Climate protection, health and other motives for active transport - results of a cross-sectional survey in Germany.

BACKGROUND: Active transport- for example walking and bicycling to travel from place to place- may improve physical fitness and health and mitigate climate change if it replaces motorised transport. The aim of this study is to analyse the active transport behaviour of adults living in Germany, to investigate differences among population groups and to determine whether climate protection is a frequent motive for this behaviour. METHODS: This study uses self-reported data of 4,971 adults who participated in a national health survey (German Health Update 2021), which was conducted as a telephone survey from July to December 2021. Associations between active transport behaviour and corresponding motives with sociodemographic and health-related variables were analysed using logistic regression models. RESULTS: Of the adult population, 83% use active transport at least once a week. The frequency and duration of walking per week are significantly higher than those for bicycling (walking 214 min/week; bicycling 57 min/week). Those with a lower education level are less likely to practise active transport than those with a higher education level. Furthermore, women are less likely to use a bicycle for transport than men. Among those practising active transport, the most frequently mentioned motive is "is good for health" (84%) followed by "to be physically active" (74%) and "is good for the climate/environment" (68%). Women and frequent bicyclists (at least 4 days/week) mention climate protection as a motive more often than men and those bicycling occasionally. CONCLUSIONS: The improvement of active transport, especially among people with lower education and women (for bicycling), may benefit from better insights into motives and barriers. Climate protection is an important motivator for practising active transport within the adult population living in Germany and should therefore have greater emphasis in behavioural change programmes.

[Social situation, health, and health behavior of children and adolescents in one-parent households at the end of the COVID-19 pandemic: Results of the KIDA study 2022-2023]. / Soziale Lage, Gesundheit und Gesundheitsverhalten von Kindern und Jugendlichen in Ein-Eltern-Haushalten zum Ende der COVID-19-Pandemie. Ergebnisse der KIDA-Studie 2022­2023.

INTRODUCTION: During the COVID-19 pandemic, single parents and their children were particularly exposed to stress due to the containment measures and to limited resources. We analyzed differences in the social and health situation of children and adolescents in one-parent households and two-parent households at the end of the pandemic. METHODS: The analysis is based on data from the KIDA study, in which parents of 3­ to 15-year-old children as well as 16- to 17-year-old adolescents were surveyed in 2022/2023 (telephone: n = 6992; online: n = 2896). Prevalences stratified by family type were calculated for the indicators psychosocial stress, social support, health, and health behavior. Poisson regressions were adjusted for gender, age, level of education, and household income. RESULTS: Children and adolescents from one-parent households are more likely to be burdened by financial restrictions, family conflicts, and poor living conditions and receive less school support than peers from two-parent households. They are more likely to have impairments in health as well as increased healthcare needs, and they use psychosocial services more frequently. Furthermore, they are less likely to be active in sports clubs, but they take part in sporting activities at schools as often as minors from two-parent households. The differences are also evident when controlling for income and education. DISCUSSION: Children and adolescents from one-parent households can be reached well through exercise programs in a school setting. Low-threshold offers in daycare centers, schools, and the community should therefore be further expanded. Furthermore, interventions are needed to improve the socioeconomic situation of single parents and their children.

The role of personality traits and social support in relations of health-related behaviours and depressive symptoms.

BACKGROUND: Previous evidence has suggested that physically inactive individuals and extensive media users are at high risk for experiencing depressive symptoms. We examined personality traits and perceived social support as potential moderators of this association. Personality and perceived social support were included as two of the most frequently considered variables when determining predispositioning factors for media use phenomena also discussed in relation to physical activity. METHODS: We analysed cross-sectional data from 1402 adults (18-31 years old) who participated in a national health survey in Germany (KiGGS, Study on the health of children and adolescents in Germany, wave 2). The data included one-week accelerometer assessments as objective indicators of physical activity, self-reported media use, depressive symptoms, perceived social support and Big 5 personality traits. An elastic net regression model was fit with depressive symptoms as outcome. Ten-fold cross-validation was implemented. RESULTS: Amongst the main effects, we found that high media use was positively correlated with depressive symptoms, whereas physical activity was not correlated. Looking at support and individual differences as moderators, revealed that PC use was more strongly correlated with depressive symptoms in cases of low levels of perceived social support. Positive associations of social media use with depressive symptoms were more pronounced, whereas negative associations of moderate to vigorous physical activity with depressive symptoms were less pronounced in extraverts than they were in introverts. CONCLUSIONS: Results highlight the importance of considering individual factors for deriving more valid recommendations on protective health behaviours.

