Further stabilization and even decrease in the prevalence rates of overweight and obesity in German children and adolescents from 2005 to 2015: a cross-sectional and trend analysis

Annette Keß, Ulrike Spielau, Christoph Beger, Ruth Gausche, Mandy Vogel, Tobias Lipek, Antje Körner, Roland Pfäffle, Wieland Kiess, Annette Keß, Ulrike Spielau, Christoph Beger, Ruth Gausche, Mandy Vogel, Tobias Lipek, Antje Körner, Roland Pfäffle, Wieland Kiess

Abstract

Objective: Recently several industrialized countries reported a stabilization or even a decrease in childhood overweight and obesity prevalence rates. In Germany, this trend started in 2004. The present study therefore aimed to evaluate whether this trend has continued or even leads in a clear direction. Design/Setting/Subjects BMI (>90th percentile (overweight), >97th percentile (obesity)) from the CrescNet database was analysed in 326 834 children and adolescents according to three age groups (4-7·99, 8-11·99 and 12-16 years), gender and between time points (2005-2015).

Results: Trend analysis from 2005 to 2010 demonstrated that the prevalence of overweight and obesity decreased significantly in boys and girls in the entire group (4-16 years) and in 4-7·99-year-olds. From 2010 to 2015 there was a significant decrease in boys for overweight and obesity in the entire group and for overweight among 8-11·99-year-olds. Within the cross-sectional analysis, prevalence rates for overweight decreased significantly for both genders in the age groups of 4-7·99 and 8-11·99 years (2005 v. 2015). For obesity, prevalence rates showed a significant decrease for boys (2005 v. 2015) and girls (2005 v. 2010) in 4-7·99-year-olds.

Conclusions: We observed a further stabilization of overweight and obesity prevalence rates for all age groups and even a decrease in the rates for the younger ages (4-7·99 years, 8-11·99 years). As other industrialized countries have also reported similar trends, it seems that the epidemic of childhood overweight and obesity is reaching a turning point in the industrial part of the world.

Keywords: Adolescents; Childhood obesity; Prevalence; Stabilizing trend; Trend analysis.

Figures

Fig. 1
Fig. 1
Further stabilization of the prevalence rates and even a decrease of the prevalence of overweight and obesity for the younger age groups of German children and adolescents from 2005 to 2015. Trends of overweight (■, upper line) and obesity (♦, lower line) prevalence rates, with their 95% CI represented by vertical bars, between 2005 and 2015 for: the entire age group (4–16-year-old children) separately for boys (a) and girls (b); the age group of 4–7·99 years separately for boys (c) and girls (d); the age group of 8–11·99 years separately for boys (e) and girls (f); and the age group of 12–16 years separately for boys (g) and girls (h). The thin jagged lines show the calculations of the prevalence rates for every single day of the period based on raw values taken from the CrescNet database and straightened with a running mean with a 5 % window. The broad, black and smooth lines show a weighted smooth spline with six degrees of freedom. Slope is given for each age group, both genders, and every overweight or obesity group. Each slope, which is marked with black line, included and compared data of five years (2005–2010 and 2010–2015). Differences in prevalence: *P<0·05, **P<0·001

