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Background: Physical inactivity is often reported in youth and differs among boys and girls. The aim of this study is to assess sex/gender considerations in intervention studies promoting physical activity and reducing sedentary behavior in youth using a sex/gender checklist. Methods: A systematic search was conducted in August 2018 to identify all relevant controlled trials. Studies screened must have reported a quantified measure of physical activity and/or sedentary behavior, and identified participants by sex/gender at baseline. For evaluation of the sex/gender consideration, the authors used a sex/gender checklist developed by expert consensus. Results: The authors reviewed sex/gender considerations in all aspects of intervention development, implementation, and evaluation in 217 studies. Sex/gender aspects were only rudimentarily taken into account, most frequently during statistical analyses, such as stratification or interaction analysis. Conclusions: Sex/gender effects are not sufficiently reported. To develop guidelines that are more inclusive of all girls and boys, future interventions need to document sex/gender differences and similarities, and explore whether sex/gender influences different phases of intervention programs. The newly developed sex/gender checklist can hereby be used as a tool and guidance to adequately consider sex/gender in the several steps of intervention planning, implementation, and evaluation.

This study was supported by a research Grant from the Czech Science Foundation under Reg. No. 17-12579S and a governmental project under Reg. No. CZ.02.1.01/0.0/0.0/16_025/0007294. Objectives: The aim of the study was to determine secular trends in vigorous physical activity (VPA) among adolescents in relation to family affluence across 34 countries. Methods: This study used data from the Health Behaviour in School-aged Children (HBSC) study from 34 countries in Europe and North America. Adolescents (N = 501,647) aged 11, 13 and 15 years across three survey cycles (2006, 2010, 2014) self-reported data on VPA and a family affluence scale (FAS) using standardized questionnaires. Results: A significant increase in VPA was found in low-FAS boys (girls) in four (10) countries and a decrease in four (three) countries. In high-FAS boys (girls), a significant increase was observed in nine (11) countries and a decrease in two(three) countries. An overall significant increase in meeting the VPA recommendations was found in high-FAS boys (OR 1.11; 95% CI 1.06–1.16) and in all FAS groups in girls, with the largest effect being found among high-FAS girls (OR 1.24; 95% CI 1.18–1.30). Conclusions: A country-specific increase in VPA was observed primarily in the medium- and high-FAS categories. This study suggests a need to focus on increasing VPA efforts, especially in low- and medium-FAS boys. Publisher PDF

It is widely proven that being physically active and avoiding sedentary behaviour help to improve adolescents&rsquo, well-being and keep them in better health in general. We aimed to investigate the relationship between modes of transport to school and subjective complaints among schoolchildren. Analyses were based on the HBSC (Health Behaviour in School-aged Children) surveys conducted in 2017/18 in nine countries (N = 55,607, mean age 13.43 &plusmn, 1.64 yrs.). The main outcome showed that health complaints consisted of somatic and psychological complaints. Transport to school was characterized by mode of getting there (walking, biking, or another passive mode). A total of 46.1% of students walked and 7.3% cycled to school, 46.6% commuted by passive means. Biking to school was more frequent in Denmark (37.9%), Norway (26.5%), and Germany (26.6%). The multivariate generalized linear model adjusted for age, gender, country, and school proximity showed that biking to school is protective against reports of health complaints. The beta parameters were equal to &minus, 0.498 (p &lt, 0.001) for the general HBSC-SCL index, &minus, 0.208 (p &lt, 0.001) for the somatic complaint index, and &minus, 0.285 (p &lt, 0.001) for the psychological complaints index. Young people who actively commute to school are less likely to report health complaints, especially psychological symptoms.