The relationship of self-reported and device-based measures of physical activity and health-related quality of life in adolescents.

BACKGROUND: Physical activity (PA) has beneficial effects on health and health-related quality of life (HRQoL), which is a protective factor of illness and mortality. The purpose of this examination was to investigate if self-reported and device-based measures of PA were related to HRQoL in adolescents. METHODS: Participants (N = 1565; 54.3% female; Mage = 14.37 years, SDage = 1.99) were recruited from 167 sample points across Germany. Adolescents self-reported their PA, supplemented by a 1-week examination of device-based PA using accelerometry. Additionally, they completed the multidimensional KIDSCREEN-27 to assess HRQoL. RESULTS: Results showed that self-reported PA was correlated with overall HRQoL, Physical Well-Being, Psychological Well-Being, Social Support & Peers, and School Environment, whereas device-based PA was only correlated with Physical as well as Psychological Well-Being. Further, self-reported PA significantly predicted all facets of HRQoL except for Autonomy and Parent Relations, whereas device-based PA solely heightened the amount of explained variance in the Physical Well-Being subscale. CONCLUSIONS: Findings demonstrate the importance of self-reported PA as it is related to almost all facets of HRQoL. Both measures of PA are not congruent in their relationship with HRQoL and thus implications have to be carefully considered. Future studies should investigate the direct effect of PA on HRQoL and health in a longitudinal approach to account for the causality of effects.

Comparison of self-reported & device-based, measured physical activity among children in Germany.

BACKGROUND: As children show a more complex but less structured movement behavior than adults, assessment of their many spontaneous and impulsive movements is a challenge for physical activity (PA) assessment. Since neither questionnaires nor accelerometers enable optimal detection of all facets of PA, a multimodal, combined approach of self-reported and device-based methods is recommended. Based on the number of days on which the participants reached the physical activity (PA) values given in the WHO guideline, this study examines 1) the difference between self-reported and device-based, measured PA and 2) whether PA differences between age and gender groups obtained by two methods are comparable. METHODS: Participants aged 6-17 years were randomly chosen and data were collected representatively at 167 sample points throughout Germany within the Motorik-Modul Study. PA of n = 2694 participants (52.3% female) was measured using the ActiGraph accelerometer (ACC) and a physical activity questionnaire (PAQ). The sample was divided into three age groups (6-10 yrs. n = 788, 11-13 yrs. n = 823, 14-17 yrs. n = 1083). Numbers of days per week with at least 60 min moderate to vigorous PA (MVPA) were analyzed for both methods. RESULTS: Only every 25th respondent (4%) reaches the WHO standard of 60 min MVPA every day if measured with ACC. Self-reported PA was slightly higher (9%) (meanPAQ = 3.82 days; meanACC = 2.34 days; Fmethod = 915.85; p = <.001; fCohen = .64). The differences between the methods are significantly smaller in younger children than in the older age groups (Fage = 264.2, p < .001; fCohen = .48). The older the subjects are, the lower is the proportion of those who meet the WHO guideline on each day, with girls meeting the guideline less frequently than boys in all age groups. CONCLUSION: Children and adolescents living in Germany show a very low adherence to the WHO guideline on PA. While younger children are much more active with their free play, especially children over 10 years of age and especially girls should be the target of programs to increase PA.

[Reference Values for Cardiorespiratory Fitness of the General Population: The German National Health Interview and Examination Survey for Adults (DEGS1) 2008-2011]. / Referenzwerte für die kardiorespiratorische Fitness der allgemeinen Bevölkerung: Die Studie zur Gesundheit Erwachsener in Deutschland (DEGS1) 2008­2011.

