Determinants of the prevalence and incidence of overweight in children and adolescents

Abstract

Objective: To systematically analyse determinants of overweight prevalence and incidence in children and adolescents, as a basis of treatment and prevention. Design: Cross-sectional and longitudinal data of the Kiel Obesity Prevention Study (KOPS). Setting: Schools in Kiel, Germany. Subjects: Cross-sectional data from 6249 students aged 5-16 years and 4-year longitudinal data from 1087 children aged 5-11 years. Weight status of students was assessed and familial factors (weight status of parents and siblings, smoking habits), social factors (socio-economic status, nationality, single parenting), birth weight as well as lifestyle variables (physical activity, media time, nutrition) were considered as independent variables in multivariate logistic regression analyses to predict the likelihood of the student being overweight. Results: The cross-sectional data revealed the prevalence of overweight as 18?3 % in boys and 19?2 % in girls. In both sexes determinants of overweight prevalence were overweight and obese parents, overweight siblings, parental smoking, single parenthood and non-German nationality. High birth weight and low physical activity additionally increased the risk in boys. High media time and low parental education were significant determinants in girls. Effect of media time was mediated by maternal weight status in boys as well as by socio-economic status and age in girls. From the longitudinal data, the 4-year cumulative incidence of overweight was 10?0 % in boys and 8?2 % in girls. Parental obesity, parental smoking and low physical activity were determinants of overweight incidence in boys, whereas paternal obesity increased the risk in girls.Conclusions: Treatment and prevention should address family and social determinants with a focus on physical activity and media use.Childhood obesity is a major public health challenge. At present there is a lack of convincing evidence about suitable and effective strategies for the prevention of childhood overweight. Recently, an obesity prevention evidence framework has been proposed (1) . Key policies include: (i) building a case for action on obesity; (ii) identifying contributing factors and points of intervention; (iii) defining opportunities for action; (iv) evaluating potential interventions; and (v) selecting a portfolio of specific policies, programmes and actions. Therefore, a systematic analysis of determinants of overweight in the micro-as well as the macro-environment is necessary to provide a sound basis for developing strategies against overweight. The systematic analysis should include an analysis of the determinants of overweight prevalence as well as overweight incidence, separately. Childhood overweight (and not only obesity) is predictive for adult morbidity and mortality (2) . In addition, the life-long persistence and health consequences of overweight and obesity in many children suggest a strong need for the prevention of overweight (2) . Primary prevention strategies address the whole population, in particular normalweight sub...

Ingesta de energía y nutrientes en niños de 2-4 años que asisten al programa "Buen Comienzo", Medellín (Colombia)

“…La ingesta alta de energía en los niños es un aspecto preocupante; estudios realizados en niños alemanes han mostrado que la ganancia de peso se debe a un pequeño, pero positivo, balance de energía que se realiza constantemente (35), y que, para prevenir el sobrepeso en los niños, la brecha de energía no debe exceder de 46 a 72 kcal al día (36). En nuestro estudio, los niños obesos y eutróficos consumieron en promedio 175 y 340 kcal más de lo que requieren respectivamente, lo cual lleva a pensar que si los niños continúan con esta ingesta se promueve una ganancia de peso que supera lo deseado y además se ha evidenciado que la ganancia de peso después de los 2 años ejerce efectos predominantemente perjudiciales para la salud en términos de factores de riesgo a largo plazo (37).…”

Längsschnittdaten der Kieler Adipositas-Präventionsstudie (KOPS)

“…In Querschnittuntersuchungen wurden Adipositas der Eltern, ein niedriger sozialer Status, eine hohe Gewichtszunahme in früher Kindheit, eine geringe körperli-che Aktivität und ein hoher Medienkonsum als Hauptdeterminanten von Über-gewicht im Kindesalter identifiziert [6,7,8,9,10,11]. Eine Reduktion der Medienzeit versprach den größten Effekt auf das Übergewicht [12,13].…”

“…In diesem letzten Alterssegment stieg die Persistenz von Überge-wicht wieder leicht an, während sich die Inzidenz weiter verminderte. Um zu überprüfen, ob sich die betrachteten Faktoren gegenseitig beeinflussen, wurden Interaktionsterme zwischen Lebensstilfaktoren und dem Ernährungs-status der Eltern sowie dem sozialen Status zusätzlich in das Modell aufgenommen [7]. Diese zeigten jedoch keine Signifikanz.…”

“…Allerdings ist es schwierig, geringe Unterschiede oder Veränderungen in der Ernährung mit Ernährungserhebungsmethoden zu erfassen. Aufgrund dieser Tatsache lässt sich eventuell erklären, warum in epidemiologischen Untersuchungen ein Einfluss der Ernährung in Quer-und Längs-schnittuntersuchungen nicht beziehungsweise nur sehr schwer nachgewiesen werden konnte [7,9,12].…”

Some determinants of nourishment rates of boys and girls enrolling primary schools and in adolescence (7, 14 and 17 years of age), the 1996 generation born in Zajecar

“…Faktori koji utiču na indeks telesne mase (ITM) dece i mladih su stanje uhranjenosti, fizička aktivnost, sedanterni stil života i pojedine determinante kao što su gojaznost roditelja, njihova dob, obrazovanje, zanimanje, broj članova porodice, dužina dojenja, telesna masa na roĎenju, stil života. [2,3]. Poznavanje pojedinih determinanti koristi pri usmeravanju preventivnih programa za sprečavanje nastanka gojaznosti meĎu decom i mladima.…”