BACKGROUND The combined impact of multiple healthy behaviors on health exceeds that of single behaviors. This study aimed to estimate trends in the prevalence of a healthy lifestyle among adults in Germany. METHODS A data set of 18,058 adults aged 25-69 years from three population-based national health examination surveys 1990-92, 1997-99 and 2008-11 with complete information for five healthy behavior factors was used. A 'daily intake of both fruits and vegetables, 'sufficient physical exercise', 'no current smoking' and 'no current risk drinking' were assessed with self-reports and 'normal body weight' was calculated based on measured body weight and height. A dichotomous 'healthy lifestyle' indicator was defined as meeting at least four out of five healthy behaviors. Age-standardized prevalence was calculated stratified by sex, age groups (25-34, 35-44, 45-54 and 55-69 years) and education level (low, medium and high). Trends were expressed in relative change (RC) between 1990-92 and 2008-11. RESULTS In Germany, the overall prevalence of healthy lifestyle increased from 9.3% in 1990-92 to 13.5% in 1997-99 and to 14.7% in 2008-11 (RC: +58.1%). The prevalence increased among men and women and in all age groups, with the exception of men aged 45-54 years. The RC of increasing healthy lifestyle prevalence between 1990-92 and 2008-11 was stronger albeit on a higher level among women compared to men. Therefore, the gender difference in healthy lifestyle has increased, but age-related differences have overall decreased in this period. Among high educated men the prevalence of a healthy lifestyle increased between 1990-92 and 2008-11 from 10.6% to 16.3% (p = 0.01) and among high educated women from 16.4% to 30.3% and also among medium educated women (10.9 to 16.6, p<0.01), but no significant increase in healthy lifestyle prevalence was observed among men with low and medium education and among women with low education level. CONCLUSIONS The prevalence of a lifestyle with at least four out of five healthy behaviors markedly increased from 1990-92 to 2008-11. Nevertheless, additional health promotion interventions are needed to improve the number of combined healthy behavior factors and the awareness in the population that each additional healthy behavior factor leads to a further improvement in health, especially in men in the age-range 45 to 54 years, and among persons with low education level.

中文翻譯：

德國成年人健康生活方式的時(shí)間趨勢：1990 年至 2011 年間三項(xiàng)全國健康訪談和檢查調(diào)查的結(jié)果。

背景技術(shù)多種健康行為對(duì)健康的綜合影響超過單一行為。本研究旨在估計(jì)德國成年人健康生活方式的流行趨勢。方法 使用1990-92年、1997-99年和2008-11年三項(xiàng)基于人口的全國健康檢查調(diào)查的18,058名25-69歲成年人的數(shù)據(jù)集，其中包含五種健康行為因素的完整信息。通過自我報(bào)告評(píng)估“每日攝入水果和蔬菜”、“足夠的體育鍛煉”、“目前不吸煙”和“目前沒有危險(xiǎn)飲酒”，并根據(jù)測量的體重和身高計(jì)算“正常體重”。二分法“健康生活方式”指標(biāo)被定義為至少滿足五分之四的健康行為。按性別、年齡組（25-34、35-44、45-54 和 55-69 歲）和教育水平（低、中和高）分層計(jì)算年齡標(biāo)準(zhǔn)化患病率。1990-92 年至 2008-11 年間的趨勢以相對(duì)變化 (RC) 表示。結(jié)果 在德國，健康生活方式的總體流行率從 1990-92 年的 9.3% 上升到 1997-99 年的 13.5%，再到 2008-11 年的 14.7%（RC：+58.1%）。除 45-54 歲男性外，男性和女性以及所有年齡組的患病率均有所增加。1990-92 年和 2008-11 年間，健康生活方式流行率不斷提高的 RC 更強(qiáng)，盡管與男性相比，女性的水平較高。因此，這一時(shí)期健康生活方式的性別差異有所增加，但與年齡相關(guān)的差異總體上有所減少。1990-92 年至 2008-11 年間，受過高等教育的男性中，健康生活方式的流行率從 10.6% 上升至 16.3%（p = 0.01），受過高等教育的女性中，這一比例從 16.4% 上升至 30.3%，受中等教育的女性中，健康生活方式的比例也從 10.9% 上升至 30.3%。 16.6，p<0.01），但在中低教育水平的男性和低教育水平的女性中，健康生活方式的流行率沒有顯著增加。結(jié)論 從 1990-92 年到 2008-11 年，五項(xiàng)健康行為中至少有四項(xiàng)的生活方式的流行率顯著增加。然而，需要額外的健康促進(jìn)干預(yù)措施來提高綜合健康行為因素的數(shù)量，并提高人們對(duì)每一個(gè)額外的健康行為因素都會(huì)導(dǎo)致健康狀況進(jìn)一步改善的認(rèn)識(shí)，特別是在 45 至 54 歲的男性中，以及教育水平低的人。

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網(wǎng)址: Time trends in healthy lifestyle among adults in Germany: Results from three national health interview and examination surveys between 1990 and 2011.,PLOS ONE http://m.u1s5d6.cn/newsview1257373.html