Longitudinal associations of health-related behavior patterns in adolescence with change of weight status and self-rated health over a period of 6 years: results of the MoMo longitudinal study

Background: Promoting a healthy lifestyle especially in adolescents is important because health-related behaviors adopted during adolescence most often track into adulthood. Longitudinal studies are necessary for identifying health-related risk groups of adolescents and defining target groups for health-promoting interventions. Multiple health behavior research may represent a useful approach towards a better understanding of the complexity of health-related behavior. The aim of this study was to examine the longitudinal association of health-related behavior patterns with change of weight status and self-rated health in adolescents in Germany. Methods: Within the framework of the longitudinal German Health Interview and Examination Survey for Children and Adolescents (KiGGS) and the Motorik-Modul (MoMo), four clusters of typical health-related behavior patterns of adolescents have been previously identified. Therefor the variables 'physical activity', 'media use' and 'healthy nutrition' were included. In the current study longitudinal change of objectively measured weight status (N = 556) and self-rated health (N = 953) in the four clusters was examined. Statistical analyses comprised T-tests for paired samples, McNemar tests, multinomial logistic regression analysis and two-way ANOVA with repeated measures. Results: The prevalence of overweight increased in all four clusters. The health-related behavior pattern of low activity level with high media use and low diet quality had the strongest increase in prevalence of overweight, while the smallest and non-significant increase was found with the behavior pattern of a high physical activity level and average media use and diet quality. Only some significant relationships between health-related behaviour patterns and change in self-rated health were observed. Conclusions: High-risk patterns of health-related behavior were identified. Further, cumulative as well as compensatory effects of different health-related behaviors on each other were found. The information gained in this study contributes to a better understanding of the complexity of health-related behavior and its impact on health parameters and may facilitate the development of targeted prevention programs.