Study on Health of Older People in Germany (‘Gesundheit 65+’): Objectives, design and implementation

Background: The longitudinal population-based study Gesundheit 65+ aimed to close data gaps on health and well-being of older adults in Germany in times of the COVID-19 pandemic. Methods: The target population comprised persons 65 years and older permanently residing in Germany and with sufficient German language skills. Proxy interviews were possible and consent from legal representatives was obtained as necessary in order to enable participation of physically or cognitively impaired persons. A two-stage sampling process, was used to draw 128 primary sample points (PSUs) and within these PSUs sex- and age-stratified random samples were drawn from population registries. A mixed-mode design was applied to contact the study population and for data collection. Data were collected between June 2021 and April 2023. Participants were surveyed a total of four times at intervals of four months. At month 12 participants were offered a home visit including a non-invasive examination. Data on all-cause mortality and information on neighborhood social and built environment as well as health insurance data will be linked to primarily collected data at the individual level. Discussion: Results will inform health politicians and other stakeholders in the care system on health and health care needs of older people in Germany

Studie zur Gesundheit älterer Menschen in Deutschland (Gesundheit 65+): Zielsetzung, Konzeption und Durchführung

Hintergrund: Die bevölkerungsbezogene Längsschnittstudie Gesundheit 65+ hatte zum Ziel, Datenlücken zu Gesundheit und Wohlbefinden älterer Menschen in Deutschland während der COVID-19-Pandemie zu schließen. Methode: Die Grundgesamtheit umfasste Personen ab 65 Jahren mit ständigem Wohnsitz in Deutschland und ausreichenden Deutschkenntnissen. Um die Teilnahme körperlich/kognitiv eingeschränkter Personen zu ermöglichen, waren u. a. Befragung einer Stellvertreterin/eines Stellvertreters oder Einwilligung durch eine gesetzliche Vertretung erlaubt. Mithilfe eines zweistufigen Stichprobenverfahrens wurden 128 primäre Stichprobeneinheiten und innerhalb dieser geschlechts- und altersgeschichtete Einwohnermeldeamtsstichproben per Zufall gezogen. Die Kontaktierung und Datenerhebung erfolgten nach einem Mixed-Mode-Design. Die Datenerhebung fand zwischen Juni 2021 und April 2023 statt. Dabei wurden die Teilnehmenden im Abstand von jeweils vier Monaten insgesamt vier Mal befragt. Zwölf Monate nach der Basisbefragung erfolgte eine Untersuchung im Hausbesuch. Die Erhebungsdaten sind mit externen Daten zur Gesamtmortalität, Informationen über soziale und bauliche Merkmale des Wohnumfeldes und ambulanten Abrechnungsdaten der gesetzlichen Krankenversicherung verknüpfbar. Schlussfolgerung: Die Studienergebnisse dienen der Gesundheitspolitikberatung und Information anderer Akteurinnen und Akteure im Versorgungssystem über die Gesundheit und den Versorgungsbedarf älterer Menschen in Deutschland

SARS-CoV-2 Transmissibility Within Day Care Centers—Study Protocol of a Prospective Analysis of Outbreaks in Germany

Introduction: Until today, the role of children in the transmission dynamics of SARS-CoV-2 and the development of the COVID-19 pandemic seems to be dynamic and is not finally resolved. The primary aim of this study is to investigate the transmission dynamics of SARS-CoV-2 in child day care centers and connected households as well as transmission-related indicators and clinical symptoms among children and adults. Methods and Analysis: COALA (“Corona outbreak-related examinations in day care centers”) is a day care center- and household-based study with a case-ascertained study design. Based on day care centers with at least one reported case of SARS-CoV-2, we include one- to six-year-old children and staff of the affected group in the day care center as well as their respective households. We visit each child's and adult's household. During the home visit we take from each household member a combined mouth and nose swab as well as a saliva sample for analysis of SARS-CoV-2-RNA by real-time reverse transcription polymerase chain reaction (real-time RT-PCR) and a capillary blood sample for a retrospective assessment of an earlier SARS-CoV-2 infection. Furthermore, information on health status, socio-demographics and COVID-19 protective measures are collected via a short telephone interview in the subsequent days. In the following 12 days, household members (or parents for their children) self-collect the same respiratory samples as described above every 3 days and a stool sample for children once. COVID-19 symptoms are documented daily in a symptom diary. Approximately 35 days after testing the index case, every participant who tested positive for SARS-CoV-2 during the study is re-visited at home for another capillary blood sample and a standardized interview. The analysis includes secondary attack rates, by age of primary case, both in the day care center and in households, as well as viral shedding dynamics, including the beginning of shedding relative to symptom onset and viral clearance. Discussion: The results contribute to a better understanding of the epidemiological and virological transmission-related indicators of SARS-CoV-2 among young children, as compared to adults and the interplay between day care and households.Peer Reviewe

