corresponds to the regional distribution in Germany. The International Standard Classification for Education (ISCED) was used to ensure the respondents’ responses on education were comparable [11]. A detailed description of the methodology applied in GEDA 2014/2015EHIS can be found in the article German Health Update: New data for Germany and Europe in issue 1/2017 of the Journal of Health Monitoring. Results and discussion According to results from the GEDA 2014/2015-EHIS study, 42.6% of women and 48.0% of men meet the WHO’s recommendation on aerobic activity (Tables 1 and Table 2). 56.7% of men aged between 18 and 29 meet GEDA 2014/2015-EHIS Data holder: Robert Koch Institute Aims: To provide reliable informa tion about the population’s health status, health-related behaviour and health care in Germany, with the possibility of a European comparison Method: Questionnaires completed on paper or online Population: People aged 18 years and above with permanent residency in Germany Sampling: Registry office sample; randomly selected individuals from 301 communities in Germany were invited to participate Participants: 24,016 people (13,144 women; 10,872 men) Response rate: 26.9% Study period: November 2014 July 2015 Data protection: This study was undertaken in strict accordance with the data protection regulations set out in the German Federal Data Protection Act and was approved by the German Federal Commissioner for Data Protection and Freedom of Information. Participation in the study was voluntary. The participants were fully informed about the study’s aims and content, and about data protection. All participants provided written informed consent. More information in German is available at www.geda-studie.de Journal of Health Monitoring Health-enhancing physical activity during leisure time among adults in Germany Journal of Health Monitoring 2017 2(2) FACT SHEET 37 the WHO’s recommendations on aerobic activity; the same can be said of around 45% of men in other age groups. Among women, compliance with the recommendations is highest in the 45-to-64 age group (47.8%). No uniform pattern can be observed among women in terms of age distribution. A smaller proportion of women (27.6%) and men (31.2%) meet the WHO’s recommendation on muscle-strengthening activity. About one fifth of women (20.5%) and one quarter of men (24.7%) meet both recommendations. An association exists between level of education and health-enhancing aerobic physical activity among women Table 1 Health-enhancing physical activity during leisure time among women according to age and educational status (n=12,511) Source: GEDA 2014/2015-EHIS 42.6% of women and 48.0% of men in Germany meet the World Health Organization’s recommendations on aerobic activity by undertaking at least 2.5 hours of aerobic physical activity per week. and men of all age groups: the proportion of adults who meet the recommendations on physical activity is lower in groups with lower levels of education compared to those with the higher levels of education (Table 1 and Table 2). The proportion of women in Thuringia who meet the recommendations on aerobic activity is below the national average; in Hamburg, it is above the national average. The proportion of men in Mecklenburg-West Pomerania and Saxony who meet the recommendations on aerobic activity is below the national average; in Bremen, it is above the national average (Figure 1). Women Aerobic activity at least 2.5 hours per week Muscle-strengthening activity at least 2 times a week Aerobic and muscle-strengthening activity recommendations compliance % (95% CI) % (95% CI) % (95% CI) Women total 42.6 (41.3-43.9) 27.6 (26.7-28.6) 20.5 (19.6-21.4) 18-29 Years 45.2 (42.3-48.2) 34.5 (32.1-37.0) 25.8 (23.6-28.2) Low education 40.1 (34.2-46.3) 29.5 (24.3-35.3) 21.9 (17.2-27.3) Medium education 44.4 (40.6-48.2) 35.8 (32.6-39.1) 26.0 (23.1-29.1) High education 55.0 (49.6-60.2) 35.6 (31.5-40.0) 29.3 (25.1-33.8) 30-44 Years 38.8 (36.7-41.0) 21.1 (19.5-22.9) 16.3 (14.8-17.9) Low education 34.2 (27.7-41.5) 12.7 (8.9-17.7) 11.1 (7.5-16.1) Medium education 36.7 (34.0-39.5) 20.2 (18.1-22.5) 15.0 (13.1-17.1) High education 46.4 (42.9-49.8) 28.1 (25.0-31.3) 22.3 (19.5-25.4) 45-64 Years 47.8 (46.0-49.6) 29.4 (27.9-30.9) 22.7 (21.3-24.2) Low education 44.3 (39.7-49.1) 26.1 (22.5-30.1) 20.0 (16.7-23.7) Medium education 46.5 (44.3-48.8) 29.3 (27.4-31.2) 22.4 (20.6-24.2) High education 55.0 (51.5-58.3) 32.7 (30.2-35.4) 26.2 (23.8-28.7) ≥ 65 Years 36.5 (34.0-39.1) 26.

