Determinants of obesity in the Ulm Research on Metabolism, Exercise and Lifestyle in Children (URMEL-ICE)

Abstract

We investigated the prevalence of overweight and obesity in German schoolchildren and analyzed determinants of overweight. In the context of a randomized intervention study, a baseline cross-sectional assessment was carried out in 2006. During a physical examination, height, weight, skin fold thickness, and upper arm and waist circumferences were measured according to a standardized protocol among 1.079 children aged 6-9 years. Overweight and obesity were classified according to the definitions of the International Obesity Task Force. Parents completed a questionnaire on potential determinants of overweight. Logistic regression models were calculated for determinants of overweight and obesity. The prevalence of overweight was 16.5% in boys and 17.3% in girls and of obesity 3.5% and 3.6%, respectively. Migration (29.4 %) was correlated with overweight and obesity. In particular, among boys with migration background, overweight (24.0%) and obesity (6.6%) were highly prevalent. Higher obesity prevalence was associated with maternal smoking during pregnancy, parental overweight, and low parental education. Indicators for physical inactivity such as watching television more than 1 h per weekday, participation in club sports less than once a week, consumption of sweetened drinks (>or=3 times per week), and skipping breakfast before school were associated with childhood obesity. Our results provide further evidence that parental factors such as migration background and education are strongly associated with body mass of the offspring. Physically inactive children with regular consumption of sweetened drinks and no breakfast were prone to be overweight or obese. Changes of these lifestyle factors as targets of interventions are promising to prevent childhood obesity.

Factors associated with overweight in children living in the neighbourhoods of an urban area of Brazil

“…Moreover, national data published by the PNDS found that, as the number of years of formal education increases, so does the exposure to overweight and obesity (3) . The association found in the present study is similar to that found in developed countries, which also show an inverse relationship between being overweight and socio-economic status (28,(42)(43)(44) . Recent data have shown that the relationship between socio-economic factors and being overweight results mainly from the access that the population has to healthier and less energy-dense foods.…”

“…Through the analysis of other physical activity variables, it was hypothesized that these variables could possibly be acting as confounding factors; that is, they may reflect more the socio-economic status of the children than their actual physical activity level. This hypothesis was based on the fact that wealthier children tend to spend more time on sedentary activities, such as watching television or playing video games/using a computer, than poorer children (28) ; therefore, the socio-economic level of the children in this sample appears to be playing a major role in their nutritional status. Based on this argument, it was decided to use only the variable type of transportation (on foot/bicycle v. car/bus/taxi) as a proxy measure of the physical activity level of children.…”

Qualitätskriterien für Maßnahmen der Gesundheitsförderung und Primärprävention von Übergewicht bei Kindern und Jugendlichen

“…Der Einfluss der Gene ist unbestritten, wie Zwillingsstudien zeigen (Stunkard et al 1990 Kleiser et al 2009, Nagel et al 2009). In der DONALD-Studie ist der Zusammenhang zwischen der Menge an süßen Getränken und einem höheren Gewicht zumindest bei Mädchen belegt .…”

“…Korrelationen zwischen keinem Frühstück am Morgen und Übergewicht bzw. Adipositas sind ebenfalls in Studien zu sehen (Nagel et al 2009). …”

“…Dabei ist der Einfluss des Rauchens der Mutter, vor allem während der Schwangerschaft, etwas stärker als der des Vaters (Robert Koch-Institut und BZgA 2008, Al Mamun et al 2006, Bergmann et al 2009, Gorog et al 2009, Kleiser et al 2009, Nagel et al 2009 Gerade in der Arbeit mit inhomogenen Zielgruppen, wie sie für Maßnahmen der Gesundheitsförderung und Primärprävention anzutreffen sind, sollten Akteure sensibel für mögliche Stigmatisierungen sein. Die Maßnahmen werden entsprechend so gestaltet, dass diese Nebenwirkungen vermieden werden können.…”