Gert B M Mensink

Robert Koch Institut, Berlín, Berlin, Germany

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Publications (148)312.34 Total impact

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    [Show abstract] [Hide abstract] ABSTRACT: Background Monitoring of serum lipid concentrations at the population level is an important public health tool to describe progress in cardiovascular disease risk control and prevention. Using data from two nationally representative health surveys of adults 18–79 years, this study identified changes in mean serum total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) in relation to changes in potential determinants of serum lipids between 1997–99 and 2008–11 in Germany. Methods Sex-specific multivariable linear regression analyses were performed with serum lipids as dependent variables and survey wave as independent variable and adjusted for the following covariables: age, fasting duration, educational status, lifestyle, and use of medication. Results Mean TC declined between the two survey periods by 13 % (5.97 mmol/l vs. 5.19 mmol/l) among men and by 12 % (6.03 mmol/l vs. 5.30 mmol/l) among women. Geometric mean TG decreased by 14 % (1.66 mmol/l vs. 1.42 mmol/l) among men and by 8 % (1.20 mmol/l vs. 1.10 mmol/l) among women. Mean HDL-C remained unchanged among men (1.29 mmol/l vs. 1.27 mmol/l), but decreased by 5 % among women (1.66 mmol/l vs. 1.58 mmol/l). Sports activity and coffee consumption increased, while smoking and high alcohol consumption decreased only in men. Processed food consumption increased and wholegrain bread consumption decreased in both sexes, and obesity increased among men. The use of lipid-lowering medication, in particular statins nearly doubled over time in both sexes. Among women, hormonal contraceptive use increased and postmenopausal hormone therapy halved over time. The changes in lipid levels between surveys remained significant after adjusting for covariables. Conclusion Serum TC and TG considerably declined over one decade in Germany, which can be partly explained by increased use of lipid-lowering medication and improved lifestyle among men. The decline in serum lipids among women, however, remains unexplained. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-2826-2) contains supplementary material, which is available to authorized users.
    Full-text · Article · Dec 2016 · BMC Public Health
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    Mariachiara Di Cesare · James Bentham · Gretchen A Stevens · Bin Zhou · Goodarz Danaei · Yuan Lu · Honor Bixby · Melanie J Cowan · Leanne M Riley · Kaveh Hajifathalian · [...] · Sabina Zambon · Tomasz Zdrojewski · Yi Zeng · Dong Zhao · Wenhua Zhao · Yingfeng Zheng · Maigeng Zhou · Dan Zhu · Esther Zimmermann · Julio Zuñiga Cisneros ·
    Full-text · Dataset · Apr 2016
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    Mariachiara Di Cesare · James Bentham · Gretchen A Stevens · Bin Zhou · Goodarz Danaei · Yuan Lu · Honor Bixby · Melanie J Cowan · Leanne M Riley · Kaveh Hajifathalian · [...] · Sabina Zambon · Tomasz Zdrojewski · Yi Zeng · Dong Zhao · Wenhua Zhao · Yingfeng Zheng · Maigeng Zhou · Dan Zhu · Esther Zimmermann · Julio Zuñiga Cisneros ·
    [Show abstract] [Hide abstract] ABSTRACT: Summary Background Underweight and severe and morbid obesity are associated with highly elevated risks of adverse health outcomes. We estimated trends in mean body-mass index (BMI), which characterises its population distribution, and in the prevalences of a complete set of BMI categories for adults in all countries. Methods We analysed, with use of a consistent protocol, population-based studies that had measured height and weight in adults aged 18 years and older. We applied a Bayesian hierarchical model to these data to estimate trends from 1975 to 2014 in mean BMI and in the prevalences of BMI categories (<18·5 kg/m2 [underweight], 18·5 kg/m2 to <20 kg/m2, 20 kg/m2 to <25 kg/m2, 25 kg/m2 to <30 kg/m2, 30 kg/m2 to <35 kg/m2, 35 kg/m2 to <40 kg/m2, ≥40 kg/m2 [morbid obesity]), by