Health risks of sedentary behaviour at work are a matter of concern. Solutions are needed based on interdisciplinary collaborations of research experts and practitioners in the field of occupational safety and health.In February 2019, at a workshop in Berlin, experts from different fields discussed the health risks of sedentary behaviour at work and solutions for the workplace based on scientific evidence. The workshop is documented here in 2 parts. Gender relevant aspects are distinguished if possible.Part I describes the workshop contributions on current scientific findings regarding health risks of sedentary behavior in leisure time and at work as well as prevalence and determinants of sedentary work. The following contribution presents suggestions for the development of theory-based intervention strategies. Furthermore, available evidence from systematic reviews for intervention strategies to reduce sedentary time at work is shown.In spite of many studies and evidence in favour of taking into consideration sedentary behavior at work, there are still research gaps predominantly regarding etiology, possibilities of compensation, determinants, and intervention strategies. In this context, documentation of differences between men and women is insufficient. Part II presents selected workplace solutions and the results of the discussions in the workshop.ZIEL: Die Gesundheitsgefährdung durch sedentäres Verhalten am Arbeitsplatz ist ein wichtiges Problem unserer Zeit. Seine Lösung verlangt nach interdisziplinärer Zusammenarbeit von Expertinnen und Experten aus Wissenschaft und betrieblicher Praxis.Hierzu wurde im Februar 2019 in Berlin ein Workshop mit Fachleuten aus verschiedenen Bereichen durchgeführt, der die derzeitigen wissenschaftlichen Erkenntnisse der Gesundheitsgefährdung durch lange, wenig unterbrochene Sitzzeiten am Arbeitsplatz thematisiert und ausgewählte betriebliche Lösungsansätze aufzeigt. Dieser Workshop wird hier in 2 Teilen dokumentiert. Genderrelevante Aspekte werden, wenn möglich, hervorgehoben.Im vorliegenden Teil I werden die Beiträge zu aktuellen wissenschaftlichen Erkenntnissen bezogen auf die Gesundheitsrisiken durch sedentäre Lebens- und Arbeitsweisen sowie Prävalenz und Determinanten für sedentäres Verhalten in der Arbeitswelt referiert. Die darauf aufbauenden Beiträge zu theoriegeleiteten Interventionsstrategien und zur Evidenz für erfolgreiche Interventionsstrategien aus systematischen Reviews zeigen mögliche Lösungswege auf.Trotz vieler Studien und Hinweise, die für eine stärkere Berücksichtigung des sedentären Verhaltens im betrieblichen Kontext sprechen, gibt es Wissenslücken v.a. bezogen auf Ätiologie, Möglichkeiten der Kompensation, Determinanten und Interventionsstrategien. Auch sind Unterschiede zwischen Männern und Frauen in diesem Zusammenhang unzureichend dokumentiert. Im Teil II werden ausgewählte betriebliche Lösungsansätze und die Ergebnisse der Workshop-Diskussion vorgestellt.

This systematic review aims to evaluate the extent of sex/gender consideration and effectiveness of interventions designed to reduce sedentary behaviour (SB). We searched for randomised or non-randomised controlled trials with the outcome SB and a sex/gender analysis in eleven electronic databases. Sixty-seven studies were included. Sex/gender considerations were qualitatively rated. Sex/gender was reported separately in 44.8% of studies, 14.9% of studies conducted a sex/gender interaction analysis, and 19.4% enrolled either girls or boys. SB was significantly reduced for girls in 16.4%, for boys in 11.9% and for both in 13.4%. No sex/gender intervention effect was found in 38.8%. According to the qualitative rating, studies without significant sex/gender effects reached “detailed” rating twice as often as studies finding a significant intervention effect for either girls or boys, or both. Overall, no clear pattern according to the qualitative rating and in terms of intervention effectiveness can be drawn. The results reveal a lack of sufficient sex/gender information in intervention planning and delivery. Further research should consider analysing sex/gender intervention effects as well as consider sex/gender inclusive intervention planning and delivery.

The study was supported from European Regional Development Fund-Project “Effective Use of Social Research Studies for Practice” (No. CZ.02.1.01/0.0/0.0/16_025/0007294) and the Czech Science Foundation under reg. No. 18-24977S. Objectives: Associations between the perceived social and physical environment and self-reported moderate-to-vigorous physical activity (MVPA) and screen time (ST) were examined among adolescents in four European countries. Methods: Representative samples were surveyed with standardised methodologies. Associations between environmental variables and meeting MVPA recommendations and tertiles of ST were tested in gender-specific logistic regression models. Moderation by country and country-specific relationships were also examined. Results: The most consistent findings across countries were found for the significant associations between neighbourhood social environment and MVPA in both boys and girls. Significant associations with the physical environment varied more between countries and by gender. The most consistent negative associations with ST were found for the social environmental variable of having parental rules for spending time outside the home. Conclusions: The present findings provided evidence for the generalisability of the associations between environmental correlates and MVPA across four European countries. The findings show clear differences in correlates for MVPA and ST. Further research is needed to better understand the unique aspects of the social and physical environment which explain each of the two behaviours. Postprint