References

    1. Meigen C, Keller A, Gausche R et al.. (2008) Secular trends in body mass index in German children and adolescents: a cross-sectional data analysis via CrescNet between 1999 and 2006. Metabolism 57, 934–939.
    1. Kêkê L, Samouda H, Jacobs J et al.. (2015) Body mass index and childhood obesity classification systems: a comparison of the French, International Obesity Task Force (IOTF) and World Health Organization (WHO) references. Rev Epidemiol Sante Publique 63, 173–182.
    1. Wijnhoven T, van Raaij J, Joop M A et al.. (2014) WHO European Childhood Obesity Surveillance Initiative: school nutrition environment and body mass index in primary schools. Int J Environ Res Public Health 11, 11261–11285.
    1. World Health Organization (2016) Report of the Commission on Ending Childhood Obesity. Geneva: WHO.
    1. de Onis M, Blossner M & Borghi E (2010) Global prevalence and trends of overweight and obesity among preschool children. Am J Clin Nutr 92, 1257–1264.
    1. Lange M, Butschalowsky H, Jentsch F et al.. (2014) Die erste KiGGS-Folgebefragung (KiGGS Welle 1): Studiendurchführung, Stichprobendesign und Response. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 57, 747–761.
    1. Kurth B-M & Schaffrath Rosario A (2007) Die Verbreitung von Ubergewicht und Adipositas bei Kindern und Jugendlichen in Deutschland. Ergebnisse des bundesweiten Kinder- und Jugendgesundheitssurveys (KiGGS). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 50, 736–743.
    1. Körner A, Kratzsch J, Gausche R et al.. (2007) New predictors of the metabolic syndrome in children role of adipocytokines. Pediatr Res 61, 640–645.
    1. Cote A, Phillips A, Harris K et al.. (2015) Obesity and arterial stiffness in children: systematic review and meta-analysis. Arterioscler Thromb Vasc Biol 35, 1038–1044.
    1. Wabitsch M (2004) Kinder und Jugendliche mit Adipositas in Deutschland. Aufruf zum Handeln. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 47, 251–255.
    1. Wabitsch M, Hauner H, Hertrampf M et al.. (2004) Type II diabetes mellitus and impaired glucose regulation in Caucasian children and adolescents with obesity living in Germany. Int J Obes Relat Metab Disord 28, 307–313.
    1. Wiegand S, Maikowski U, Blankenstein O et al.. (2004) Type 2 diabetes and impaired glucose tolerance in European children and adolescents with obesity – a problem that is no longer restricted to minority groups. Eur J Endocrinol 151, 199–206.
    1. Wabitsch M, Kunze D, Keller E et al.. (2002) Adipositas bei Kindern und Jugendlichen in Deutschland. Deutliche und anhaltende Zunahme der Pravalenz–Aufruf zum Handeln. Fortschr Med Originalien 120, 99–106.
    1. Swinburn B, Egger G & Raza F (1999) Dissecting obesogenic environments: the development and application of a framework for identifying and prioritizing environmental interventions for obesity. Prev Med 29, 563–570.
    1. Wijnhoven T, van Raaij J, Yngve A et al.. (2015) WHO European Childhood Obesity Surveillance Initiative: health-risk behaviours on nutrition and physical activity in 6–9-year-old schoolchildren. Public Health Nutr 18, 3108–3124.
    1. Wabitsch M, Moss A & Kromeyer-Hauschild K (2014) Unexpected plateauing of childhood obesity rates in developed countries. BMC Med 12, 17.
    1. Stunkard A, Foch T & Hrubec Z (1986) A twin study of human obesity. JAMA 256, 51–54.
    1. Lange D, Plachta-Danielzik S, Landsberg B et al.. (2010) Soziale Ungleichheit, Migrationshintergrund, Lebenswelten und Übergewicht bei Kindern und Jugendlichen. Ergebnisse der Kieler Adipositas-Präventionsstudie (KOPS). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 53, 707–715.
    1. Lobstein T, Baur L & Uauy R (2004) Obesity in children and young people: a crisis in public health. Obes Rev 5, Suppl. 1, 4–104.
    1. Blüher S, Meigen C, Gausche R et al.. (2011) Age-specific stabilization in obesity prevalence in German children: a cross-sectional study from 1999 to 2008. Int J Pediatr Obes 6, 199–206.
    1. van Jaarsveld CH & Gulliford MC (2015) Childhood obesity trends from primary care electronic health records in England between 1994 and 2013: population-based cohort study. Arch Dis Child 100, 214–219.
    1. Ogden C, Carroll M, Lawman H et al.. (2016) Trends in obesity prevalence among children and adolescents in the United States, 1988–1994 through 2013–2014. JAMA 315, 2292–2299.
