title: Clustering of lifestyle factors and association with overweight in adolescents of the Kiel Obesity Prevention Study.
abstract: OBJECTIVE
  To identify lifestyle clusters in adolescents and to characterize their association with overweight and obesity.
  
  
  METHODS
  Cross-sectional and longitudinal data of the Kiel Obesity Prevention Study.
  
  
  METHODS
  Schools in Kiel, Germany.
  
  
  METHODS
  Cross-sectional data of 1894 adolescents aged 14 years and 4-year longitudinal data of a subsample of 389 children aged 10 and 14 years. Self-reported data of physical activity, modes of commuting to school, media time, nutrition, alcohol consumption and smoking were used to identify lifestyle clusters with two-step cluster analysis. Obesity indices (height, weight, waist circumference and fat mass (FM)) were measured.
  
  
  RESULTS
  Three lifestyle clusters were identified: a 'low activity and low-risk behaviour' cluster (cluster 1: n 740, 39·1 %); a 'high media time and high-risk behaviour' cluster (cluster 2: n 498, 26·3 %); and a 'high activity and medium-risk behaviour' cluster (cluster 3: n 656, 34·6 %). Strictly speaking, none of these clusters was considered to be markedly healthy. The prevalence of overweight and obesity tended to be lower in cluster 3 (15·9 %) than in clusters 1 (20·4 %) and 2 (20·5 %; P = 0·053). Longitudinally, 4-year changes in FM were found to be lowest in cluster 2, but the 4-year incidence rate of obesity was lowest in cluster 3.
  
  
  CONCLUSIONS
  Explicit healthy lifestyles do not exist, but an active lifestyle reduces the incidence of obesity. In adolescents, health promotion should take into account the diversity of lifestyles and address specific lifestyle clusters.
authors.affiliation: Institut für Humanernährung und Lebensmittelkunde, Christian-Albrechts-Universität zu Kiel, Düsternbrooker Weg 17, D-24105 Kiel, Germany.
authors.forename: Beate
authors.initials: B
authors.lastname: Landsberg
authors.forename: Sandra
authors.initials: S
authors.lastname: Plachta-Danielzik
authors.forename: Dominique
authors.initials: D
authors.lastname: Lange
authors.forename: Maike
authors.initials: M
authors.lastname: Johannsen
authors.forename: Jasmin
authors.initials: J
authors.lastname: Seiberl
authors.forename: Manfred James
authors.initials: MJ
authors.lastname: Müller
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D002648:Child; D002652:Child Behavior; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D015994:Incidence; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D009765:Obesity / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D050177:Overweight / Q000453:epidemiology / Q000209:etiology*; D015995:Prevalence; D057185:Sedentary Behavior; D057566:Self Report