Background: Aim of this intervention study was to evaluate whether availability of standing desks in classrooms may reduce sitting time and enhance standing and stepping time during lessons and breaks. Further, we evaluated if differences in standing desk use differed by physical fitness (PF) levels of children. Methods: To assess sitting, standing and stepping during a typical school week in 3rd grade primary school children (N = 52), activPAL monitors were used at baseline: T0, 1st follow-up: T1 and 2nd follow-up: T2. At baseline, PF was measured using the standing long jump and the 6-min jog-walk to assign children as having low PF (LPF) or high PF (HPF). Standing desks were assigned randomly to intervention and control groups at T1 (group 1) and T2 (group 2) with a cross-over design. Changes of sitting, standing and stepping were analyzed to investigate intervention effects at follow-up, using linear mixed models. Results: At baseline, children spent about 60 and 30% of time sitting during lessons and breaks, respectively. After installing standing desks (T1), significantly lower proportions of sitting were observed in the intervention group 1 [-13.1%, 95%-CI: (-20.5; -5.72)] and the control group 2 [-9.78%, 95%-CI: (-17.3; -2.28)]. Compared to the baseline measurement (T0), lower proportions of sitting were particularly expressed during school breaks in group 1 and 2 after intervention in T1 [group 1: -10.3%, 95%-CI: (-16.4; -4.25)] or in T2 [group 2: -8.59%, 95%-CI: (-15.2; -1.94)]. In general, children with higher physical fitness were less sedentary and more active, but intervention effects did not differ by fitness levels. Conclusion: Standing desks provide an opportunity to reduce sedentary time during lessons and breaks at school in primary school children, but do not directly increase PA of high intensity such as stepping. Future studies should consider potential bandwagon effects caused by structural interventions. Copyright © 2020 Sprengeler, Hebestreit, Gohres, Bucksch and Buck.

Objectives: To develop a road map towards a harmonized pan-European surveillance system for children and adolescents. Methods: Representatives of five European surveillance systems and the German Health Interview and Examination Survey for Children and Adolescents contributed to the road map through a structured workshop in 2016. Results: A conceptual framework for this road map was developed with seven action points (APs) guiding the successive cross-country harmonization. First, key indicators of health behaviour and their determinants in children and adolescents will be identified (AP1, 2); short screening instruments will be developed and implemented to assess and monitor key indicators (AP3, 4). In parallel, optional supplementary modules could be implemented to provide objective data (AP5). This would allow mutual calibration and improvement of existing instruments before their progressive replacement by more comparable measurement tools (AP6). The establishment of a competence platform is envisaged for guiding the harmonization process (AP7). Conclusions: This approach builds on existing systems, provides comparable key health indicators across European regions, helps to assess temporal trends and—once in place—will facilitate health reporting and monitoring of national and international health targets.

This study assessed the associations between these factors in a random sample of Czech families with preschool and school-aged children. A nationally representative sample comprised 185 families with preschool children and 649 families with school-aged children (dyads; both parents and child n = 365, mother and child n = 730, and father and child n = 469). The participants wore Yamax Digiwalker SW-200 pedometers at least four weekdays and both weekend days and completed family logbooks (anthropometric parameters, daily step counts (SC), and screen time (ST)). When a parent (fathers at weekends and mothers both on weekdays and at weekends) achieved 10,000 SC per day, their children were also significantly (OR = 2.93-6.06, 95% CI = 2.02-9.26) more likely to meet the daily SC recommendation. On the contrary, the involvement of fathers in organized leisure-time PA reduced their children's odds of meeting the SC recommendation on weekdays (OR = 0.53, 95% CI = 0.31-0.89) and at weekends (OR = 0.41, 95% CI = 0.24-0.72). The excessive ST of parents at weekends reduced the odds of their children meeting the SC recommendation (mother-child dyads: OR = 0.44, 95% CI = 0.26-0.72; father-child dyads: OR = 0.63, 95% CI = 0.37-1.06). High levels of parents' PA contribute to the achievement of the recommended daily PA in children on weekdays and at weekends. Excessive weekend ST of parents reduces their odds of their children achieving the recommended daily PA; however, the influence of parents' PA on their children's achieving the recommended daily PA is stronger than the inhibitory effect of ST.

