Determinants and health risks of overweight and obesity among children and adolescents in Germany

The worldwide growing prevalence of overweight and obesity is becoming an important public health concern, also among children and adolescents. To establish effective prevention strategies, it is important to identify potential determinants and health related consequences in an early stage of life. In the present study, major determinants of overweight and obesity as well as the association between overweight and cardiovascular disease (CVD) risk factors were analysed using data from the large nationally representative German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Furthermore, the relevance of different anthropometric overweight measures for assessing health risk was evaluated. From the obtained information, parental overweight was identified as a major determinant of overweight and obesity among children and adolescents. A positive independent association with obesity was also seen for low socio-economic status (SES), migration background (only significant among 3-13 year olds), high weight gain during pregnancy (only significant for normal weight mothers), maternal smoking during pregnancy, high birth weight, short sleep duration (only significant among 3-10 year olds), and high media consumption. A low SES was also associated with a higher occurrence of unfavourable behaviour and conditions. All observed overweight measures, showed a consistent positive association with adverse CVD risk factors, even in children younger than 11 years of age. Depending on the overweight measure chosen, the highest differences in the adjusted mean values of CVD risk factors between overweight and non-overweight were 14 mg/dl for total cholesterol, 12 mg/dl for LDL cholesterol, -10 mg/dl for HDL cholesterol, 9 mm Hg for systolic blood pressure, 4 mm Hg for diastolic blood pressure, and 1.2 mg/l for C-reactive protein. Among adolescents, body mass index (BMI), waist circumference and waist-to-height ratio showed a stronger association with CVD risk factors than waist-to-hip ratio and skinfold thickness. Children and adolescents from families with overweight parents and low SES have a higher risk for overweight and obesity and are therefore important target groups for prevention. BMI, waist circumference and waist-to-height ratio are good predictors for adverse CVD risk factors. Combining BMI and waist circumference or BMI and waist-to-height ratio may be even more useful for risk assessment in large-scale epidemiologic studies.Determinanten und gesundheitliche Risiken von Übergewicht und Adipositas bei Kindern und Jugendlichen in Deutschland Die weltweit steigende Prävalenz von Übergewicht und Adipositas ist von zunehmender Public Health Relevanz, auch bei Kindern und Jugendlichen. Um effektive Präventionsstrategien auszuarbeiten, ist es wichtig Determinanten und gesundheitliche Konsequenzen frühzeitig zu identifizieren. In der vorliegenden Arbeit wurden die bedeutendsten Determinanten von Übergewicht und Adipositas sowie der Zusammenhang zwischen Übergewicht und kardiovaskulären Risikofaktoren analysiert. Hierzu wurden Daten des national repräsentativen Kinder- und Jugendgesundheitssurveys (KiGGS) herangezogen. Darüber hinaus wurden unterschiedliche anthropometrische Maße zur Bestimmung von Übergewicht hinsichtlich ihrer Relevanz für die Risikobewertung beurteilt. Elterliches Übergewicht wurde anhand der erhobenen Daten als wichtigste Determinante von Übergewicht und Adipositas bei Kindern und Jugendlichen identifiziert. Es zeigte sich zudem ein positiver unabhängiger Zusammenhang zwischen Adipositas und niedrigem Sozialstatus, Migrationshintergrund (nur bei 3- bis 13-Jährigen signifikant), hoher Gewichtszunahme in der Schwangerschaft (nur bei normalgewichtigen Müttern signifikant), mütterlichem Rauchen in der Schwangerschaft, hohem Geburtsgewicht, geringer Schlafdauer (nur bei 3- bis 10-Jährigen signifikant) sowie hohem Medienkonsum. Ein niedriger Sozialstatus war darüber hinaus mit einem höheren Auftreten ungünstiger Verhaltensweisen und Lebensbedingungen assoziiert. Bei allen erfassten Übergewichtsmaßen zeigte sich bereits bei Kindern unter 11 Jahren ein durchgehend positiver Zusammenhang mit ungünstigen kardiovaskulären Risikofaktoren. Abhängig vom gewählten Maß zur Bestimmung von Übergewicht zeigten sich die höchsten Unterschiede zwischen Übergewichtigen und nicht Übergewichtigen in den adjustierten Mittelwerten der kardiovaskulären Risikofaktoren mit 14 mg/dl für Gesamtcholesterin, 12 mg/dl für LDL-Cholesterin, -10 mg/dl für HDL-Cholesterin, 9 mm Hg für systolischen Blutdruck, 4 mm Hg für diastolischen Blutdruck und 1,2 mg/l für C-reaktives Protein. Bei Jugendlichen war der Zusammenhang von kardiovaskulären Risikofaktoren mit Body Mass Index (BMI), Taillenumfang und Taille-Größe-Quotient stärker ausgeprägt als der mit Taille-Hüft-Quotient und Hautfaltendicken. Kinder und Jugendliche aus Familien mit übergewichtigen Eltern und niedrigem Sozialstatus sind bedeutende Zielgruppen für die Prävention. BMI, Taillenumfang und Taille-Größe-Quotient sind gute Prädiktoren für ein ungünstiges kardiovaskuläres Risikoprofil. Eine Kombination von BMI und Taillenumfang oder BMI und Taille-Größe-Quotient kann für die Risikobewertung in großangelegten epidemiologischen Studien sinnvoll sein

How successful is the digital teaching of "cooking skills" based on self-regulated learning?