AIM OF STUDY: This study aims to provide population-based reference values for heart rate-based indicators of cardiorespiratory fitness for adults with physical activity readiness aged 18 to 64 years living in Germany. METHODS: Based on data on 2,826 individuals who participated in a submaximal cycle ergometer exercise test as part of the German National Health Interview and Examination Survey for Adults (DEGS1) between 2008 and 2011, we calculated the following indicators: physical working capacity at 150 and 130 beats/min and at 75% of estimated maximum heart rate (PWC150, PWC130 and PWC75%) as well as heart rate-based estimated maximum oxygen uptake (VO2max). We used the LMS method by Cole & Green 1992 to calculate reference values. RESULTS: 25th, 50th and 75th percentiles of PWC150 were 1.5, 1.77 and 2.08 watts/kg among men and 1.18, 1.44 and 1.69 among women. 25th, 50th and 75th percentiles of PWC130 were 1.16, 1.41 and 1.68 watts/kg among men and 0.81, 1.05 and 1.29 among women. Age-dependent median PWC75% values among men and women were 1.87 - age in years× 0.01 and 1.31 - (age in years/100)2× 0.98, respectively, and VO2max among men is 41.7 - age× 0.15. CONCLUSIONS: The references values presented can be used for individual rating of cardiorespiratory fitness among adults living in Germany. Furthermore, they can serve as a basis for regular monitoring purposes.

Equity impacts of interventions to increase physical activity among older adults: a quantitative health impact assessment.

BACKGROUND: Behavioural interventions may increase social inequalities in health. This study aimed to project the equity impact of physical activity interventions that have differential effectiveness across education groups on the long-term health inequalities by education and gender among older adults in Germany. METHODS: We created six intervention scenarios targeting the elderly population: Scenarios #1-#4 applied realistic intervention effects that varied by education (low, medium high). Under scenario #5, all older adults adapted the physical activity pattern of those with a high education. Under scenario #6, all increased their physical activity level to the recommended 300 min weekly. The number of incident ischemic heart disease, stroke and diabetes cases as well as deaths from all causes under each of these six intervention scenarios was simulated for males and females over a 10-year projection period using the DYNAMO-HIA tool. Results were compared against a reference-scenario with unchanged physical activity. RESULTS: Under scenarios #1-#4, approximately 3589-5829 incident disease cases and 6248-10,320 deaths could be avoided among males over a 10-year projection period, as well as 4381-7163 disease cases and 6914-12,605 deaths among females. The highest reduction for males would be achieved under scenario #4, under which the intervention is most effective for those with a high education level. Scenario #4 realizes 2.7 and 2.4% of the prevented disease cases and deaths observed under scenario #6, while increasing inequalities between education groups. In females, the highest reduction would be achieved under scenario #3, under which the intervention is most effective amongst those with low levels of education. This scenario realizes 2.7 and 2.9% of the prevented disease cases and deaths under scenario #6, while decreasing inequalities between education groups. Under scenario #5, approximately 31,687 incident disease cases and 59,068 deaths could be prevented among males over a 10-year projection period, as well as 59,173 incident disease cases and 121,689 deaths among females. This translates to 14.4 and 22.2% of the prevented diseases cases among males and females under scenario #6, and 13.7 and 27.7% of the prevented deaths under scenario #6. CONCLUSIONS: This study shows how the overall population health impact varies depending on how the intervention-induced physical activity change differs across education groups. For decision-makers, both the assessment of health impacts overall as well as within a population is relevant as interventions with the greatest population health gain might be accompanied by an unintended increase in health inequalities.

[Motor fitness of 4- to 10-year-old children in Germany : Results of KiGGS Wave 2 and trends]. / Motorische Leistungsfähigkeit 4­ bis 10­jähriger Kinder in Deutschland : Ergebnisse aus KiGGS Welle 2 und Trends.

Regular physical activity and good motor performance are the basis for healthy physical development in childhood and are considered a protective factor for various health risks. However, children and adolescents in Germany are not physically active enough because sedentary activities have increased. One consequence is the decline in motor capacity, the totality of structures and functions that are responsible for the performance of motor actions.In the second follow-up survey of the study on the health of children and adolescents in Germany (KiGGS Wave 2, 2014-2017), the motor performance (LF) of 4­ to 10-year-old children was examined with three motor tests: one-leg stand (EIN), stand and reach (RB), and jumping sideways (SHH). The purpose of this paper is to present the results of the tests and to compare them with data from the KiGGS baseline survey (2003-2006). It also analyzes how motor performance differs in terms of different characteristics such as sociodemographic factors, obesity, and physical activity.Compared to the KiGGS baseline survey, the 4­ to 10-year-olds' motor performance in KiGGS Wave 2 has slightly improved in EIN, but RB and SHH are stagnating at low level. The test results indicate that middle and high social status, club sport activity, and "no overweight" are associated with above-average motor performance.Health policy, sports organizations, schools, and kindergartens should work together more closely so that all children have the same chance of good motor performance.