Gesundheitsfördernde körperliche Aktivität in der Freizeitbei Erwachsenen in Deutschland

Auf Basis der Selbstangaben in GEDA 2014/2015-EHIS wurde die Einhaltung der Bewegungsempfehlungen der Weltgesundheitsorganisation (WHO) bei Erwachsenen in Deutschland ermittelt. Die Empfehlungen unterscheiden zwischen „Ausdaueraktivitäten“ und „Aktivitäten zur Muskelkräftigung“. 42,6 % der Frauen und 48,0 % der Männer geben an, mindestens 2,5 Stunden pro Woche aerobe körperliche Aktivität auszuüben und erreichen dadurch die WHO-Empfehlung zur Ausdaueraktivität. Für alle Altersgruppen bei Frauen und Männern gilt: Je höher der Bildungsstand, desto häufiger wird die WHO-Empfehlung zur Ausdaueraktivität erreicht. 27,6 % der Frauen und 31,2 % der Männer erreichen die WHO-Empfehlung für muskelkräftigende Aktivitäten mindestens zweimal pro Woche. Beide Empfehlungen erreichen etwa ein Fünftel der Frauen (20,5 %) und ein Viertel der Männer (24,7 %). Insgesamt weisen die Ergebnisse auf ein hohes Potenzial für die Bewegungsförderung in der Freizeit hin. Inaktive Personen, die beginnen sich den Empfehlungen entsprechend zu bewegen, können langfristig das Risiko frühzeitiger Sterblichkeit deutlich reduzieren. KÖRPERLICHE AKTIVITÄT · BEWEGUNGSEMPFEHLUNGEN · ERWACHSENE · DEUTSCHLAND · GESUNDHEITSMONITORING Einleitung Als körperliche Aktivität wird jede Bewegung definiert, die durch die Skelettmuskulatur erzeugt wird und den Energieverbrauch über den Grundumsatz anhebt [1]. Zu gesundheitsfördernden Aktivitäten gehören einerseits aerobe körperliche Aktivitäten (Ausdaueraktivitäten) wie Radfahren, Joggen, Fußballspielen oder Schwimmen, die eine erhöhte Atemund Herzfrequenz erzeugen und über einen Zeitraum von mindestens 10 Minuten ohne Unterbrechung ausgeübt werden [2]. Diese Aktivitäten leisten einen wichtigen Beitrag zur Erhaltung bzw. Wiedererlangung der Gesundheit des Herz-Kreislaufund Stoffwechselsystems [3, 4]. Andererseits wirken auch Aktivitäten zur Muskelkräftigung wie Krafttraining, Pilates oder Yoga gesundheitsfördernd, da diese die Leistungsfähigkeit und Gesundheit des Bewegungsapparates, der Skelettmuskeln, Gelenke, Knochen, Sehnen und Bänder fördern [2, 4]. Körperliche Inaktivität erhöht das Risiko für die wichtigsten nicht-übertragbaren Erkrankungen wie Herz-Kreislauf-Erkrankungen, Diabetes mellitus Typ 2, Brustund Darmkrebs und reduziert die Lebenserwartung [5]. Nach der Global Burden of Disease Study 2015 trägt körperliche Inaktivität in Deutschland zu einer erhebAutorinnen und Autoren: Jonas D. Finger, Gert B.M. Mensink, Cornelia Lange, Kristin Manz Journal of Health Monitoring · 2017 2(2) DOI 10.17886/RKI-GBE-2017-027 Robert Koch-Institut, Berlin Journal of Health Monitoring Gesundheitsfördernde körperliche Aktivität in der Freizeit bei Erwachsenen in Deutschland

Work-related physical activity among adults in Germany

In GEDA 2014/2015-EHIS the prevalence of work-related physical activity was estimated based on respondents’ self-reported data. 47.5% of women and 47.2% of men mostly sit or stand during work. The highest proportion of people who mostly sit or stand during work is found among 18to 29-year-old women (55.5%) and men aged 30 to 44 (50.2%). A significantly higher proportion of men (14.8%) than women (3.2%) have jobs involving mostly heavy manual labour. For both genders, the higher a person’s level of education, the more likely it is that physical activity during work is limited to sitting or standing. The results highlight great potential to promote physical activity. PHYSICAL INACTIVITY · WORK · SITTING · ADULTS · HEALTH MONITORING Introduction Physical activity is any movement by the skeletal muscles that increases the body’s energy expenditure beyond the basal metabolic rate (BMR) [1]. Physically non-demanding activities performed whilst sitting or standing hardly raise energy expenditure beyond the BMR [2]. Sitting for long hours, as is normal in office jobs, constitutes a risk factor for non-communicable diseases [3, 4]. According to current estimates, the general mortality risk for adults increases by 2% for every hour spent