The Health Behaviour in School-Aged Children study (HBSC) uses the Family Affluence Scale (FAS) as a tool to identify the socioeconomic status of children and adolescents. Even though it is now widely applied in research studies, the external criterion validation of FAS has not been verified in terms of objective economic indicators in Central Europe. The aim of this study is to validate FAS in terms of disposable income per capita in 14 Czech administrative regions. Regional differences in the FAS score were analyzed using Pearson correlation and linear regression to measure the dependency of the aggregated mean of the FAS index at the regional level on data from the Czech HSBC survey carried out from April to June 2014 (n = 10,361). The data analysis has shown an overall positive correlation between the FAS index and regional disposable income (R = 0.77, p < 0.01). The regional disposable income per person could explain 59.7% of the variance in the FAS index (p < 0.01). By validating individual items, the authors identified three items with a significant correlation (p < 0.01): number of computers, dishwasher at home, and number of holidays. FAS seems to be a valid instrument to measure adolescents’ socioeconomic status.

Sedentary behaviour is a health risk factor independent of physical activity. Interventions that aim to reduce sitting at the workplace are particularly important as office workers spend a large proportion of their working hours sitting. This systematic review examines whether these interventions (SB or PA interventions during work time) reduce sitting time among office workers and which variables moderate intervention effects.A systematic literature search was conducted from April to May 2016 in the following databases: PubMed, PsycINFO and SPORTDiscus. In total, we identified 17 studies that assessed the time spent in sedentary behaviour at the office workplace. To summarize the study results, we applied a best-evidence synthesis. Additionally, we evaluated potential moderators, such as intervention strategies.Multi-component interventions and sit-stand workstations were most promising sedentary reduction interventions. The analysis of moderators highlighted that the proportion of positive intervention effects was higher in interventions based on the strategies "environmental restructuring", "adding objects to the environment" and "instructions on how to carry out the behaviour". Furthermore, interventions focusing on sedentary behaviour only and studies using objective measurement tools showed more often positive interventions effects.There are many promising interventions to reduce sitting time at the office workplace. However, there is insufficient evidence if the effects of these interventions are sustainable in the long term. Moreover, the considerable heterogeneity of included studies limits the validity of our findings. Future intervention studies should build on a theoretical planning approach and use subjective as well as objective evaluation measures.Sitzendes Verhalten wird zunehmend als ein eigenständiger gesundheitlicher Risikofaktor eingeschätzt. Ein wesentliches Handlungsfeld für Interventionen zur Reduzierung sitzenden Verhaltens stellt deshalb der Büroarbeitsplatz dar. Dieses systematische Review untersucht, ob sitz- und/oder bewegungsspezifische Interventionen die Sitzzeiten von Büroangestellten am Arbeitsplatz reduzieren.Von April bis Mai 2016 wurde in den Datenbanken „PubMed“, „PsycINFO“ und „SPORTDiscus“ eine systematische Literaturrecherche durchgeführt. Insgesamt ließen sich 17 Studien identifizieren, welche die Sitzzeiten von Büroangestellten untersuchten. Die relevanten Studien wurden in einer „Best Evidence Synthesis“ zusammengefasst. Zusätzlich wurde eine Moderatoranalyse (u. a. Interventionsmethoden) durchgeführt.Multikomponenten-Interventionen und Sitz-Steh-Arbeitsstationen sind vielversprechend zur Reduzierung der Sitzzeiten von Büroangestellten. In der Moderatoranalyse fiel der Anteil signifikant positiver Interventionsergebnisse für die Interventionsmethoden „Umweltveränderungen“, „Hinzufügen von Objekten zur Umgebung“ und „Anleitungen, um ein Verhalten auszuführen“ am höchsten aus. Interventionen mit spezifischem Fokus auf das Sitzen sowie Studien mit objektiver Messmethodik zur Erhebung der Sitzzeit zeigten sich erfolgversprechender.Es existieren verschiedene erfolgversprechende Interventionen zur Reduzierung der Sitzzeiten am Büroarbeitsplatz. Hier sind Mehrkomponenten-Interventionen und die Installation von Sitz-Steh-Arbeitsstationen hervorzuheben. Wenig Evidenz liegt für die Langzeitwirkung vor. Die Heterogenität der Studien schränkt zudem allgemeingültige Wirksamkeitsaussagen ein. Zukünftige Studien sollten Interventionen stärker theoriebasiert planen und die Sitzzeiten mithilfe subjektiver und objektiver Messinstrumente erfassen.