sex in 200 countries and territories, organised in 21 regions. We calculated the posterior probability of meeting the target of halting by 2025 the rise in obesity at its 2010 levels, if post-2000 trends continue. Findings We used 1698 population-based data sources, with more than 19·2 million adult participants (9·9 million men and 9·3 million women) in 186 of 200 countries for which estimates were made. Global age-standardised mean BMI increased from 21·7 kg/m2 (95% credible interval 21·3–22·1) in 1975 to 24·2 kg/m2 (24·0–24·4) in 2014 in men, and from 22·1 kg/m2 (21·7–22·5) in 1975 to 24·4 kg/m2 (24·2–24·6) in 2014 in women. Regional mean BMIs in 2014 for men ranged from 21·4 kg/m2 in central Africa and south Asia to 29·2 kg/m2 (28·6–29·8) in Polynesia and Micronesia; for women the range was from 21·8 kg/m2 (21·4–22·3) in south Asia to 32·2 kg/m2 (31·5–32·8) in Polynesia and Micronesia. Over these four decades, age-standardised global prevalence of underweight decreased from 13·8% (10·5–17·4) to 8·8% (7·4–10·3) in men and from 14·6% (11·6–17·9) to 9·7% (8·3–11·1) in women. South Asia had the highest prevalence of underweight in 2014, 23·4% (17·8–29·2) in men and 24·0% (18·9–29·3) in women. Age-standardised prevalence of obesity increased from 3·2% (2·4–4·1) in 1975 to 10·8% (9·7–12·0) in 2014 in men, and from 6·4% (5·1–7·8) to 14·9% (13·6–16·1) in women. 2·3% (2·0–2·7) of the world's men and 5·0% (4·4–5·6) of women were severely obese (ie, have BMI ≥35 kg/m2). Globally, prevalence of morbid obesity was 0·64% (0·46–0·86) in men and 1·6% (1·3–1·9) in women. Interpretation If post-2000 trends continue, the probability of meeting the global obesity target is virtually zero. Rather, if these trends continue, by 2025, global obesity prevalence will reach 18% in men and surpass 21% in women; severe obesity will surpass 6% in men and 9% in women. Nonetheless, underweight remains prevalent in the world's poorest regions, especially in south Asia. Funding Wellcome Trust, Grand Challenges Canada.
    Full-text · Article · Apr 2016 · The Lancet
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    [Show abstract] [Hide abstract] ABSTRACT: Background: A domain-specific physical activity questionnaire (EHIS-PAQ) was developed in the framework of the second wave of the European Health Interview Survey (EHIS). This article presents the EHIS-PAQ and describes its development and evaluation processes. Methods: Research institutes from Belgium, Estonia and Germany participated in the Improvement of the EHIS (ImpEHIS) Grant project issued by Eurostat. The instrument development process comprised a non-systematic literature review and a systematic HIS/HES database search for physical activity survey questions. The developed EHIS-PAQ proposal was reviewed by survey experts. Cognitive testing of the EHIS-PAQ was conducted in Estonia and Germany. The EHIS-PAQ was further tested in a pilot survey in Belgium, Estonia and Germany in different modes of data collection, face-to-face paper and pencil interview (PAPI) and computer assisted telephone interview (CATI). Results: The EHIS-PAQ is a rather pragmatic tool aiming to evaluate how far the population is physically active in specific public health relevant settings. It assesses work-related, transport-related and leisure-time physical activity in a typical week. Cognitive testing revealed that the EHIS-PAQ worked as intended. The pilot testing showed the feasibility of using the EHIS-PAQ in an international health interview survey setting in Europe. It will be implemented in all 28 European Union Member States via European Union implementing regulation in the period between 2013 and 2015. This will be a first opportunity to get comparable data on domain-specific physical activity in all 28 EU MS and to publish indicators at the EU level. Conclusions: The EHIS-PAQ is a short, domain-specific PA questionnaire based on PA questions which have been used in large-scale health interview surveys before. It was designed by considering the respondents' perspective in answering PA questions.