sitting per day [4]. Where employment involves physical activity, such as for example in agriculture, work-related physical activity is often a person’s greatest expenditure of energy, as working days usually comprise eight-hour shifts [5]. Whilst work-related physical activity has health benefits, these are not as great as the health benefits of aerobic physical exercise during leisure time [6-8]. The reason is that work-related physical activity is often repetitive, and usually involves working overhead and carrying heavy objects. This can increase muscular strength, yet hardly improves aerobic endurance capacity [9-11]. Endurance capacity improves during aerobic leisure activities such as jogging and swimming, and is particularly important with regard to preventing non-communicable diseases (such as cardiovascular diseases, certain types of cancer or diabetes) and their underlying cardiometabolic risk factors (such as hypertension, lipometabolic disorders and obesity) [12]. Due to the high relevance of physical inactivity as a contributing factor to disease development, the World Health Organization (WHO), in its Global Action Plan for the Prevention and Control of Non-Communicable-Diseases 2013-2020, established the goal of a 10% relative reduction in prevalence of insufficient physical activity by 2025 (compared with 2010) [13]. Authors: Jonas D. Finger, Gert B. M. Mensink, Cornelia Lange, Kristin Manz Journal of Health Monitoring · 2017 2(2) DOI 10.17886/RKI-GBE-2017-039 Robert Koch Institute, Berlin Journal of Health Monitoring Journal of Health Monitoring 2017 2(2) FACT SHEET 29 Work-related physical activity among adults in Germany Indicator Using a validated German version of the European Health Interview Survey – Physical Activity Questionnaires (EHISPAQ), the German Health Update (GEDA 2014/2015EHIS) survey for the first time measured work-related physical activity [14, 15]. In GEDA 2014/2015-EHIS, respondents were asked: ‘When you work, what best describes what you do? (a) mostly sitting or standing; (b) mostly walking or tasks of moderate physical effort; (c) mostly heavy labour or physically demanding work, or (d) not performing any working tasks.’ Work, here, encompasses not only paid but also unpaid work (for example, studying or housework). Respondents were asked to select only one answer. For the purpose of the analysis presented here, these four answers on work-related physical activity for the 18-to-64 age group were stratified by gender, age group, level of education and federal state. A statistically significant difference between groups is assumed when confidence intervals do not overlap. The analyses are based on the data received from 18,026 participants of working age, aged 18-to-64 (10,146 women and 7,880 men) with valid data in EHIS-PAQ. Calculations were carried out using a weighting factor that corrects for deviations within the sample from the German population (as of 31 December 2014) with regard to gender, age, community type and education. The community type accounts for the degree of urbanisation and reflects the regional distribution in Germany. The International Standard Classification for Education (ISCED) was used to ensure that the responses provided on educational levels were comparable [16]. A detailed description of the methodology applied in the GEDA 2014/2015-EHIS study can be found in the article German Health Update – New data for Germany and Europe in issue 1/2017 of the Journal of Health Monitoring. Results and discussion Nearly half of all women (47.5%) and men (47.2%) of working age (18 to 64) stated that they sit or stand most of the time during work and therefore spend many hours per day physically inactive. Among women, the prevalence of work-related physical inactivity (mostly sitting or standing) is highest in the 18-to-29 age group (55.5%) (Table 1). Among men, it is highest in the 30-to-44 age group (50.2%) (Table 2). Compared with women, men nearly five times as often reported being employed in jobs that involve mostly heavy manual labour. The observed regional and educational