Changing educational inequalities in sporting inactivity among adults in Germany: a trend study from 2003 to 2012.

BACKGROUND: Social inequalities in health can be explained in part by the social patterning of leisure-time physical activity, such as non-participation in sports. This study is the first to explore whether absolute and relative educational inequalities in sporting inactivity among adults have changed in Germany since the early 2000s. METHODS: Data from four cross-sectional national health surveys conducted in 2003 (n = 6890), 2009 (n = 16,418), 2010 (n = 17,145) and 2012 (n = 13,744) were analysed. The study population was aged 25-69 years in each survey. Sporting inactivity was defined as no sports participation during the preceding 3 months. The regression-based Slope Index of Inequality (SII) and Relative Index of Inequality (RII) were calculated to estimate the extent of absolute and relative educational inequalities in sporting inactivity, respectively. RESULTS: Sporting inactivity was consistently more prevalent in less-educated groups. The overall prevalence of sporting inactivity declined significantly over time. However, the decline was observed only in the high and medium education groups, while no change was observed in the low education group. Both absolute and relative educational inequalities in sporting inactivity were found to have widened significantly between 2003 (SII = 0.30, 95% CI = 0.25-0.35; RII = 2.08, 95% CI = 1.83-2.38) and 2012 (SII = 0.41, 95% CI = 0.37-0.45; RII = 3.44, 95% CI = 3.03-3.91). Interaction analysis showed that these increases in inequalities were larger in the younger population under the age of 50 than among the elderly. CONCLUSIONS: The findings suggest that the gap in sports participation between adults with high and low educational attainment has widened in both absolute and relative terms because of an increase in sports participation among the better educated. Health-enhancing physical activity interventions specifically targeted to less-educated younger adults are needed to prevent future increases in social inequalities in health.

[Recommendations for Physical Activity and Sedentary Behaviour for Children and Adolescents: Methods, Database and Rationale]. / 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.

[What potential do geographic information systems have for population-wide health monitoring in Germany? : Perspectives and challenges for the health monitoring of the Robert Koch Institute]. / Welches Potenzial haben Geoinformationssysteme für das bevölkerungsweite Gesundheitsmonitoring in Deutschland? : Perspektiven und Herausforderungen für das Gesundheitsmonitoring am Robert Koch-Institut.

Geographic information systems (GISs) are computer-based systems with which geographical data can be recorded, stored, managed, analyzed, visualized and provided. In recent years, they have become an integral part of public health research. They offer a broad range of analysis tools, which enable innovative solutions for health-related research questions. An analysis of nationwide studies that applied geographic information systems underlines the potential this instrument bears for health monitoring in Germany. Geographic information systems provide up-to-date mapping and visualization options to be used for national health monitoring at the Robert Koch Institute (RKI). Furthermore, objective information on the residential environment as an influencing factor on population health and on health behavior can be gathered and linked to RKI survey data at different geographic scales. Besides using physical information, such as climate, vegetation or land use, as well as information on the built environment, the instrument can link socioeconomic and sociodemographic data as well as information on health care and environmental stress to the survey data and integrate them into concepts for analyses. Therefore, geographic information systems expand the potential of the RKI to present nationwide, representative and meaningful health-monitoring results. In doing so, data protection regulations must always be followed. To conclude, the development of a national spatial data infrastructure and the identification of important data sources can prospectively improve access to high quality data sets that are relevant for the health monitoring.

Determinants of organised sports participation patterns during the transition from childhood to adolescence in Germany: results of a nationwide cohort study.