    Full-text · Article · Dec 2015
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    [Show abstract] [Hide abstract] ABSTRACT: Background/objectives: The objective of this study was to quantify body weight changes in German adult populations during the past decades. Subjects/methods: Longitudinal analysis of seven cohort studies covering different age ranges between 18 and 83 years. Baseline examinations were between 1994 and 2007 and follow-up durations between 4.0 and 11.9 years. For each study, mean change in body weight per year and 10-year change in body mass index (BMI) classification were analyzed. For the middle age group of 45-64 years, meta-analysis was conducted to obtain an overall estimate for Germany. Results: Among men weight gain was highest in the youngest participants and decreased with advancing age. Among women weight gain was on a stable high level among those younger than 45 years and decreased at older age. Within 10 years, 30-40% of middle-aged participants with normal baseline weight became pre-obese or obese and 20-25% of those with pre-obesity at baseline became obese, whereas >80% of persons who were obese at baseline remained obese over time. The estimated average weight change in adults aged 45-64 years was 0.25 (95% confidence interval (CI): 0.18-0.33) kg/year among men and 0.24 (0.17-0.30) kg/year among women. Conclusions: We could observe a moderate weight gain over the past years in German middle-aged populations of 0.25 kg/year. Obesity prevention needs to be targeted to specific subgroups in the population, especially to younger adults, who seem to be most vulnerable for gaining weight. Obesity intervention needs to be improved, as the majority of obese adults remained obese over time.European Journal of Clinical Nutrition advance online publication, 28 October 2015; doi:10.1038/ejcn.2015.179.
    Full-text · Article · Oct 2015 · European journal of clinical nutrition
  • [Show abstract] [Hide abstract] ABSTRACT: Choline is an important nutrient for humans. Choline intake of the European population was assessed considering the European Food Safety Authority European Comprehensive Food Consumption Database and the United States Department of Agriculture Nutrient Database. Average choline intake ranges were 151-210 mg/d among toddlers (1 to ≤3 years old), 177-304 mg/d among other children (3 to ≤10 years old), 244-373 mg/d among adolescents (10 to ≤18 years old), 291-468 mg/d among adults (18 to ≤65 years old), 284-450 mg/d among elderly people (65 to ≤75 years old) and 269-444 mg/d among very elderly people (≥75 years old). The intakes were higher among males compared with females, mainly due to larger quantities of food consumed per day. In most of the population groups considered, the average choline intake was below the adequate intake (AI) set by the Institute of Medicine in the USA. The main food groups contributing to choline intake were meat, milk, grain, egg and their derived products, composite dishes and fish. The main limitations of this study are related to the absence of choline composition data of foods consumed by the European population and the subsequent assumption made to assess their intake levels. Given the definition of AI, no conclusion on the adequacy of choline intake can be drawn for most European population groups. Such results improve the knowledge on choline intake in Europe that could be further refined by the collection of choline composition data for foods as consumed in Europe.
    No preview · Article · Oct 2015 · The British journal of nutrition
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    [Show abstract] [Hide abstract] ABSTRACT: Background: Control of modifiable cardiovascular disease (CVD) risk factors has substantially reduced CVD mortality, but risk factor levels in populations may change and need continuous monitoring. This study aims to provide current estimates of the prevalence of these risk factors in Germany according to sex and history of coronary heart disease (CHD) or stroke. Methods: The analyses were based on data from the German Health Interview and Examination Survey for Adults (DEGS1; age 40-79 years, n = 5101), which is a cross-sectional population-based examination survey. CVD risk factors were defined according to recommendations in the European Guidelines on Cardiovascular Disease Prevention in Clinical Practice 2012. Results: The mean age was 57 years and 52% were female; 493 participants had prior CHD and 163 participants a prior stroke. The overall prevalence of behavioural risk factors ranged from 17.9% for high risk alcohol consumption to 90% for low vegetable intake. Blood pressure ≥ 140/90 mmHg was found in 21% and 69% had total cholesterol ≥ 5.0 mmol/l. Only 16% met the targets for five behavioural factors combined (smoking, physical activity, fruit intake, alcohol intake and obesity), 13% of those with and 16% of those without CHD or stroke. The prevalences of most behavioural risk factors were higher among men compared to women. Conclusions: There is a high prevention potential from modifiable cardiovascular risk factors in the general population aged 40-79 years in Germany and among those with prior CHD or stroke. Risk factors are often co-occurring, are interrelated and require combined educational, behavioral, medical and policy approaches.