We present the 7-year follow-up analysis in overweight children and adolescents, who had participated originally in a randomized control trial of a lifestyle intervention. We compared them to an untreated population-based control group to demonstrate the effectiveness of the intervention.Degree of overweight (BMI-SDS) was determined in 32 overweight children (mean age 11.5 ± 1.5yrs, 65.6% females, mean BMI 23.7 ± 1.5 kg/mThe participants in the intervention group reduced significantly their BMI-SDS between T0-T1 (mean ± standard deviation -0.28 ± 0.28, p 0.001) and demonstrated no significant changes between T1-T2 (mean ± standard deviation -0.10 ± 0.34) and between T2-T3 (median +0.07; interquartile range: -0.54-0.62). BMI-SDS at T3 was significantly (p = 0.015) lower compared to T0. At T3, 46.8% of the participants in the intervention were normal-weight. The reduction in BMI-SDS between T0-T3 was significantly (p = 0.043) greater in the intervention group (median -0.26; interquartile range -0.87-0.23 BMI-SDS) compared to the control group (mean ± standard deviation -0.05 ± 0.77).The lifestyle intervention led to a significant reduction of overweight in the 7-year follow-up period. This decrease in BMI-SDS was significantly greater than the changes in BMI-SDS in a control group. This study is registered at clinicaltrials.gov (NCT00422916).

OBJECTIVE: Screen-based behaviours such as watching television or computer use are among the most prevalent sedentary behaviours adolescents spend time on. There is a lack of recent estimates on prevalence and changes in the amount of time spent on screen-based behaviour across Central and Eastern Europe. The main aim is to assess the trends in the prevalence of current recommendations for the screen time (≤2 hours per day) of school-aged children in the Czech Republic between 2002 and 2014.METHODS: We used an internationally established methodology based on the Health Behaviour in School-aged Children (HSBC) study. Data was derived from Czech national representative samples of 11-, 13- and 15-year-olds collected in the years 2002 (N=4,065), 2006 (N=4,170), 2010 (N=3,962) and 2014 (N=4,338).RESULTS: The results indicated that the boys and girl surveyed in 2014 are up to two times more likely to meet the current recommendations for watching television in comparison with groups of schoolchildren of the same age surveyed in 2002. In contrast, computer use by adolescents increased markedly between 2006 and 2014. Taking total screen time into account, spending two hours per day or less on it decreased significantly among boys (OR=0.74, 95% CI=0.62-0.89) and girls (OR=0.80, 95% CI=0.70-0.92) between 2006 and 2014.CONCLUSIONS: As screen time is an important indicator of time spent in a sedentary way, our findings call for more interventions to reduce the time that school-aged children spend in front of screens.

Background: The aim of this study is to explore if perception of an activity-friendly environment is associated with more physical activity and fewer screen-based activities among adolescents. Methods: We collected self-reported data in 2014 via the Health Behavior in School-aged Children cross-sectional study from four European countries (n = 13,800, mean age = 14.4, 49.4% boys). We explored the association of perceived environment (e.g., "There are other children nearby home to go out and play with") with physical activity and screen-based activities using a binary logistic regression model adjusted for age, gender, family affluence and country. Results: An environment perceived as activity-friendly was associated with higher odds that adolescents meet recommendations for physical activity (odds ratio (OR) for one standard deviation (SD) change = 1.11, 95% confidence interval (CI) 1.05-1.18) and lower odds for excessive screen-based activities (OR for 1 SD better = 0.93, 95% CI 0.88-0.98). Conclusions: Investment into an activity-friendly environment may support the promotion of active life styles in adolescence.

