Prevention of obesity—more than an intention. Concept and first results of the Kiel Obesity Prevention Study (KOPS)

Abstract

OBJECTIVE:Obesity prevention is necessary to address the steady rise in the prevalence of obesity. Although all experts agree that obesity prevention has high priority there is almost no research in this area. The effectiveness of different intervention strategies is not well documented. There is also no structured framework for obesity prevention. DESIGN: Based on (i) our current and limited knowledge and (ii) the idea that prevention of childhood obesity is an effective treatment of adult obesity, the Kiel Obesity Prevention Study (KOPS) was started in 1996. Concept, intervention strategies and first results of KOPS are reported in this paper. KOPS is an ongoing 8 y follow-up study. We first enrolled a large scale cohort of 5 to 7-y-old children, providing sufficient baseline data. KOPS allows further analyses of the role of individual risk factors as well as of long-term effectiveness of different intervention strategies. RESULTS: From 1996 to 1999 a representative group of 2440 5 to 7-y-old children was recruited (ie 30.2% of the total population of 5 to 7-y-old children examined by the school physicians) and a full data set was obtained from 1640 children. Of the children, 340 (20.7%) were considered as overweight and obese, 1108 children (67.6%) were normal weight, and underweight was found in 192 children (11.7%). Of the normal-weight children, 31% or 346 (21.1% of the total population) were considered to have a risk of becoming obese. Cross-sectional data provided evidence that (i) there is an inverse social gradient in childhood overweight as well as health-related behaviours and (ii) parental fatness had a strong influence on childhood overweight. We observed considerable changes in health-related behaviours within 1 y after combined 'school-' and 'family-based' interventions. Interventions aimed to improve health-related behaviours had significant effects on the agedependent increases in median triceps skinfolds of the whole group (from 10.9 to 11.3 mm in 'intervention schools' vs from 10.7 to 13.0 mm in 'control schools', P < 0.01) as well as in percentage fat mass of overweight children (increase by 3.6 vs 0.4% per year without and with intervention, respectively; P < 0.05). CONCLUSION: First results of KOPS are promising. Besides health promotion, a better school education and social support seem to be promising strategies for future interventions.

Children with a TV in their bedroom at higher risk for being overweight

“…However, despite creative efforts and the investment of substantial resources, there has been very limited success preventing obesity through interventions targeting individual behaviors. 39,40 In this study, frequency of child internet use was not significantly associated with overweight status. This finding supports the notion that the association between TV viewing and child overweight is not simply due to the amount of time children spend in front of a screen.…”

Interventions to prevent obesity in children and adolescents: a systematic literature review

“…Although the study was mentioned, it was not included in the table since the quality had been rated as low. 10 This study has now been included. Results from the study by Luepker,11 referred to previously, were followed up further, 5-6 years in total.…”

Prevention of overweight in preschool children: results of kindergarten-based interventions

“…Few randomized controlled studies aiming at reducing overweight have been carried out with children o7 years of age. [13][14][15][16][17][18][19][20][21] In recent years, preschool age has been identified as a critical period for targeting interventions against obesity prevention. 22 Our goal was to evaluate interventions with young children that could be incorporated into existing schools, community and health-care programs, with physicians and community involvement, to optimize effectiveness and resources.…”