    Full-text · Article · Jul 2015 · BMC Public Health
  • A Borrmann · Gert B M Mensink
    [Show abstract] [Hide abstract] ABSTRACT: A high fruit and vegetable intake contributes to a healthy diet, which is very important for the development of children and adolescents. With data from the first follow-up survey of the Child and Adolescent Health Surveys (KiGGS wave 1) the fruit and vegetable intake and its association with determinants are analyzed. Via telephone interviews the average numbers of portions of fruits and vegetables consumed by 9,950 girls and boys aged 3-17 years were assessed. In addition, the proportion of persons achieving five portions of fruits and vegetables per day was calculated. The number of portions was analyzed in association with social status, parent's educational level, media consumption, and other determinants via multiple linear regression models. Only 12.2 % of girls and 9.4 % of boys consume the recommended five portions of fruits and vegetables per day. 38.6 % of girls and 33.5 % of boys consume at least three portions per day. On average, girls consume 2.7 and boys 2.4 portions of fruits and vegetables per day. Younger participants consume significantly more portions of fruits than older participants. The percentage of persons consuming five or at least three portions per day increases significantly with higher socioeconomic status, higher parent's educational level, and lower media consumption. Furthermore, children who conduct sport outside of school, those who are physically active every day, and boys living in central Germany consume significantly more portions of fruit and vegetables. Most children and adolescents do not consume enough fruits and particularly vegetables. The consumption differs considerably according to socio-demographic background and lifestyle factors, which should be considered in promotional campaigns.
    No preview · Article · Jul 2015 · Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz
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    [Show abstract] [Hide abstract] ABSTRACT: Background: In 1998, more than half of the adult population in Germany had serum 25-hydroxy-vitamin-D [25(OH)D] levels below the common threshold of 50 nmol/l. Since then, there has been a lot of attention for vitamin D in the scientific community, the media and the general population and serum 25(OH)D levels may have increased as a consequence. With data from the 'German Health Interview and Examination Survey for Adults' (DEGS1) the current situation of vitamin D status can be analysed. Methods: DEGS1, a national health survey among adults in Germany conducted by the Robert Koch Institute between 2008 and 2011, included 6,995 persons with available serum 25(OH)D levels. We calculated the proportion of participants with serum 25(OH)D levels <30 nmol/l, 30- < 50 nmol/l and > =50 nmol/l overall and according to age, season and latitude of residence as well as percentiles of serum 25(OH)D according to month of examination. Determinants of vitamin D status were analysed with multiple linear regression models. Results: Mean serum 25(OH)D level was 45.6 nmol/l with no significant sex differences (p = 0.47). 61.6 % of the participants had serum 25(OH)D levels <50 nmol/l, 30.2 % had levels <30 nmol/l. During summer, half of the participants had levels > =50 nmol/l, during winter time, 25 % of the participants had levels <30 nmol/l. A significant latitudinal gradient was observed in autumn for men and in winter for women. Conclusions: Serum 25(OH)D levels below the threshold of 50 nmol/l are still common among adults in Germany, especially during winter and spring and in higher latitudes. Potentially modifiable factors of poorer vitamin D status are higher BMI, lack of sport activity and high media use.
