Adolescence is a critical period in life for adopting health behaviors, and these adopted health behaviors most probably track into adulthood [1–4]. Hence, understanding health behavior in adolescents is very important. It is well known that many adolescents in Germany do not meet the current physical activity recommendations, spend much time using electronic media, and eat too much processed meat and sweets and not enough vegetables and fruit compared to current recommendations [5–7]. Activity level and dietary habits have been recognized as key aspects of lifestyle that influence the risk for chronic diseases such as cardiovascular disease, diabetes, obesity, cancer and depression [8–10]. Hence, promoting a healthy lifestyle systematically, especially during adolescence is critical. However, primary prevention programs can only be implemented effectively if the specific characteristics of the target group are known. For instance, Carr stated that “there is a need for clearer definitions of target groups, their characteristics and particular needs” . Because previous studies mainly focused on each one of the different health-related behaviors separately , currently little is known about the co-occurrence of these health-related behaviors.
The approach of clustering of health-related behaviors is based on the concept of health-related lifestyles  which originates from the work of Max Weber (1922) . Health-related lifestyles comprise a person’s health-related behaviors, health-related attitudes and their socio-structural context. Cockerham  defined “health lifestyles” as “collective patterns of health-related behavior based on choices from options available to people according to their life chances”. Because it is assumed that a person’s health-related lifestyle is a composition of individual choices and social conditions , it is important to consider not only behavior patterns but also their socio-demographic correlates. This approach can be used to identify and precisely describe clusters of different behavior patterns.
To date, only few studies aimed to identify typical health-related behavior patterns and their association with socio-structural variables in adolescents [12, 16–24]. While most studies identified three to seven clusters, these studies included different health-related behaviors in their analyses (e.g. tobacco use, dental care, alcohol consumption, playing sports with parents, sleep duration, doing homework), and hence the results of these studies are not comparable. Some of these studies focused on energy balance-related behaviors (amongst others) [12, 16, 20–24] and partly examined the association with overweight. Further, Ottevaere et al.  focused on physical activity, sedentariness and dietary behavior in European adolescents and identified five clusters representing typical behavior patterns with different overweight prevalence. Moreover, to date limited information is available on health-related behavior patterns in German adolescents’. All previous German studies were based on regionally restricted samples [25–27].
The aims of the study were (a) to identify typical health-related behavior patterns in German adolescents focusing on physical activity, media use and dietary behavior; (b) to describe the socio-demographic correlates of the identified clusters and (c) to study their association with overweight.