How Healthy is the Lifestyle of Adolescents in Germany? Results from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS)

Background: Studies on the health behaviour of adolescents mostly examine single health behaviour indicators in a separate manner for each one. However, health behaviours are not independently developed, but occur within a broader behavioural scheme acquired during socialisation. The aim of this study is to analyse the distribution of health-related behaviour patterns in adolescence by using a composite index made up of 6 single indicators allowing for sociodemographic and socioeconomic variables. Methods: The data are derived from a subsample of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), carried out by the Robert Koch Institute between May 2003 and May 2006 (age: 11-17 years, n=6813). The creation of an additive healthy lifestyle index (HLI) is based upon data regarding smoking behaviour, body mass index, physical activity, use of electronic media, alcohol intake and fruit and vegetable consumption. The highest score of HLI is taken as a single indicator of a healthy lifestyle. Independent variables are socioeconomic status (SES) of the family of origin, school type and migration background. All analyses were done taking into account potential age and gender differences. Results: Girls adhere more often to a recommended healthy lifestyle than boys (25.4% and 18.7%, respectively). The proportion of adolescents adhering to all 6 HLI categories decreases with every year of life. Adolescents with a low SES and adolescents from secondary general schools ("Hauptschule") reach to a significantly lower extent the highest score of HLI than peers with a middle or high SES and adolescents attaining other types of schools. Conclusions: The results of the created HLI refer to latent potentials for prevention and specific target groups for health promotion measures.