    Full-text · Article · Jul 2015 · BMC Public Health
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    [Show abstract] [Hide abstract] ABSTRACT: The positive association between parental socioeconomic position (PSEP) and health among adolescents may be partly explained by dietary behaviour. We investigated the associations between fruit intake, vegetable intake, energy-dense food intake, the Healthy Nutrition Score for Kids and Youth (HuSKY) and parental education in a nationwide, cluster-randomized sample of adolescents in Germany. The German Health Interview and Examination Survey for Children and Adolescents 2003-2006 (KiGGS) included 17,641 individuals aged 0-17 years and their parents. Complete information on relevant variables was available for 6359 individuals in the 11-17 age group. The associations between nutrition indicators and parental education were analysed separately for boys and girls, using multivariate logistic regression analysis. Odds ratios (ORs) adjusted for age, region, income, occupation, physical activity and weight status related variables, were calculated for the associations between parental education and nutrition indicators. After full adjustment, higher parental education level was associated with lower energy-dense food intake - with an OR of 1.3 (95 % CI 1.0-1.7) for boys with secondary educated parents and 1.8 (1.4-2.3) for boys with tertiary educated parents compared to boys with primary educated parents; the corresponding ORs for girls were 1.2 (0.9-1.5) and 1.6 (1.2-2.2). Higher parental education was associated with higher fruit intake - with an OR of 1.3 (1.0-1.7) for boys with secondary educated parents and 2.0 (1.5-2.7) for boys with tertiary educated parents compared to boys with primary educated parents; the corresponding ORs for girls were 1.0 (0.8-1.4) and 1.5 (1.0-2.1). Among boys and girls with tertiary educated parents compared to those with primary educated parents an OR of 1.3 (CI boys: 1.0-1.7, CI girls: 1.0-1.6) was observed for high vegetable intake. Among boys with tertiary educated parents compared to boys with primary educated parents an OR of 1.6 (1.2-2.2) was observed for a high HuSKY; the corresponding OR for girls was 1.5 (1.1-1.9). A high PSEP is associated with consumption of less energy-dense food, more fruits and vegetables and more favourable overall dietary behaviour. Preferably school-based interventions are needed to promote healthy dietary behaviour among German adolescents and a special effort is needed to reach adolescents from low-PSEP families.
    Full-text · Article · May 2015 · BMC Public Health
  • Amanda K Buttery · Gert B M Mensink · Markus A Busch
    [Show abstract] [Hide abstract] ABSTRACT: Background: Health risk behaviours such as smoking, physical inactivity and poor diet are independently associated with depression. However, there is a paucity of data examining associations between combined healthy behaviours and mental distress and depression. Methods: Using cross-sectional data from a nationwide population-based sample of adults in Germany [German Health Update (GEDA) 2009 and 2010 telephone surveys; n = 21 940 women, n = 17 061 men], we examined associations between five healthy behaviours and frequent mental distress (FMD) and self-reported diagnosed depression in the past 12 months. Healthy behaviours included non-smoking, low-risk alcohol drinking, regular sport, maintaining normal weight and healthy fruit and vegetable consumption. Multiple logistic regression analyses adjusted for potential confounders examined associations between the combined number of healthy behaviours and FMD and self-reported diagnosed depression. Results: FMD was reported by 13.6 and 8.0% and diagnosed depression in the last 12 months by 8.3 and 4.7% of women and men, respectively. At least four of five assessed healthy behaviours were reported by 29.1% of women and 17.8% of men. Compared with those with less than two healthy behaviours, women and men with at least four behaviours were about half as likely to report FMD [odds ratio (OR) 0.53, 95% confidence interval (CI) 0.44-0.64, and OR 0.52, 95% CI 0.41-0.66, respectively) and women with at least four behaviours were less likely to report diagnosed depression (OR 0.76, 95% CI 0.61-0.95). Conclusion: A higher number of healthy behaviours are associated with a lower prevalence of FMD for both women and men and of self-reported diagnosed depression in women.
    No preview · Article · Jul 2014 · The European Journal of Public Health
  • [Show abstract] [Hide abstract] ABSTRACT: 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.