differences in work-related physical activity are stronger among men than among women (Table 1 and Table 2; Figure 1). In all age groups, men with higher levels of education responded nearly twice as often as men with lower levels of education that they mostly sit or stand during work. The highest value for mostly sitting or standing during work was found in 30to 44-year-old men with higher education levels (79.7%). Conversely, men with lower education levels are seven times as likely to state that their work implies heavy manual labour than those with higher levels of education. The same is true for women: the higher their level of education, the more likely they are to work sitting or standing. For women in Hamburg, the amount of work-related physical inactivity is statistically significantly higher than the German average. For men in Thuringia, MecklenGEDA 2014/2015-EHIS Data holder: Robert Koch Institute Aims: To provide reliable informa tion about the population’s health status, health-related behaviour and health care in Germany, with the possibility of a European comparison Method: Questionnaires completed on paper or online Population: People aged 18 years and above with permanent residency in Germany Sampling: Registry office sample; randomly selected individuals from 301 communities in Germany were invited to participate Participants: 24,016 people (13,144 women; 10,872 men) Response rate: 26.9% Study period: November 2014 July 2015 Data protection: This study was undertaken in strict accordance with the data protection regulations set out in the German Federal Data Protection Act and was approved by the German Federal Commissioner for Data Protection and Freedom of Information. Participation in the study was voluntary. The participants were fully informed about the study’s aims and content, and about data protection. All participants provided written informed consent. More information in German is available at www.geda-studie.de Journal of Health Monitoring Work-related physical activity among adults in Germany Journal of Health Monitoring 2017 2(2) FACT SHEET 30 Table 2 Physical activity during work among men according to age and educational status (n=7,880) Source: GEDA 2014/2015-EHIS Table 1 Physical activity during work among women according to age and educational status (n=10,146) Source: GEDA 2014/2015-EHIS Roughly 47.5% of women and 47.2% of men mostly sit or stand during work. Women Mostly sitting or standing (physical inactivity) Mostly walking or tasks of moderate physical effort Mostly heavy labour or physically demanding work Not performing any working tasks % (95% CI) % (95% CI) % (95% CI) % (95% CI) Women total 47.5 (46.1-49.0) 40.6 (39.0-42.1) 3.2 (2.8-3.7) 8.7 (8.0-9.5) 18-29 Years 55.5 (52.6-58.4) 33.7 (30.9-36.7) 3.9 (2.9-5.0) 6.9 (5.6-8.6) Low education 43.5 (36.9-50.4) 36.5 (30.0-43.5) 3.3 (1.6-6.6) 16.7 (12.5-22.0) Medium education 55.9 (52.1-59.5) 34.9 (31.3-38.6) 4.9 (3.6-6.6) 4.4 (3.1-6.1) High education 73.0 (67.9-77.6) 23.9 (19.6-28.8) 0.8 (0.3-2.1) 2.3 (1.2-4.4) 30-44 Years 49.5 (47.0-51.9) 42.2 (39.7-44.8) 2.9 (2.3-3.8) 5.4 (4.3-6.8) Low education 29.7 (23.7-36.6) 50.1 (42.8-57.5) 6.3 (3.5-11.0) 13.8 (9.2-20.3) Medium education 46.3 (43.2-49.3) 45.7 (42.5-48.8) 3.1 (2.3-4.1) 5.0 (3.9-6.5) High education 67.8 (63.9-71.4) 29.7 (26.2-33.4) 0.7 (0.4-1.4) 1.8 (1.1-3.0) 45-64 Years 42.7 (40.8-44.6) 42.7 (40.8-44.6) 3.1 (2.6-3.7) 11.5 (10.5-12.7) Low education 24.2 (20.6-28.1) 52.9 (48.5-57.1) 3.8 (2.5-5.9) 19.1 (15.8-22.9) Medium education 41.7 (39.3-44.0) 43.8 (41.5-46.1) 3.4 (2.7-4.3) 11.2 (9.8-12.7) High education 62.5 (59.5-65.3) 29.9 (27.4-32.7) 1.4 (0.9-2.1) 6.2 (4.8-8.0) Total (women and men) 47.3 (46.1-48.6) 35.6 (34.5-36.7) 9.0 (8.3-9.8) 8.0 (7.5-8.6) Men Mostly sitting or standing (physical inactivity) Mostly walking or tasks of moderate physical effort Mostly heavy labour or physically demanding work Not performing any working tasks % (95% CI) % (95% CI) % (95% CI) % (95% CI) Men total 47.2 (45.6-48.8) 30.7 (29.3-32.0) 14.8 (13.5-16.1) 7.4 (6.6-8.3) 18-29 Years 46.4 (43.5-49.3) 30.4 (27.5-33.5) 16.7 (14.3-19.5) 6.4 (5.0-8.2) Low education 35.4 (29.1-42.3) 31.6 (25.9-37.9) 18.0 (13.4-23.6) 15.0 (10.7-20.7) Medium education 44.2 (40.6-47.9) 33.4 (29.5-37.5) 18.9 (15.5-22.7) 3.5 (2.6-4.9) High education 77.1 (71.2-82.1) 14.8 (11.0-19.8) 5.1 (3.2-8.1) 2.9 (1.0-8.0) 30-44 Years 50.2 (47.6-52.9) 30.0 (27.7-32.4) 15.9 (13.9-18.0) 3.9 (2.8-5.4) Low education 28.2 (21.4-36.1) 37.5 (29.9-45.9) 24.1 (17.7-31.9) 10.2 (6.3-16.2) Medium education 39.3 (36.0-42.6) 36.0 (32.7-39.4) 20.8 (18.0-23.9) 4.0 (2.6-6.0) High education