BACKGROUND: Organised sports (OS) participation is an important health behaviour but it seems to decline from childhood to adolescence. The aim of this study was to investigate OS participation patterns from childhood to adolescence and potential determinants for those patterns. METHODS: Data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) cohort study with a 6 year follow-up period were used (KiGGS0: 2003-06, KiGGS1: 2009-12). Participants aged 6-10 years at KiGGS0, who were aged 12-16 at KiGGS1, were included (n = 3790). The outcome variable was 'OS participation' between KiGGS0 and KiGGS1 with the categories 'maintenance' (reference), 'dropout', 'commencement' and 'nonparticipation'. Relative risk ratios (RRRs) were calculated using multinomial logistic regression to identify potential predictors for OS patterns. Socio-demographic, family-related, health-related, behavioural and environmental factors were considered as independent variables. RESULTS: 48.5 % maintained OS, 20.5 % dropped out, 12.3 % commenced OS between KiGGS0 and KiGGS1 and 18.7 % did not participate at both times. The RRRs for dropout rather than maintenance were 0.6 (95 % Cl 0.5-0.7) for boys versus girls, 1.5 (1.3-1.9) for the age group 8-10 versus 6-7 years, 0.7 (0.5-0.9) for high versus intermediate parental education, 1.4 (1.1-1.8) for low versus middle household income, 1.4 (1.0-1.8) for below-average versus average motor fitness. The RRRs for commencement rather than maintenance were 0.6 (0.5-0.8) for boys versus girls, 0.6 (0.5-0.8) for the age group 8-10 versus 6-7 years, 1.5 (1.1-2.1) for low versus intermediate parental education, 1.5 (1.1-2.0) for low versus middle household income, 0.7 (0.5-1.0) for no single-parent versus single parent family, 1.8 (1.3-2.5) for below-average and 0.6 (0.4-0.8) for above-average versus average motor fitness, and 1.4 (1.1-1.9) for high versus middle screen-based media use. The RRRs for abstinence rather than maintenance were 0.6 (0.4-0.7) for boys versus girls, 1.5 (1.1-2.0) for low versus intermediate parental education, 2.2 (1.7-2.8) for low and 0.6 (0.5-0.8) for high versus middle household income, 1.6 (1.2-2.1) for psychopathological problems versus no problems, 1.7 (1.3-2.2) for below-average and 0.4 (0.3-0.6) for above-average versus average motor fitness, and 1.6 (1.0-2.6) for rural versus metropolitan residential area. CONCLUSIONS: OS participation rates among all children living in Germany need to be improved. More tailored offerings are needed which consider the preferences and interests of adolescents as well as a cooperation between public health actors to reduce barriers to OS.

The Challenge of Incomplete Data in Accelerometer Studies: Characteristics of Nonparticipation and Noncompliance in a Nationwide Sample of Adolescents and Young Adults in Germany.

BACKGROUND: Incomplete data due to nonparticipation and noncompliance with the study protocol can bias the results of studies. We investigated how a nationwide accelerometer sample of adolescents and young adults is affected by such incomplete data. METHODS: We analyzed cross-sectional data from 6465 participants (11-31 y old) who participated in a national health survey in Germany (KiGGS Wave 2; 2014-2017). The data included information about the participation in the measurement of physical activity using accelerometers, compliance with the wear-time protocol, and sociodemographic and health-related variables. Multivariable regression analyses were conducted to detect factors associated with incomplete data. RESULTS: Of the total sample, 78.0% participated in the accelerometer part of the study, and 83.5% of the participants with data available complied with the wear-time protocol. In 11- to 17-year-olds, the likelihood of having incomplete accelerometer data was higher in boys, older adolescents, adolescents with a lower sociodemographic status, adolescents with overweight, adolescents not participating in organized sport, adolescents not speaking only German at home, current smokers, and adolescents having a higher soft drink consumption. In 18- to 31-year-olds, the likelihood of having incomplete accelerometer data was higher in men, adults with a lower educational level, adults not speaking only German at home, and adults who smoke. CONCLUSIONS: Our results suggest that accelerometer samples are biased such that participants with more beneficial health behaviors provide complete accelerometer data more often. This knowledge should be used to design effective recruitment strategies and should be considered when interpreting results of accelerometer studies.

Perspectives of individuals on reducing meat consumption to mitigate climate change: protocol for a scoping review.

INTRODUCTION: High consumption of red and processed meat increases the risk of several chronic diseases. Many people, especially in high-income countries, eat more meat than recommended by nutritional and health agencies. Meat production also has negative impacts on the environment and contributes to climate change. Therefore, climate protection, besides health or animal welfare, could motivate individuals to eat less meat. Willingness to reduce meat consumption and motives to do so are not yet fully understood. METHODS AND ANALYSIS: Based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) extended guidelines, a scoping review of peer-reviewed original studies will be conducted to address three questions: What is the evidence regarding (1) the willingness of individuals to reduce meat consumption to mitigate climate change, (2) the awareness of individuals about the link between their meat consumption and the potential to mitigate climate change and (3) individuals having reduced meat consumption for the reason of climate protection? We will search the databases Medline (via PubMed), Scopus, Embase, Greenfile (via Ebsco) and PsynDex/CurrentContent/Agris (via Livivo) using a systematic search string. Studies from 2015 onwards, published in English, German, Danish or Dutch, will be included. We will include observational studies, qualitative studies, intervention studies (if they include surveys) and reviews. Data will be summarised in a narrative synthesis, comprising methods, population characteristics, meat type under study, indicators measured and limitations. Key findings will be grouped according to the research questions. This scoping review will help clarify the role of climate protection in individual reduction of meat consumption and identify research gaps in this field. ETHICS AND DISSEMINATION: Formal ethical approval is not required, as primary data will not be collected in this study. Findings of this scoping review will be presented at scientific conferences and published in a peer-reviewed journal. TRIAL REGISTRATION NUMBER: https://doi.org/10.17605/OSF.IO/MWB85.

