Rates of at-risk drinking and unhealthy nutrition in Germany vary across regions

March 12, 2020

Rates of at-risk alcohol consumption are higher in the South and East of Germany, compared to the North and West, according to a study published in the open access journal BMC Public Health. However, compared to West Germany, people in East Germany eat more healthily, while rates of smoking and lack of physical activity appear to be similar across regions.

Josefine Atzendorf, the corresponding author said: "Previous studies on lifestyle risk factors generally focused on age- or gender-specific differences. However, there are indicators that smoking, nutrition, alcohol consumption and physical activity also vary across regions. We examined how these behaviours differed according to sociodemographic factors, and between North, South, East and West Germany."

Using data on 9,204 people living in Germany, the authors found that East Germany had the highest prevalence for at-risk alcohol consumption (18.3% of the population), followed by South Germany (16.7%), West Germany (14.6%) and North Germany (13.9%). At-risk alcohol consumption was defined as drinking 12 grams or more of ethanol per day for women and 24 grams or more for men. Women were less likely to drink alcohol at at-risk levels than men, but individuals with higher education were more likely to report at-risk alcohol consumption than individuals with lower education.

Unhealthy nutrition was most prevalent in West Germany (70.6%) and least prevalent in East Germany (66.7%), while prevalence of physical activity did not differ between regions. Women were more likely to report lower physical activity but less likely to report unhealthy nutrition than men. Individuals with higher education were more likely to report lower physical activity but less likely to report unhealthy nutrition than individuals with lower education.

Daily smoking, defined as having smoked at least one cigarette, cigar, pipe or cigarillo per day in the past 30 days, was equally distributed across all four regions. Women and individuals with higher education were less likely to smoke on a daily basis.

The authors used data on 5,090 women and 4,114 men aged 18 to 64 from the 2015 Epidemiological Survey of Substance Abuse, which assessed the substance use among the general population in Germany at regular intervals between 1980 and 2015. Participants were asked about their daily smoking, diet, alcohol consumption and physical activity.

The authors caution that the use of self-reported data may have introduced bias towards socially desirable answers. Hence, the prevalence of unhealthy behaviors may have been underestimated. The observational nature of the study does not allow for conclusions about cause and effect.

Josefine Atzendorf said: "Our results indicate that health-promoting strategies to reduce lifestyle risk factors in Germany are currently insufficient. Our findings could provide starting points for the development or adjustment of health policies, considering differences between regions. However, for smoking and low physical activity, where no regional differences exist, prevention and intervention measures should focus on Germany as a whole."
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Notes to editor:

1. Research article:

Do smoking, nutrition, alcohol use, and physical activity vary between regions in Germany? - results of a cross-sectional study

Atzendorf et al. BMC Public Health 2020

DOI: 10.1186/s12889-020-8352-2

For an embargoed copy of the research article, please contact Anne Korn at BMC.

After the embargo lifts, the article will be available here: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-8352-2

Please name the journal in any story you write. If you are writing for the web, please link to the article. All articles are available free of charge, according to BMC's open access policy.

2. BMC Public Health is an open access, peer-reviewed journal that considers articles on the epidemiology of disease and the understanding of all aspects of public health. The journal has a special focus on the social determinants of health, the environmental, behavioral, and occupational correlates of health and disease, and the impact of health policies, practices and interventions on the community.

3. A pioneer of open access publishing, BMC has an evolving portfolio of high quality peer-reviewed journals including broad interest titles such as BMC Biology and BMC Medicine, specialist journals such as Malaria Journal and Microbiome, and the BMC series. At BMC, research is always in progress. We are committed to continual innovation to better support the needs of our communities, ensuring the integrity of the research we publish, and championing the benefits of open research. BMC is part of Springer Nature, giving us greater opportunities to help authors connect and advance discoveries across the world.

BMC (BioMed Central)

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