    1. Hoepffner W, Pfaffle R, Gausche R et al.. (2011) Early detection of growth disorders with the CrescNet system at the Leipzig treatment center. Dtsch Arztebl Int 108, 123–128.
    1. Cole T (1990) The LMS method for constructing normalized growth standards. Eur J Clin Nutr 44, 45–60.
    1. Kromeyer-Hauschild K, Wabitsch M, Kunze D et al.. (2001) Percentiles of body mass index in children and adolescents evaluated from different regional German cohorts. Monatsschr Kinderheilkd 149, 807–818.
    1. Wabitsch M & Kunze D (2001) Adipositas im Kindes- und Jugendalter. Monatsschr Kinderheilkd 149, 805–806.
    1. Brettschneider A-K, Schaffrath Rosario A, Kuhnert R et al.. (2015) Updated prevalence rates of overweight and obesity in 11- to 17-year-old adolescents in Germany. Results from the telephone-based KiGGS Wave 1 after correction for bias in self-reports. BMC Public Health 15, 1101.
    1. Brettschneider A-K, Schienkiewitz A, Schmidt S et al.. (2017) Updated prevalence rates of overweight and obesity in 4- to 10-year-old children in Germany. Results from the telephone-based KiGGS Wave 1 after correction for bias in parental reports. Eur J Pediatr 176, 547–551.
    1. Moss A, Klenk J, Simon K et al.. (2012) Declining prevalence rates for overweight and obesity in German children starting school. Eur J Pediatr 171, 289–299.
    1. Moss A, Wabitsch M, Kromeyer-Hauschild K et al.. (2007) Pravalenz von Ubergewicht und Adipositas bei deutschen Einschulkindern. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 50, 1424–1431.
    1. Koebnick C, Mohan Y, Li X et al.. (2015) Secular trends of overweight and obesity in young Southern Californians 2008–2013. J Pediatr 167, 1264–1271.
    1. Bancej C, Jayabalasingham B, Wall R et al.. (2015) Evidence Brief – Trends and projections of obesity among Canadians. Health Promot Chronic Dis Prev Can 35, 109–112.
    1. Olaya B, Moneta M, Pez O et al.. (2015) Country-level and individual correlates of overweight and obesity among primary school children: a cross-sectional study in seven European countries. BMC Public Health 15, 475.
    1. Castetbon K (2015) Recent prevalence of child and adolescent overweight and obesity in France and abroad. Arch Pediatr 22, 111–115.
    1. Wheaton N, Millar L, Allender S et al.. (2015) The stability of weight status through the early to middle childhood years in Australia: a longitudinal study. BMJ Open 5, e006963.
    1. Schaller K (2015) Den Tsunami der chronischen Krankheiten stoppen: Vier Maßnahmen für eine wirkungsvolle und bevölkerungsweite Prävention. Strategiepapier der Deutschen Allianz Nichtübertragbare Krankheiten (DANK) zur Primärprävention (accessed May 2017).
    1. Bundesministerium für Ernährung und Landwirtschaft, Bundesministerium für Gesundheit (2008) IN FORM – Broschüre “Nationaler Aktionsplan zur Prävention von Fehlernährung, Bewegungsmangel, Übergewicht und damit zusammenhängende Krankheiten”. (accessed May 2017).
    1. Bundesministerium für Ernährung und Landwirtschaft, Bundesministerium für Gesundheit (2009) Aufgaben und Ziele der Vernetzungsstellen Schulverpflegung (VNS). (accessed August 2017).
    1. Kit B, Fakhouri T, Park S et al.. (2013) Trends in sugar-sweetened beverage consumption among youth and adults in the United States: 1999–2010. Am J Clin Nutr 98, 180–188.
    1. de Sa J & Lock K (2008) Will European agricultural policy for school fruit and vegetables improve public health? A review of school fruit and vegetable programmes. Eur J Public Health 18, 558–568.
    1. Farpour-Lambert N, Baker J, Hassapidou M et al.. (2015) Childhood obesity is a chronic disease demanding specific health care – a position statement from the Childhood Obesity Task Force (COTF) of the European Association for the Study of Obesity (EASO). Obes Facts 8, 342–349.
    1. Stamatakis E, Wardle J & Cole T (2010) Childhood obesity and overweight prevalence trends in England: evidence for growing socioeconomic disparities. Int J Obes (Lond) 34, 41–47.
    1. Sundblom E, Petzold M, Rasmussen F et al.. (2008) Childhood overweight and obesity prevalences levelling off in Stockholm but socioeconomic differences persist. Int J Obes (Lond) 32, 1525–1530.
    1. Kautiainen S, Koivisto A-M, Koivusilta L et al.. (2009) Sociodemographic factors and a secular trend of adolescent overweight in Finland. Int J Pediatr Obes 4, 360–370.

Source: PubMed

Sponsoren und Mitarbeiter

Krankheiten

Drogeninterventionen

3
Abonnieren