Epidemiologie der körperlichen Aktivität und Inaktivität

Die Epidemiologie korperlicher Aktivitat und Inaktivitat (Bewegungsepidemiologie) ist die Erforschung der korperlichen Aktivitat als Ursache (Exposition) oder Wirkung (Zielvariable) im Spannungsfeld gesundheitlicher Probleme und Ressourcen mit den Methoden der Epidemiologie. Es werden Verteilung und Verbreitung korperlicher Aktivitat in der Bevolkerung, Ursachen fur spezifische Bewegungsverhaltensmuster sowie kausale Zusammenhange zwischen korperlicher Aktivitat und Gesundheitsindikatoren untersucht. Das Kapitel fuhrt kurz in die Terminologie der Epidemiologie ein, beschreibt die Verteilung und Entwicklung korperlicher Aktivitat und Inaktivitat in der bundesdeutschen Bevolkerung sowie auf europaischer und WHO-Ebene und gibt einen kurzen Uberblick uber die gesundheitliche Bedeutung korperlicher Aktivitat und Inaktivitat sowie uber wichtige Determinanten des Bewegungsverhaltens.

Alcohol consumption among adults in Germany:heavy episodic drinking

Consuming harmful amounts of alcohol is considered a contributing factor in over 200 diseases. Heavy episodic drinking is a particularly risky drinking pattern, with possible consequences such as acute alcohol intoxication, injuries and violence. GEDA 2014/2015-EHIS defines heavy episodic drinking as the consumption of six or more alcoholic beverages on one occasion at least once per month. 24.9% of women and 42.6% of men show this drinking pattern at least once per month. Regular heavy episodic drinking is most common among 18to 29-yearolds. The prevalence of heavy episodic drinking among highly educated women (all age groups) and men (aged over 45) is lower than it is among those with lower levels of education. The prevention of harmful levels of alcohol consumption requires measures including social and environmental interventions as well as targeting the individual behaviour which are focused on young adults as well as the diverse drinking patterns seen among groups with different levels of education. ALCOHOL · HEAVY EPISODIC DRINKING · ADULTS · HEALTH MONITORING · GERMANY Introduction Alcohol is a potentially addictive psychoactive substance. Consuming harmful levels of alcohol is considered a contributing factor to over 200 diseases; globally, it is among the five key risk factors for disease, impairment and death [1]. In addition, to the impacts harmful amounts of alcohol can potentially have on a person’s health, the World Health Organization (WHO) also highlights the socioeconomic costs for individuals who drink and the consequences for others and society in general [1]. For society, the consequences of people consuming harmful levels of alcohol include the direct costs to the health system, as well as the costs related to the loss of productivity and immaterial costs such as the loss of quality of life. In Germany, alcohol consumption is estimated to cost the economy around EUR 40 billion annually, with around one quarter of this sum being spent directly on the health care system [2, 3]. Heavy episodic drinking is a drinking pattern which poses a particularly high risk to an individual’s health and can lead to acute alcohol intoxication, injuries and violence. On the long-term, it can lead to addiction and damages to multiple organs [4]. Such damage can occur even if a person’s alcohol consumption is, on average, relatively low [1]. To reduce the population’s consumption of harmful levels of alcohol, the WHO has Authors: Cornelia Lange, Kristin Manz, Benjamin Kuntz Journal of Health Monitoring · 2017 