Sedentary behaviour is itself a health-related behaviour. This systematic review examines whether family-based interventions can reduce sitting time among children and adolescents and which variables moderate potential intervention effects.Using a systematic literature search we identified family-based randomised controlled intervention studies that focus on sedentary behaviour in 3‑ to 18-year-old children and youth. The methodological quality of studies as well as the intervention effects according to different outcomes (screen-based vs. overall sitting) were analysed and evaluated for moderating effects.Of 29 studies, 17 reported significant effects and 11 studies showed positive trends for reduced sitting time. The content of interventions, the level of theoretical underpinning as well as the methodological quality of studies were heterogeneous. Most often, screen-based sitting and seldom overall sitting was examined. Concise characteristics of intervention success were not clearly apparent. The proportion of positive intervention effects was higher in reducing sitting in front of TVs compared to other outcomes. An analysis of moderators highlighted that intervention programs among pre-schoolers showed more often positive intervention effects.There are many promising opportunities to reduce sitting time using family-based approaches. Statements in terms of replication of interventions and explanations of the effective mechanisms within interventions are limited. Therefore, future interventions should use subjective as well as objective evaluation measures and consider overall sitting time. To strengthen the basis of interventional effort in this research field, a theoretical planning approach is recommended.

Background This study focuses on the comparison of weekday/weekend parent-child behavioural patterns (step count (SC) and screen time (ST)) and answers the question of whether achieving the recommendations for daily SC (10,000) in parents also helps their preschool children achieve the recommended daily SC (11,500). Methods The participants (278 parents aged 30–45 and their 194 children aged 4–7) were randomly recruited from 10 Czech public kindergartens. The participants recorded SC (pedometer Yamax Digiwalker SW-200) and ST duration (proxy-report) for seven consecutive days (≥8 h/day) during September–October 2014 and April–May 2015. Differences between weekdays/weekends SC or ST were tested using a paired t-test. The odds of achieving the recommended daily SC for children were estimated using general logistic regression separately for weekdays and weekends. Results Only the mothers were found to have a significantly lower SC at weekends than on weekdays. All of the participants showed significantly more ST at weekends than on weekdays (daughters: 78.6 vs. 45.7 min/day, p

Background: There is a growing body of international data on the association between physical activity (PA) and variables of the perceived environment. German data is still lacking. The purpose of this study was to provide data on PA (moderate-to-vigorous PA (MVPA) vs. walking) and the perceived environment in urban and rural areas. Methods: We conducted a cross-sectional survey with inhabitants of urban ( n = 310) and rural ( n = 345) areas in the western part of Germany. The sample consisted of 655 adults [49.8% women; mean age = 43.3 (SD = 12.7)]. The International Physical Activity Questionnaire (IPAQ)-short version and the IPAQ environmental module were used. Outcome variables were time in MVPA as well as in walking. We analysed the association between perceived environmental variables and PA by a series of linear regressions. Results: We observed associations between PA and access to destinations, well-maintained sidewalks, seeing physically active people in the neighbourhood, higher residential density and neighbourhood safety. The associations varied as a function of PA (MVPA vs. walking) and area (urban vs. rural). The variance explaining the models including environmental variables as well as sex and age ranged from 1% (model: MVPA in rural area) up to 9.9% (model MVPA in urban area). Conclusions: Our findings suggest that the perceived environment is important to promote both MVPA and walking in rural and urban areas. To better understand environmental correlates in rural structures, we particularly need more specific studies.

Background:\ud The use of electronic media has been found to be a risk factor for higher BMI and for being overweight. Physical activity has been found to be associated with lower BMI and lower risk for being overweight. Little is known about whether the associations between physical activity and electronic media use are additive or interactive in predicting BMI and risk for overweight among adolescents.\ud \ud Methods:\ud The data used in this study stem from the 2009/2010 survey of “Health Behaviour in School-aged Children (HBSC) study: A WHO Cross-National Survey. The sample consisted of 107184 13 and 15 year students from 30 different countries. Multilevel regression models were used to produce the presented estimates.\ud \ud Results:\ud Overall, 18% of boys and 11% of girls were classified as overweight. EM use was found to be associated with increased BMI z-scores and odds for overweight among both boys and girls who did not comply with physical activity guidelines. Among physically active adolescents, EM was found to be significantly associated with BMI or odds for overweight among girls, but not among boys.\ud \ud Conclusion:\ud While the usage of EM appear to be inconsequential for BMI and the risk of overweight among physically active boys, we find evidence indicating that EM use is associated with BMI and risk for overweight among girls, including those who report complying with MVPA guidelines.

