Background: From

In recent years, a high prevalence of vitamin D deficiency among children and adolescents has been reported in countries with moderate climates. Those with an immigrant background living under these conditions are at especially high risk. To date, representative data in Germany is lacking. We analyzed 25-hydroxyvitamin D [25(OH)D] concentrations of 10,015 children and adolescents, aged 1-17 y, who participated in the German National Health Interview and Examination Survey for Children and Adolescents. The proportion of immigrants was 25.4%, corresponding well to their percentage of the population. Among 3- to 17-y-old participants, 29% of immigrant boys and 31% of immigrant girls had 25(OH)D concentrations <25 nmol/L (severe to moderate vitamin D deficiency) compared with 18% of nonimmigrant boys and 17% of nonimmigrant girls. Furthermore, 92% of immigrant boys and 94% of immigrant girls had 25(OH)D concentrations <75 nmol/L (levels above 75 nmol/L are defined as optimal regarding various health outcomes) compared with 87% of nonimmigrants. Boys with a Turkish or Arab-Islamic background had an increased risk of having 25(OH)D concentrations <25 nmol/L compared with nonimmigrants (odds ratio [OR] 2.3; [95% CI] 1.4-3.8 and OR 7.6; [95% CI] 3.0-19.1). The same was true for girls with a Turkish (OR 5.2; [95% CI] 2.9-9.6), Arab-Islamic (OR 5.9; [95% CI] 2.5-14.0), Asian (OR 6.7; [95% CI] 2.2-19.8), or African (OR 7.8; [95% CI] 1.5-40.8) background. Supplementation of vitamin D beyond infancy, especially in high-risk groups, or fortification of food should be considered.

Data on the health status of migrants are still scarce. One of the reasons for this is that migration status has not been well recorded in official statistics and epidemiological studies. In order to obtain an adequate and standardised operationalisation of migrant status, we first need an exact definition of the terms "migrant" and "migration background". We discuss approaches to the definition of terms and the surveying of ethnic minorities and migrants, and then develop a basic set of migration status indicators for use in epidemiological research. This set of indicators includes country of birth of the father and mother, year of immigration, mother tongue, German language skills and status of residence. The key indicator for the identification of migrants is the country of birth of the parents and not the nationality as was previously often the case. Thus, the classification based on the judicial category of nationality is replaced by a classification based on the biographical event "migration". Migration brings with it specific life conditions and challenges that can impact health across several generations. An instrument for surveying migrant status must be further developed both to reflect the special conditions of the life situation resulting from the migration experience and to take as full account as possible of all aspects of a migrant's history.

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Migrant status, including ethnic minority status, is an important determinant of health inequalities. Previous studies point to a complex, multifactorial relationship between migration and health, however current explanatory approaches focus mostly on the effects of single determinants. In this article, an explanatory and analytical model of migration and health will be developed in an effort to structure and integrate previous approaches by drawing upon existing definitions of the target population and theories of the relationship between migration and health status.

Objective: More than 30 years ago Frisch and Revelle proposed a body weight threshold for the onset of menarche. Based on this hypothesis, a further acceleration of age at menarche can be expected in times of childhood obesity. Design: A cross-sectional study of 1840 healthy school girls (Berlin school children's cohort, BSCOC) within the age groups 10-15 years was conducted in 2006-2007. Methods: Median age of menarche was calculated by Kaplan-Meier survival analysis. Bi-and multivariate analyses were performed to analyze the associations between menarche age and weight status. A locally weighted regression was used to analyze the relationship respectively between height, weight, and body mass index (BMI)-SDS and age stratified by menarche status. Results: Nine hundred and thirty six (50.9%) girls had already experienced menarche at a median age of 12.8 years. Two hundred and thirty six of these girls reached their menarche recently. Obese/overweight girls reached menarche significantly earlier (12.5 years), than normal weight (12.9 years), and underweight girls (13.7 years). The mean total body weight was similar in all girls at menarche irrespective of age (mean 51.1 kg, S.D. 8.1) and height. BMI-SDS remained the only significant factor for onset of menarche within a multiple regression model for early menarche (OR 2.1, 95% confidence interval 1.3-3.3, PZ0.002). Conclusions: Age at onset of menarche did not accelerate even in a childhood population with more than 10% obesity prevalence. Nevertheless, a negative correlation of BMI-SDS with age at onset of menarche exists.

The aspects emerging as relevant to residents' subjective quality of life extend far beyond care- and health-related aspects. Nevertheless, some of the quality of life dimensions reconstructed are within the direct influence of the home (e.g., variety of stimuli and activities or being kept informed) and can possibly be improved by attending to the residents' objective situation.

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