2(2) DOI 10.17886/RKI-GBE-2017-045 Robert Koch Institute, Berlin Journal of Health Monitoring Alcohol consumption among adults in Germany: heavy episodic drinking Journal of Health Monitoring 2017 2(2) FACT SHEET 72 developed global and European strategies [5, 6]. The WHO Global Action Plan for the Prevention and Control of Non-communicable Diseases strives for a relative 10% reduction of harmful drinking patterns by 2025 (with 2010 levels as a benchmark) [7]. In part, the WHO strategy guides Germany’s national health target ‘Reduce alcohol consumption’, which was initially published in 2015 [8]. Indicator Heavy episodic drinking (HED) is defined as the intake of 60 g or more of pure alcohol at a single occasion at least once per month [1]. This is the equivalent to six standard drinks containing roughly 10 g of pure alcohol per glass. To assess the frequency and amounts of alcohol people consume, the German Health Update 2014/2015-EHIS (GEDA 2014/2015-EHIS) survey used the instruments provided by the European Health Interview Survey (EHIS) [9]. To assess HED, the survey asked: ‘In the past 12 months, how often have you had 6 or more drinks containing alcohol on one occasion? For instance, during a party, a meal, an evening out with friends, alone at home, ...’. To calculate the indicator, the nine possible answers were condensed into four categories: (1) at least once a week (every day or almost every day, 5-6 days a week, 3-4 days a week, 1-2 days a week); (2) every month (on 2-3 days per month, once a month); (3) less than once a month; and (4) never (not in the past 12 months, never in my whole life). Furthermore, the category of at least monthly heavy episodic drinking was established that combines the categories at least once a week and every month. The results are stratified based on gender, age and education, and for at least monthly heavy episodic drinking, according to gender and German federal state. Statistically, where confidence intervals do not overlap, the survey assumes significant differences between groups. The analyses are based on the data received from 23,704 respondents aged 18 and above (12,953 women, 10,751 men) who gave valid answers on heavy episodic drinking. Calculations were carried out using a weighting factor that corrects for deviations within the sample from the German population (as of 31 December 2014) with regard to gender, age, district type and education. The district type accounts for the degree of urbanisation and reflects the regional distribution in Germany. The International Standard Classification of Education (ISCED) was used to ensure that the responses provided on educational levels were comparable [10]. A detailed description of the methodology applied in the GEDA 2014/2015-EHIS study can be found in the article German Health Update: New data for Germany and Europe in issue 1/2017 of the Journal of Health Monitoring. Results and discussion 48.8% of women and 29.7% of men responded that they had never, or at least not during the past 12 months, drunk six or more alcoholic beverages on a single occasion. 24.9% of women and 42.6% of men (Table 1 and Table 2) said they engaged in heavy episodic drinking at least once per month. Monthly heavy episodic drinking is most widespread among 18to 29-year-olds (women 35.6%, men 54.3%). In the other age groups, no notable GEDA 2014/2015-EHIS Data holder: Robert Koch Institute Aims: To provide reliable informa tion about the population’s health status, health-related behaviour and health care in Germany, with the possibility of a European comparison Method: Questionnaires completed on paper or online Population: People aged 18 years and above with permanent residency in Germany Sampling: Registry office sample; randomly selected individuals from 301 communities in Germany were invited to participate Participants: 24,016 people (13,144 women; 10,872 men) Response rate: 26.9% Study period: November 2014 July 2015 Data protection: This study was undertaken in strict accordance with the data protection regulations set out in the German Federal Data Protection