Background: The present study was designed to analyse Web pages of German gynaecologists with regard to postmenopausal hormone therapy ( HT). There is a growing body of evidence, that the overall health risks of HT exceed the benefits. Making one's own informed choice has become a central concern for menopausal women. The Internet is an important source of health information, but the quality is often dubious. The study focused on the analysis of basic criteria such as last modi. cation date and quality of the HT information content. The results of the Women's Health Initiative Study (WHI) were used as a benchmark. Methods: We searched for relevant Web pages by entering a combination of key words (9 x 13 = 117) into the search engine www.google.de. Each Web page was analysed using a standardized questionnaire. The basic criteria and the quality of content on each Web page were separately categorized by two evaluators. Disagreements were resolved by discussion. Main Findings: Of the 97 websites identified, basic criteria were not met by the majority. For example, the modi. cation date was displayed by only 23 (23.7%) Web pages. The quality of content of most Web pages regarding HT was inaccurate and incomplete. Whilst only nine (9.3%) took up a balanced position, 66 (68%) recommended HT without any restrictions. In 22 cases the recommendation was indistinct and none of the sites refused HT. With regard to basic criteria, there was no difference between HT-recommending Web pages and sites with balanced position. Conclusion: Evidence-based information resulting from the WHI trial was insufficiently represented on gynaecologists' Web pages. Because of the growing number of consumers looking online for health information, the danger of obtaining harmful information has to be minimized. Web pages of gynaecologists do not appear to be recommendable for women because they do not provide recent evidence-based findings about HT.

Increasing physical activity and reduction of sedentary behaviour play important roles in health promotion and prevention of lifestyle-related diseases in children and adolescents. However, the question of how much physical activity is useful for which target group is still a matter of debate. International guidelines (World Health Organization; European Association for the Study of Obesity), which are mainly based on expert opinions, recommend 60 min of physical activity every day. Age- and sex-specific features and regional differences are not taken into account. Therefore, expert consensus recommendations for promoting physical activity of children and adolescents in Germany were developed with special respect to national data, but also with respect to aspects of specific target groups, e.g., children with a lower socio-economic status (SES) or with migration background. They propose 90 min/day of physical activity, or at least 12,000 steps daily. Additionally, lifestyle factors, especially restriction of media consumption, were integrated. The recommendations provide orientation for parents and caregivers, for institutions such as schools and kindergartens as well as for communities and stakeholders. © 2014 S. Karger GmbH, Freiburg.

Background:\ud Studies in youth highlight that moderate-to-vigorous physical activity (MVPA) and screen-time behaviours such as television viewing and PC use are associated with a range of health outcomes. However, little is known about recent trends in these behaviours in adolescents. This paper presents time trends in German adolescents’ television time, non-gaming PC use as well as MVPA from 2002 to 2010.\ud \ud Methods:\ud Data were derived from the cross-sectional German Health Behaviour in School-aged Children (HBSC) study in 2002, 2006 and 2010. Analyses were based on 16,918 11-to 15-year olds boys (49.1%) and girls. Outcome variables were time spent in TV viewing and using a PC (weekday and weekend day) as well as the number of days achieving 60 minutes of MVPA. Changes in both screen-time behaviours and MVPA over time were analysed using sex-specific linear regression, controlling for age and family affluence.\ud \ud Results:\ud TV viewing on weekdays, but not at weekends, declined steadily over time with a difference between 2002 and 2010 of 12.4 min/day in girls and 18.3 min/day in boys (p for trend < .01). We found a strong increase in PC use for non-gaming purposes over time for girls only, with a difference between 2002 and 2010 of 54.1 min/weekday and 68.8 min/weekend day (p < .001). For MVPA we found a slight statistically significant increase in terms of meeting PA guidelines as well as days/week in MVPA for boys and girls (p < .001). In 2010 14.0% of girls and 19.9% of boys met PA guideline.\ud \ud Conclusion:\ud Although MVPA increased from 2002 to 2010 in German adolescents, the time spent in MVPA was still low. Despite the observed decrease in TV viewing, there was no overall decline in the observed screen-based behaviours, especially for girls. This is mainly due to a marked increase in use of a PC for chatting on-line, internet, emailing, homework etc. among girls during the last ten years which outweighs the corresponding decrease in TV viewing. The findings highlight a need for strategies and interventions aimed at reducing screen-time behaviours and promoting MVPA.

