title: Clustering patterns of physical activity, sedentary and dietary behavior among European adolescents: The HELENA study.
abstract: BACKGROUND
  Evidence suggests possible synergetic effects of multiple lifestyle behaviors on health risks like obesity and other health outcomes. A better insight in the clustering of those behaviors, could help to identify groups who are at risk in developing chronic diseases. This study examines the prevalence and clustering of physical activity, sedentary and dietary patterns among European adolescents and investigates if the identified clusters could be characterized by socio-demographic factors.
  
  
  METHODS
  The study comprised a total of 2084 adolescents (45.6% male), from eight European cities participating in the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) study. Physical activity and sedentary behavior were measured using self-reported questionnaires and diet quality was assessed based on dietary recall. Based on the results of those three indices, cluster analyses were performed. To identify gender differences and associations with socio-demographic variables, chi-square tests were executed.
  
  
  RESULTS
  Five stable and meaningful clusters were found. Only 18% of the adolescents showed healthy and 21% unhealthy scores on all three included indices. Males were highly presented in the cluster with high levels of moderate to vigorous physical activity (MVPA) and low quality diets. The clusters with low levels of MVPA and high quality diets comprised more female adolescents. Adolescents with low educated parents had diets of lower quality and spent more time in sedentary activities. In addition, the clusters with high levels of MVPA comprised more adolescents of the younger age category.
  
  
  CONCLUSIONS
  In order to develop effective primary prevention strategies, it would be important to consider multiple health indices when identifying high risk groups.
authors.affiliation: Department of Public Health, Ghent University, Ghent, Belgium. charlene.ottevaere@ugent.be
authors.forename: Charlene
authors.initials: C
authors.lastname: Ottevaere
authors.forename: Inge
authors.initials: I
authors.lastname: Huybrechts
authors.forename: Jasmin
authors.initials: J
authors.lastname: Benser
authors.forename: Ilse
authors.initials: I
authors.lastname: De Bourdeaudhuij
authors.forename: Magdalena
authors.initials: M
authors.lastname: Cuenca-Garcia
authors.forename: Jean
authors.initials: J
authors.lastname: Dallongeville
authors.forename: Maria
authors.initials: M
authors.lastname: Zaccaria
authors.forename: Frederic
authors.initials: F
authors.lastname: Gottrand
authors.forename: Mathilde
authors.initials: M
authors.lastname: Kersting
authors.forename: Juan P
authors.initials: JP
authors.lastname: Rey-López
authors.forename: Yannis
authors.initials: Y
authors.lastname: Manios
authors.forename: Dénes
authors.initials: D
authors.lastname: Molnár
authors.forename: Luis A
authors.initials: LA
authors.lastname: Moreno
authors.forename: Emmanouel
authors.initials: E
authors.lastname: Smpokos
authors.forename: Kurt
authors.initials: K
authors.lastname: Widhalm
authors.forename: Stefaan
authors.initials: S
authors.lastname: De Henauw
mesh_terms: D000293:Adolescent; D000886:Anthropometry; D016000:Cluster Analysis; D004032:Diet; D005060:Europe; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D057185:Sedentary Behavior; D011795:Surveys and Questionnaires