Act and was approved by the German Federal Commissioner for Data Protection and Freedom of Information. Participation in the study was voluntary. The participants were fully informed about the study’s aims and content, and about data protection. All participants provided written informed consent. More information in German is available at www.geda-studie.de Journal of Health Monitoring Alcohol consumption among adults in Germany: heavy episodic drinking Journal of Health Monitoring 2017 2(2) FACT SHEET 73 differences in the prevalence of heavy episodic drinking among women exist. In the older age groups (≥ 30 years), around one fifth of women drink six alcoholic beverages or more on a single occasion at least once per month. For men, the prevalence of heavy episodic drinking drops with age; yet still over one third of men (35.1%) aged 65 and over engage in heavy episodic drinking at least once per month. Across all age groups, there are fewer highly educated women who drink six or more alcoholic beverages in a single session than women with a lower or medium level of education. For men in the 18-44 age group, no such association with education appears to exist. For men over 45, the prevalence of heavy episodic drinking among those highly educated is lower than among the group with a lower level of education. Compared to figures for the consumption of risky amounts, the figures for heavy episodic drinking reveal an inverse education gradient. These results are in line with other surveys that indicate the higher prevalence of risky drinking patterns, such as heavy episodic drinking, in socially disadvantaged groups [11]. Moreover, drinking Table 1 Heavy episodic drinking among women according to age and educational status (n=12,953) Source: GEDA 2014/2015-EHIS 25% of women and 43% of men engage in heavy episodic drinking at least once per month. CI=confidence interval Women Never (in the past 12 months) Less than once a month Every month At least once week At least monthly heavy episodic drinking % (95% CI) % (95% CI) % (95% CI) % (95% CI) % (95% CI) Women total 48.8 (47.5-50.0) 26.4 (25.4-27.3) 19.2 (18.3-20.1) 5.7 (5.3-6.2) 24.9 (23.9-25.8) 18-29 Years 32.9 (30.3-35.7) 31.4 (28.9-34.1) 28.6 (26.0-31.4) 7.0 (5.6-8.6) 35.6 (32.9-38.4) Low education 40.7 (34.1-47.7) 23.8 (18.2-30.6) 26.0 (20.3-32.5) 9.5 (6.2-14.2) 35.4 (29.2-42.1) Medium education 29.5 (26.5-32.6) 32.9 (29.8-36.1) 30.9 (27.8-34.1) 6.8 (5.3-8.7) 37.7 (34.4-41.0) High education 34.4 (29.3-39.9) 37.8 (32.7-43.2) 23.7 (19.3-28.6) 4.1 (2.6-6.4) 27.8 (23.1-33.0) 30-44 Years 47.2 (44.7-49.6) 30.8 (28.8-32.9) 17.6 (15.9-19.5) 4.4 (3.6-5.4) 22.0 (20.0-24.2) Low education 46.2 (38.9-53.6) 32.2 (25.8-39.4) 17.8 (13.0-24.0) 3.8 (1.9-7.6) 21.6 (16.1-28.4) Medium education 43.8 (40.8-46.8) 31.4 (28.9-34.0) 19.7 (17.3-22.3) 5.2 (4.0-6.7) 24.9 (22.2-27.8) High education 55.9 (52.1-59.7) 28.8 (25.5-32.4) 12.5 (10.5-14.8) 2.8 (1.9-4.0) 15.3 (13.1-17.6) 45-64 Years 50.2 (48.3-52.0) 26.0 (24.5-27.5) 18.3 (16.9-19.7) 5.6 (4.9-6.4) 23.9 (22.4-25.5) Low education 47.1 (42.8-51.4) 23.5 (20.0-27.5) 20.7 (17.6-24.3) 8.6 (6.4-11.5) 29.3 (25.5-33.5) Medium education 50.1 (47.8-52.5) 26.3 (24.4-28.2) 18.3 (16.5-20.2) 5.3 (4.4-6.4) 23.6 (21.7-25.7) High education 52.9 (50.2-55.7) 27.2 (24.8-29.6) 16.0 (14.0-18.3) 3.9 (2.9-5.2) 19.9 (1

Empfehlungen für körperliche Aktivität und Inaktivität von Kindern und Jugendlichen – Methodisches Vorgehen, Datenbasis und Begründung

The benefits of physical activity and a reduction of sedentary behaviour in childhood and adolescence are well established.Based on a quality-assured literature review, the German recommendations were updated. Guidelines for infants, toddlers, children of kindergarten and primary school age and youth are clearly depictedIn general, a higher amount of physical activity is associated with more health benefits. Preschool age children should have 180 min of physical activity daily, and from primary school age on, at least 90 min daily are recommended. Sedentary behaviour, especially time in front of screens, is to be reduced to a minimum.