Das Sommersemester 2020 stellte aufgrund der COVID-19-Pandemie Dozierende und Studierende anwendungsbezogener Seminare im Bereich der „cooking skills“ vor große Herausforderungen. Bewährte Präsenzkonzepte mussten auf Digitallehre umgestaltet werden. Ziel dieses Beitrags ist, beispielhaft ein digitales Konzept aufzuzeigen, durch das sich Studierende auf Basis weitgehend selbstregulierten Lernens Kompetenzen im Kontext von „cooking skills“ aneignen konnten. (DIPF/Orig.)Due to the COVID-19 pandemic, the summer semester of 2020 poses a huge challenge for lecturers and students of application-related seminars in the field of “cooking skills”. Proven presence concepts had to be redesigned to digital teaching. This article aims to demonstrate a digital concept that allows students to acquire “cooking skills” based on largely self-regulated learning. (DIPF/Orig.

HuSKY: a healthy nutrition score based on food intake of children and adolescents in Germany

For many epidemiological questions an overall indicator of healthy nutrition can be useful. Based on the data from the FFQ of the German Health Interview and Examination Study for children and adolescents (KiGGS) we developed a healthy nutrition score based on a comparison with current recommendations for children and adolescents. We observed independent and statistically significant relationships between the nutrition score and age, sex, socio-economic status, immigration background, level of urbanisation and residence in former East v. former West Germany. Furthermore, the nutrition score was statistically significantly related to serum concentrations of homocysteine (inverse association) and folate (positive associations). The construction of a healthy nutrition score appears to be useful for several reasons. For instance, our score can be used to summarise an abundance of dietary information to a single measure, to get an overall impression of diets of individuals or groups, which can be useful to detect certain risk groups

Juvenile obesity and its association with utilisation and costs of pharmaceuticals - results from the KiGGS study

<p>Abstract</p> <p>Background</p> <p>According to a national reference, 15% of German children and adolescents are overweight (including obese) and 6.3% are obese. An earlier study analysed the impact of childhood overweight and obesity on different components of direct medical costs (physician, hospital and therapists). To complement the existing literature for Germany, this study aims to explore the association of body mass index (BMI) with utilisation of pharmaceuticals and related costs in German children and adolescents.</p> <p>Methods</p> <p>Based on data from 14, 836 respondents aged 3-17 years in the German Interview and Examination Survey for Children and Adolescents (KiGGS), drug intake and associated costs were estimated using a bottom-up approach. To investigate the association of BMI with utilisation and costs, univariate analyses and multivariate generalised mixed models were conducted.</p> <p>Results</p> <p>There was no significant difference between BMI groups regarding the probability of drug utilisation. However, the number of pharmaceuticals used was significantly higher (14%) for obese children than for normal weight children. Furthermore, there was a trend for more physician-prescribed medication in obese children and adolescents. Among children with pharmaceutical intake, estimated costs were 24% higher for obese children compared with the normal weight group.</p> <p>Conclusions</p> <p>This is the first study to estimate excess drug costs for obesity based on a representative cross-sectional sample of the child and adolescent population in Germany. The results suggest that obese children should be classified as a priority group for prevention. This study complements the existing literature and provides important information concerning the relevance of childhood obesity as a health problem.</p

Potential determinants of obesity among children and adolescents in Germany: results from the cross-sectional KiGGS study

<p>Abstract</p> <p>Background</p> <p>Obesity among children and adolescents is a growing public health problem. The aim of the present paper is to identify potential determinants of obesity and risk groups among 3- to 17-year old children and adolescents to provide a basis for effective prevention strategies.</p> <p>Methods</p> <p>Data were collected in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), a nationally representative and comprehensive data set on health behaviour and health status of German children and adolescents. Body height and weight were measured and body mass index (BMI) was classified according to IOTF cut-off points. Statistical analyses were conducted on 13,450 non-underweight children and adolescents aged 3 to 17 years. The association between overweight, obesity and several potential determinants was analysed for this group as well as for three socio-economic status (SES) groups. A multiple logistic regression model with obesity as the dependent variable was also calculated.</p> <p>Results</p> <p>The strongest association with obesity was observed for parental overweight and for low SES. Furthermore, a positive association with both overweight (including obesity) and obesity was seen for maternal smoking during pregnancy, high weight gain during pregnancy (only for mothers of normal weight), high birth weight, and high media consumption. In addition, high intakes of meat and sausages, total beverages, water and tea, total food and beverages, as well as energy-providing food and beverages were significantly associated with overweight as well as with obesity. Long sleep time was negatively associated with obesity among 3- to 10-year olds. Determinants of obesity occurred more often among children and adolescents with low SES.</p> <p>Conclusion</p> <p>Parental overweight and a low SES are major potential determinants of obesity. Families with these characteristics should be focused on in obesity prevention.</p

Maternal smoking during pregnancy and offspring overweight : is there a dose–response relationship? An individual patient data meta-analysis

We want to thank the funders of the individual studies: the UK Medical Research Council and the Wellcome Trust (Grant ref: 102215/2/13/2) and the University of Bristol, the Danish National Research Foundation, Pharmacy Foundation, the March of Dimes Birth Defects Foundation, the Augustinus Foundation, and the Health Foundation, the US NICHD (contracts no. 1-HD-4-2803 and no. 1-HD-1-3127, R01 HD HD034568), the NHMRC, the CNPq (Portuguese acronym for the National Research Council—grant 523474/96-2) and FAPESP (Portuguese acronym for the São Paulo State Research Council—grant 00/0908-7). We would like to thank the participating families of all studies for the use of data. For the ASPAC study, we want to thank the midwives for their help in recruiting families, and the whole ALSPAC team, which includes interviewers, computer and laboratory technicians, clerical workers, research scientists, volunteers, managers, receptionists, and nurses. This work was supported by the Deutschen Forschungsgesellschaft (German Research Foundation, DFG) [KR 1926/9-1, KU1443/4-1]. Dr. Gilman’s contribution was supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development.Peer reviewedPostprin