Use of vitamin and mineral supplements among adolescents living in Germany—Results from EsKiMo II

Dietary supplements may contribute to nutrient intake; however, actual data on dietary supplement use among adolescents living in Germany are rare. The aim of this analysis was to describe the current use of dietary supplements, its determinants, and reasons of use. Changes in supplement use over time were evaluated by comparing the results with those from EsKiMo I (2006). Data from the Eating Study as a KiGGS Module EsKiMo II (2015–2017) were used to analyze supplement intake according to sociodemographic, health characteristics, and physical exercise behavior of 12–17-year-olds (n = 1356). Supplement use during the past four weeks was assessed by a standardized computer assisted personal interview. Multivariable logistic regression was used to identify the association between supplement use and its determinants. Between 2015–2017, 16.4% (95%-CI: 13.0–19.7%) of the adolescents used dietary supplements, and its use decreased with lower levels of physical exercise and overweight. Most supplement users used only one supplement, often containing both vitamins and minerals. The most frequently supplemented nutrients were vitamin C and magnesium. The main reported reason to use supplements was ‘to improve health’. Prevalence of supplement use was slightly lower in 2015-2017 than in 2006 (18.5%; 95%-CI: 15.8–21.2%). The results underline the importance of including nutrient intake through dietary supplements in nutrition surveys

EsKiMo II – the Eating study as a KiGGS Module in KiGGS Wave 2

Nutrition plays an important role for health, in particular of children and adolescents. In addition to the baseline German Health Interview and Examination Survey for Children and Adolescents (KiGGS, 2003-2006), the nutrition survey EsKiMo (Eating study as a KiGGS Module) assessed the dietary habits of children and adolescents aged 6 to 17 in detail. In KiGGS Wave 2 (2014-2017) the corresponding module is EsKiMo II. Between June 2015 and September 2017, specially trained nutritionists will visit EsKiMo II participants at their homes. The parents of 6-to 11-year-olds are instructed on how to complete food records on four randomly chosen days - three consecutive days, followed later by an additional day. Participants aged 12 to 17 are interviewed personally on their food intake during the past four weeks with the dietary interview programme DISHES. Further information, for example, regarding dietary supplements is also recorded. EsKiMo II will provide an up-to-date and representative overview of the current nutrition status of 6-to 17-year-olds living in Germany, and it allows analysing changes in dietary behaviour over time. EsKiMo II can identify shortcomings in the nutrition of children and adolescents and thus may contribute with important information to nutrition and health policy