    No preview · Article · Jul 2014 · Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz
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    [Show abstract] [Hide abstract] ABSTRACT: The positive association between parental socio-economic position (PSEP) and health among adolescents may be partly explained by physical activity behaviour. We investigated the associations between physical activity, aerobic fitness and PSEP in a population based sample of German adolescents. 5,251 participants, aged 11-17 years, in the German Health Interview and Examination Survey for Children and Adolescents 2003-2006 (KiGGS) underwent a sub-maximal cycle ergometer test and completed a questionnaire obtaining information on physical activity and media use. The associations between physical activity, media use, aerobic fitness and PSEP were analysed with multivariate logistic regression models for boys and girls separately. Odds ratios (ORs) of PSEP (education, occupation and income) on the outcomes were calculated adjusted for age, region, and other influencing factors. Parental education was more strongly associated with the outcome variables than parental occupation and income. After adjusting for age and region, a higher parental education level was associated with better aerobic fitness - with an OR of 1.5 (95% CI 1.2-1.9) for girls whose parents had secondary education and 1.9 (1.4-2.5) for girls whose parents had tertiary education compared to girls whose parents had primary education. The corresponding ORs for boys were 1.3 (1.0-1.6) and 1.6 (1.2-2.1), respectively. Higher parental education level was associated with lower media use: an OR of 2.1 (1.5-3.0) for girls whose parents had secondary education and 2.7 (1.8-4.1) for girls whose parents had primary education compared to girls whose parents had tertiary education. The corresponding ORs for boys were 1.5 (1.2-1.9) and 1.9 (1.5-2.5), respectively. Higher parental education level was associated with a higher physical activity level only among girls: an OR of 1.3 (1.0-1.6) for girls whose parents had secondary education and 1.2 (0.9-1.5) for girls whose parents had tertiary education compared to girls whose parents had primary education. The corresponding ORs for boys were 0.9 (0.8-1.2) and 0.8 (0.6-1.0), respectively. Adolescents of parents with low SEP showed a lower level of aerobic fitness and higher levels of media use than adolescents of parents with higher SEP. Health-promotion interventions need to reach adolescents of parents with low PSEP and stimulate physical activity.
    Full-text · Article · Mar 2014 · International Journal of Behavioral Nutrition and Physical Activity
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    [Show abstract] [Hide abstract] ABSTRACT: Abstract BACKGROUND: High sodium intake increases blood pressure, a risk factor for cardiovascular disease, but the effects of sodium intake on global cardiovascular mortality are uncertain. METHODS: We collected data from surveys on sodium intake as determined by urinary excretion and diet in persons from 66 countries (accounting for 74.1% of adults throughout the world), and we used these data to quantify the global consumption of sodium according to age, sex, and country. The effects of sodium on blood pressure, according to age, race, and the presence or absence of hypertension, were calculated from data in a new meta-analysis of 107 randomized interventions, and the effects of blood pressure on cardiovascular mortality, according to age, were calculated from a meta-analysis of cohorts. Cause-specific mortality was derived from the Global Burden of Disease Study 2010. Using comparative risk assessment, we estimated the cardiovascular effects of current sodium intake, as compared with a reference intake of 2.0 g of sodium per day, according to age, sex, and country. RESULTS: In 2010, the estimated mean level of global sodium consumption was 3.95 g per day, and regional mean levels ranged from 2.18 to 5.51 g per day. Globally, 1.65 million annual deaths from cardiovascular causes (95% uncertainty interval [confidence interval], 1.10 million to 2.22 million) were attributed to sodium intake above the reference level; 61.9% of these deaths occurred in men and 38.1% occurred in women. These deaths accounted for nearly 1 of every 10 deaths from cardiovascular causes (9.5%). Four of every 5 deaths (84.3%) occurred in low- and middle-income countries, and 2 of every 5 deaths (40.4%) were premature (before 70 years of age). The rate of death from cardiovascular causes associated with sodium intake above the reference level was highest in the country of Georgia and lowest in Kenya. CONCLUSIONS: In this modeling study, 1.65 million deaths from cardiovascular causes that occurred in 2010 were attributed to sodium consumption above a reference level of 2.0 g per day. (Funded by the Bill and Melinda Gates Foundation.).