What is the health status of girls and boys in the COVID-19 pandemic? Selected results of the KIDA study.

Background: It is well known that there are gender differences in the health behaviour and physical and mental health of children. The COVID-19 pandemic influenced the health and lifestyles of children and adolescents by changing their living conditions. The present work investigates whether gender differences in selected health indicators are evident more than two years after the onset of the pandemic. Methods: In the study Kindergesundheit in Deutschland aktuell (KIDA) (German Children's Health Update), cross-sectional telephone surveys were conducted with parents of 3- to 15-year-olds (n=3,478). Parental information on the general and mental health of the child, on increased need for health care and mental health services, as well as on physical activity and utilisation of sports activities were queried in standardised manner. Gender differences were assessed using Chi2 tests. Results: A total of 91% of the girls and 92% of the boys had their general health assessed as being (very) good by their parents (difference not significant, n.s.). An increased need for care and support was indicated for 10.6% of the 3- to 15-year-olds (girls: 9%, boys: 12%, n.s.). Boys met the physical activity recommendations of the WHO significantly more often (60%) than girls (54%). Good to excellent mental health was reported for 93% of both boys and girls. When changes during the pandemic were reported, no differences were found in the responses for girls compared to boys. Conclusions: Gender differences were found for individual parameters and age groups. These differences must be assessed in the context of other social determinants of health, and need to be considered when planning preventive measures.

Change in sports activity and walking and cycling for transport since the COVID-19 pandemic - Results of the GEDA 2021 study.

Background: Physical activity is a significant health promotion behaviour. COVID-19 pandemic mitigation measures, such as reducing social contact, closing sports facilities and working from home offices, may make it more difficult to engage in regular physical activity. Methods: The data collected between July and October 2021 from the nationally representative study German Health Update (GEDA 2021) were used. The activity behaviour is described by the change in the amount of sports activity as well as the amount of physical active transport (walking/cycling) since the beginning of the COVID-19 pandemic. The sample comprises 2,985 participants aged 18 and older. Results: A quarter of the population reduced their sports activity compared to before the COVID-19 pandemic, while 12% increased their sports activity and 38% reported no change. In terms of physical active transport, it shows that 15% reduced the amount, 17% increased it and 55% maintained it. Compared to younger adults, older adults were more likely to maintain their activity behaviour rather than reduce or increase it. Conclusion: Even before the pandemic, physical inactivity was common among the population. The high proportion of adults who reduced their sports activity during the pandemic underlines the need for effective measures to promote physical activity.

How much do adults sit? Results from the German Health Update (GEDA 2019/2020-EHIS).

Background: Sedentary behaviour is increasingly perceived as a risk factor for the development of diseases and for increased mortality. In particular, increased time spent sitting in combination with low physical activity seems to have negative health consequences. Methods: In the nationwide cross-sectional study German Health Update (GEDA 2019/2020-EHIS), the indicator 'sitting' was captured by the self-report of the participants. Results: For at least eight hours a day, 16.7% of women and 22.3% of men sit: Men more often than women, younger persons more often than older persons and the proportion increases significantly from the low to the high education group. Similarly, about one fifth of adults in Germany sit for at least four hours a day and do not engage in physical activity in their leisure time. Conclusion: The results indicate that preventive measures are needed to reduce time spent sitting and increase physical activity.

Health behaviour and COVID-19: Initial findings on the pandemic.

The COVID-19 pandemic poses new challenges to both individuals and societies that impact health behaviour in many ways. This narrative review brings together initial findings for smoking, alcohol use, nutrition, physical activity and obesity. Smoking and obesity are potential direct risk factors for a severe course of COVID-19, and alcohol abuse, physical inactivity and an unbalanced diet can be indirect risk factors. The constraints of public life to contain the COVID-19 pandemic reduced the opportunities for physical activity and sports, although the initial results on physical activity during this period for Germany do not reflect this assumption. While a part of the population reports making healthier diet choices than before the pandemic, others do not. For smoking and risky alcohol use, data at an aggregate level for the general population do not indicate any behaviour changes. However, different trends appear to be emerging for different population groups pointing to the fact that social inequalities in pandemic-related changes to health behaviour must be assumed. Should further studies confirm these results, this would indicate a need for pandemic-specific prevention measures. Furthermore, specifically during the pandemic, prevention and health promotion measures directed at changes to health behaviour should continue to be implemented and adapted to the restrictions due to the pandemic. Equity in health should be promoted in particular.

Measurement of Physical Activity and Sedentary Behavior by Accelerometry Among a Nationwide Sample from the KiGGS and MoMo Study: Study Protocol.

BACKGROUND: Currently, no nationwide objective physical activity data exists for children and adolescents living in Germany. The German Health Interview and Examination Survey for Children and Adolescents (KiGGS) and the Motorik-Modul study (MoMo) is a national cohort study that has incorporated accelerometers in its most recent data collection wave (wave 2, since 2014). This wave 2 marks the first nationwide collection of objective data on the physical activity of children and adolescents living in Germany. OBJECTIVE: The purpose of this protocol is to describe the methods used in the KiGGS and MoMo study to capture the intensity, frequency, and duration of physical activity with accelerometers. METHODS: Participants (N=11,003, aged 6 to 31 years) were instructed to wear an ActiGraph GT3X+ or wGT3X-BT accelerometer laterally on the right hip. Accelerometers were worn on consecutive days during waking hours, including at least 4 valid weekdays and 1 weekend day (wear time >8 hours) in the evaluation. A nonwear time protocol was also implemented. RESULTS: Data collection was completed by October 2017. Data harmonization took place in 2018. The first accelerometer results from this wave were published in 2019, and detailed analyses are ready to be submitted in 2020. CONCLUSIONS: This study protocol provides an overview of technical details and basic choices when using accelerometers in large-scale epidemiological studies. At the same time, the restrictions imposed by the specified filters and the evaluation routines must be taken into account. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/14370.

Individual and interpersonal correlates of cardiorespiratory fitness in adults - Findings from the German Health Interview and Examination Survey.

Cardiorespiratory fitness (CRF) is an established predictor of adverse health outcomes. The aim of this study is to investigate potential behavioral, interpersonal and socioeconomic correlates of CRF among men and women living in Germany using data from a population-based nationwide cross-sectional study. 1,439 men and 1,486 women aged 18-64 participated in the German Health Interview and Examination Survey (2008-2011) and completed a standardized sub-maximal cycle ergometer test. Maximal oxygen consumption ([Formula: see text]) in ml·min-1·kg-1 was estimated. Mean values of VO2max for various anthropometric, behavioral, interpersonal, and sociodemographic variables were estimated. Linear regression analyses using multiple imputations technique for missing values was performed to analyze the influence of potential correlates on CRF. Women with high alcohol consumption had higher [Formula: see text], (ß = 2.20; 95% CI 0.98 to 3.42) than women with low alcohol consumption and women with high occupational status had higher [Formula: see text] (ß = 1.83; 95% CI 0.21 to 3.44) in comparison to women with low occupational status. Among men, high fruit intake (ß = 1.52; 95% CI 0.63 to 2.40), compared to low or medium fruit intake and performing at least 2.5 hours of total PA per week (ß = 2.19; 95% CI 1.11 to 3.28), compared to less than 2.5 hours was associated with higher [Formula: see text]. Among both men and women, lower body mass index, lower waist circumference and higher levels of physical exercise were considerably associated with higher [Formula: see text]. Among women, those in higher age groups showed a considerably lower level of [Formula: see text] compared with those aged 18-24. Furthermore, mean estimated [Formula: see text] was higher among men (36.5; 95% CI 36.0 to 37.0) than among women (30.3; 95% CI 29.8 to 30.7). Despite the cross-sectional nature of the current study, we conclude that several behavioral, anthropometric, and sociodemographic factors are associated with CRF in the general adult population in Germany. These results can provide evidence to tailor prevention measures according to the needs of specific subgroups.