EsKiMo II - Die Ernährungsstudie als KiGGS-Modul

Eine ausgewogene und bedarfsgerechte Ernährung ist in jeder Lebensphase wichtig, nimmt jedoch in der Kindheit und Jugend eine besondere Rolle ein. Das Lebensmittelangebot, die Umstände wo, wann, wie und mit wem gegessen wird und weitere Aspekte des Ernährungs-umfeldes verändern sich in unserer Gesellschaft ständig. Deshalb wurde etwa zehn Jahre nach EsKiMo I ein zweites Mal die „Ernährungsstudie als KiGGS-Modul“ EsKiMo II (2015-2017) durchgeführt, an der insgesamt 2.644 Kinder und Jugendliche im Alter von 6 bis 17 Jahren teilnahmen. Diese Studie liefert eine aktuelle Bestandsaufnahme der Ernährung von Kindern und Jugendlichen in Deutschland. Erste umfassende Auswertungen werden in diesem Bericht dargestellt. Die meisten Heranwachsenden essen zu wenig Obst, Gemüse und pflanzliche Lebensmittel mit einem hohen Gehalt an komplexen Kohlenhydraten, wie Vollkornbrot und Kartoffeln. Der Konsum von Fleisch, Wurstwaren und von den sogenannten geduldeten Lebensmitteln, wozu Süßigkeiten, Limonaden und Knabbereien zählen, ist deutlich zu hoch. Diese Situation hat sich gegenüber der ersten EsKiMo-Studie nicht wesentlich geändert. Positiv sind jedoch der Rückgang des Konsums von zuckergesüßten Getränken und die Zunahme des Wasserkonsums zu bewerten

Use of vitamin and mineral supplements among adolescents living in Germany—Results from EsKiMo II

Dietary supplements may contribute to nutrient intake; however, actual data on dietary supplement use among adolescents living in Germany are rare. The aim of this analysis was to describe the current use of dietary supplements, its determinants, and reasons of use. Changes in supplement use over time were evaluated by comparing the results with those from EsKiMo I (2006). Data from the Eating Study as a KiGGS Module EsKiMo II (2015−2017) were used to analyze supplement intake according to sociodemographic, health characteristics, and physical exercise behavior of 12−17-year-olds (n = 1356). Supplement use during the past four weeks was assessed by a standardized computer assisted personal interview. Multivariable logistic regression was used to identify the association between supplement use and its determinants. Between 2015−2017, 16.4% (95%-CI: 13.0−19.7%) of the adolescents used dietary supplements, and its use decreased with lower levels of physical exercise and overweight. Most supplement users used only one supplement, often containing both vitamins and minerals. The most frequently supplemented nutrients were vitamin C and magnesium. The main reported reason to use supplements was ‘to improve health’. Prevalence of supplement use was slightly lower in 2015-2017 than in 2006 (18.5%; 95%-CI: 15.8−21.2%). The results underline the importance of including nutrient intake through dietary supplements in nutrition surveys

EsKiMo II – die Ernährungsstudie als Modul in KiGGS Welle 2

Die Ernährung spielt eine bedeutende Rolle für die Gesundheit, insbesondere für Kinder und Jugendliche. In der Ernährungsstudie EsKiMo (Ernährungsstudie als KiGGS-Modul) wurde im Jahr 2006, in Ergänzung zu der Basiserhebung der Studie zur Gesundheit von Kindern und Jugendlichen in Deutschland (KiGGS, 2003 – 2006), das Ernährungsverhalten von Kindern und Jugendlichen im Alter von 6 bis 17 Jahren detailliert erhoben. Das gleiche Ziel verfolgt EsKiMo II innerhalb von KiGGS Welle 2 (2014 – 2017). Hierzu führen geschulte Ernährungswissenschaftlerinnen von Juni 2015 bis September 2017 Hausbesuche durch. Den Eltern von 6- bis 11-Jährigen wird erklärt, wie Ernährungsprotokolle an vier zufällig ausgewählten Tagen – drei aufeinanderfolgenden Tagen und einem weiteren Tag – durchgeführt werden. Die 12- bis 17-Jährigen werden mit dem Ernährungsinterviewprogramm DISHES persönlich zu ihrer Ernährung der letzten vier Wochen befragt. Darüber hinaus werden weitere Informationen, beispielsweise zum Konsum von Nahrungsergänzungsmitteln, erhoben. EsKiMo II liefert eine aktuelle und repräsentative Bestandsaufnahme der Ernährungssituation von 6- bis 17-Jährigen in Deutschland und ermöglicht zudem die Analyse zeitlicher Veränderungen im Ernährungsverhalten. EsKiMo II kann Defizite in der Ernährung von Kindern und Jugendlichen aufzeigen und liefert damit wichtige Informationen zum Handlungsbedarf für die Ernährungs- und Gesundheitspolitik