    Full-text · Article · Jan 2014
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    [Show abstract] [Hide abstract] ABSTRACT: The positive association between education level and health outcomes can be partly explained by dietary behaviour. We investigated the associations between education and several indices of food intake and potential influencing factors, placing special emphasis on physical-activity patterns, using a representative sample of the German adult population. The German National Health Interview and Examination Survey 1998 (GNHIES98) involved 7,124 participants aged between 18 and 79. Complete information on the exposure (education) and outcome (nutrition) variables was available for 6,767 persons. The associations between 'education' and indices of 'sugar-rich food', 'fat-rich food', 'fruit-and-vegetable' and 'alcohol' intake were analysed separately for men and women using multivariate logistic regression analysis. Odds ratios (OR) of education level on nutrition outcomes were calculated and adjusted for age, region (former East/West Germany), occupation, income and other influencing factors such as physical activity indicators. Men and women with only a primary education had a more frequent intake of sugar-rich and fat-rich foods and a less frequent intake of fruit and vegetables and alcohol than people with a tertiary education. 'Physical work activity' partly explained the associations between education and sugar-rich food intake. The interference with physical work activity was stronger among men than women. No significant associations between education and energy-dense food intake were observed in the retirement-age group of persons aged 65+ and among persons with low energy expenditure. In Germany, adults with a low level of education report that they consume energy-dense foods more frequently - and fruit and vegetables and alcohol less frequently - than adults with a high education level. High levels of physical work activity among adults with a low education level may partly explain why they consume more energy-dense foods.
    Full-text · Article · Nov 2013 · PLoS ONE
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    Lena Lämmle · Alexander Woll · Gert B M Mensink · Klaus Bös
    [Show abstract] [Hide abstract] ABSTRACT: Objective: The aim of the present paper was to analyze factors affecting distal and proximal health behavior within a biopsychosocial model for examining their interactions and associations with respect to health. Methods: Path analysis was based on the nationwide, cross-sectional German Health Interview and Examination Survey for Children and Adolescents (2003 to 2006). The data was collected from 4,529 participants with an average age of 9.45 years (SD = 4.01). Socio-demographic data, psychosocial factors and health behavior were assessed via questionnaire. Participants also underwent physical fitness tests and a medical examination. Results: Over the five levels of the model analyzed with socioeconomic status, immigration background, and rural-urban differences on the first level; physical activity of relatives and peers, intrinsic motivation, and quality of life on the second level; eating patterns, sedentary behavior, and physical activity on the third level; physical fitness and objective health on the fourth level; and health complaints and subjective health on the fifth level; direct, moderation, and mediation effects could be shown. Conclusions: Several distal and proximal factors are needed to take account of the multivariate complexity of health: e.g., immigration background affected health behaviors only indirectly and the effect of physical activity on objective health was mediated by physical fitness.
    Full-text · Article · Jul 2013 · International Journal of Environmental Research and Public Health
  • S. Krug · S. Jordan · G. B. M. Mensink · S. Müters · J. D. Finger · T. Lampert
    [Show abstract] [Hide abstract] ABSTRACT: Regular physical activity can have a positive effect on health at any age. Today's lifestyles, however, can often be characterised as sedentary. Therefore, the promotion of physical activity and sports has become an integral part of public health measures. The representative data of adults aged 18 to 79 years in Germany obtained from the "German Health Interview and Examination Survey for Adults" (DEGS1) provide an overview of self-estimated current physical activity behaviour. The results show that one third of the adult population claims to pay close attention to reaching a sufficient level of physical activity and one fourth participates in sports for at least 2 h/week on a regular basis. Thus, the percentage of adults regularly engaged in sports has increased compared to the previous "German National Health Interview and Examination Survey 1998". Still, four out of five adults do not achieve at least 2.5 h/week of moderate-intensity physical activity as recommended by the World Health Organisation. Consequently, future individual-level and population-level interventions should focus on target group-specific measures while continuing to promote regular physical activity in all segments of the population. An English full-text version of this article is available at SpringerLink as supplemental.