Background: Sedentary behaviour in general and sitting time in particular is an emerging global health concern. The aim of this study was to provide data on the prevalence of sitting time in German adults and to examine socio-demographic and environmental correlates of sitting time. Methods. A representative sample of German adults (n = 2000; 967 men, 1033 women; 49.3 ±17.6 years of age) filled in the Global Physical Activity Questionnaire, including one question on overall sitting time and answered questions about the neighbourhood environment, as well as concerning demographics. Daily sitting time was stratified by gender, age group, BMI, educational and income level, as well as physical activity (PA). To identify socio-demographic and environmental correlates of sitting time, we used a series of linear regressions. Results: The overall median was 5 hours (299 minutes) of sitting time/day and men sat longer than women (5 vs. 4 hours/day; p < 0.05). In both genders age and PA were negatively and the educational level positively associated with sitting time. The level of income was not a correlate of sitting time in multivariate analyses. Sitting time was significantly positively associated with higher neighbourhood safety for women. The variance of the multivariate model ranged from 16.5% for men to 8.9% for women. Conclusions: The overall sitting time was unequally distributed in the German adult population. Our findings suggest implementing specific interventions to reduce sitting time for subgroups such as men, younger aged adults and adults with a higher education and lower PA. Future studies should enhance our understanding of the specific correlates of different types and domains of sitting in order to guide the development of effective public health strategies. :doi 10.1186/1471-2458-13-196

Purpose Engaging in prolonged screen-time behaviors (STBs) is detrimental for health. The objective of the present analyses was to examine temporal trends in TV viewing and computer use among adolescents across 30 countries. Methods Data were derived from the cross-national Health Behaviour in School-aged Children study. Data on TV viewing and computer use for gaming and nongaming purposes were collected in 2002 (n = 139,725 [51.4% girls]), 2006 (n = 149,251 [51.3% girls]), and 2010 (n = 154,845 [51.2% girls]). The temporal trends in TV viewing and computer use were each tested for all countries combined and for each individual country by sex-specific univariate analysis of variance. Results Between 2002 and 2010, TV viewing decreased slightly in most of the 30 countries among both boys and girls. This decrease was more than offset by a sharp increase in computer use, which was consistent across all countries. Overall, boys reported more hours of STBs. They also reported a slightly larger decrease in TV viewing and slightly larger increase in computer use. STBs were generally more frequent on weekend days. Conclusions The overall cross-national increases in STBs should be a call to action for public health practitioners, policy-makers, and researchers that interventions specifically focused on reducing STBs in youth are sorely needed. Because all countries experienced a trend in the same direction, it might be fruitful to learn more about the determinants of STBs among those countries in which hours of STBs are generally low as compared with other countries.

To review the epidemiological evidence on the health-enhancing physical activity recommendation of the Centers for Disease Control and Prevention (CDC) and the American College for Sports Medicine (ACSM). Review of papers written in English and German, issued after the release of the CDC/ACSM recommendation (i. e. after 1995), restricted to adults and to their physical health. Due to the large body of published data, no systematic review was performed. Instead, a representative cross-section of the published studies is presented. The international epidemiological evidence supports the CDC/ACSM recommendation as a reasonable public health message. According to this recommendation, the daily accumulation of 30 minutes of physical activity of moderate intensity — independent of the context of physical activity (e. g. transport, leisure) — provides substantial benefits across a broad range of health outcomes for sedentary men and women. Nevertheless some controversial issues need further address.

BACKGROUND: There are conflicting data about the health benefits of moderately intense physical activity. OBJECTIVES: To examine the effect of such activity on all cause mortality in a German sample of men and women. METHODS: Physical activity during leisure time of 3742 men and 3445 women aged 30 to 69 was assessed in a baseline questionnaire from 1984 to 1986. The participants were observed during the follow up period until 1998 when a mortality follow up was conducted. RESULTS: During the follow up period, 300 women and 643 men had died. The multivariate rate ratios (RR) for the volume of lifestyle activities of moderate intensity (for example, gardening, walking, cycling) compared with sedentary lifestyle showed a clearly protective dose-response relation (p for trend