    No preview · Article · May 2013 · Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz
  • [Show abstract] [Hide abstract] ABSTRACT: The increase in overweight and obesity is a worldwide health problem. The first wave of the "German Health Interview and Examination Survey for Adults" (DEGS1), conducted from 2008 through 2011, provides current data about overweight and obesity among adults in Germany. Within DEGS1, a representative sample of the 18- to 79-year-old population was interviewed with regard to health relevant issues and physically examined (n = 7,116). From measurements of body height and weight, the body mass index (BMI) was calculated, which was used to define overweight (BMI ≥ 25 kg/m(2)) and obesity (BMI ≥ 30 kg/m(2)). Results are stratified for gender, age group, socioeconomic status and region and compared with results from the German National Health Interview and Examination Survey 1998 (GNHIES98) and the National Examination Surveys 1990/92. According to DEGS1, 67.1% of men and 53.0% of women are overweight. The prevalence of overweight has not changed compared to GNHIES98. The prevalence of obesity, however, has risen substantially, especially among men: in GNHIES98, 18.9% of men and 22.5% of women were obese, in DEGS1, these figures were 23.3% and 23.9%, respectively. The increase in obesity occurred especially among young adults. An English full-text version of this article is available at SpringerLink as supplemental.
    No preview · Article · May 2013 · Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz
  • S. Krug · S. Jordan · G.B.M. Mensink · S. Müters · J. Finger · T. Lampert
    [Show abstract] [Hide abstract] ABSTRACT: Regelmäßige körperliche Aktivität kann in jedem Alter einen positiven Einfluss auf Gesundheit und Wohlbefinden haben. Allerdings ist das heutige Alltagsleben oft durch körperliche Inaktivität geprägt. Sport- und Bewegungsförderung sind daher fester Bestandteil von Public-Health-Maßnahmen. Die für die 18- bis 79-jährige Bevölkerung in Deutschland repräsentativen Daten der „Studie zur Gesundheit Erwachsener in Deutschland“ (DEGS1) ermöglichen einen Überblick des selbsteingeschätzten aktuellen körperlichen Aktivitätsverhaltens. Nach den Ergebnissen von DEGS1 achtet etwa ein Drittel der Erwachsenen auf ausreichende körperliche Aktivität, und etwa ein Viertel treibt regelmäßig mindestens 2 h pro Woche Sport. Damit hat die sportliche Aktivität im Vergleich zum diesbezüglichen Umfang, der vor etwa 10 Jahren im Bundes-Gesundheitssurvey 1998 (BGS98) ermittelt wurde, zugenommen. Die von der Weltgesundheitsorganisation (WHO) für einen gesundheitlichen Nutzen empfohlene Mindestaktivitätszeit von 2,5 h pro Woche in mäßig anstrengender Intensität ist allerdings bei etwa vier Fünfteln der Bevölkerung nicht gegeben. Das Ziel sollte daher weiterhin sein, zielgruppenspezifische verhaltens- und verhältnispräventive Maßnahmen anzubieten und die Bevölkerung bei der Einbindung regelmäßiger körperlicher Aktivität in ihren Alltag zu unterstützen.
    No preview · Article · May 2013 · Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz
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    S Krug · S Jordan · G B M Mensink · S Müters · J Finger · T Lampert
    [Show abstract] [Hide abstract] ABSTRACT: Regular physical activity can have a positive effect on health at any age. Today's lifestyles, however, can often be characterised as sedentary. Therefore, the promotion of physical activity and sports has become an integral part of public health measures. The representative data of adults aged 18 to 79 years in Germany obtained from the "German Health Interview and Examination Survey for Adults" (DEGS1) provide an overview of self-estimated current physical activity behaviour. The results show that one third of the adult population claims to pay close attention to reaching a sufficient level of physical activity and one fourth participates in sports for at least 2 h/week on a regular basis. Thus, the percentage of adults regularly engaged in sports has increased compared to the previous "German National Health Interview and Examination Survey 1998". Still, four out of five adults do not achieve at least 2.5 h/week of moderate-intensity physical activity as recommended by the World Health Organisation. Consequently, future individual-level and population-level interventions should focus on target group-specific measures while continuing to promote regular physical activity in all segments of the population. An English full-text version of this article is available at SpringerLink as supplemental.
    Full-text · Article · May 2013 · Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz