Abstract
OBJECTIVES: To identify the major risk factors of overweight and obesity in prepubertal children.
DESIGN: Cross-sectional study.
SETTING: In all, 32 primary schools in Kiel (248 000 inhabitants), northwest Germany.
SUBJECTS: A total of 2631 5–7-y-old German children and their parents.
MAIN OUTCOME MEASURES: Weight status, socio-economic status (SES), parental overweight, dietary intake, activity, inactivity and further determinants (birth weight, breast feeding, nutritional status of siblings) of the children.
RESULTS: The prevalence of overweight (≥90th BMI percentile of reference) was 9.2% in boys and 11.2% in girls, respectively. Considered univariately, family-, environment- and development-related determinants showed some relations to overweight and obesity. In multivariate analyses parental overweight, a low SES as well as a high birth weight were the strongest independent risk factors of overweight and obesity in children. Additionally, there were sex-specific risk factors: parental smoking and single households were risk factors in boys, whereas a low activity was associated with obesity in girls. Birth weight was associated with obesity, but not with overweight. The prevalence of obesity reached 29.2% in boys and 33.4% in girls with all the three main risk factors.
CONCLUSIONS: Overweight families of low SES have the highest risk of overweight and obese children. Future prevention programmes must also take into account sex-specific risk factors.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Lobstein TJ, Frelut M-L . Prevalence of overweight children in Europe. Obes Rev 2003; 4: 195–200.
Livingstone B . Epidemiology of childhood obesity in Europe. Eur J Pediatr 2000; 159 (Suppl 1): S14–S34.
Dietz WH . Early influences on body weight regulation. In: Bouchard C, Bray GA (eds) Regulation of body weight—biological and behavioral mechanisms. Wiley: Chichester; 1996. pp 149–158.
Guo SS, Roche AF, Cameron Chumlea W, Gardner JD, Siervogel RM . The predictive value of childhood body mass index values for overweight at age 35y. Am J Clin Nutr 1994; 59: 810–819.
Must A, Jacques PF, Dallal GE, Bajema CJ, Dietz WH . Long-term morbidity and mortality of overweight adolescents. N Engl J Med 1992; 327: 1350–1355.
Whitaker RC, Wright JA, Pepe MS, Seidel KD, Dietz WH . Predicting obesity in young adulthood from childhood and parenteral obesity. N Engl J Med 1997; 337: 869–873.
Parsons TJ, Power C, Logan S, Summerbell CD . Chidhood predictors of adult obesity: a systematic review. Int J Obes Relat Metab Disord 1999; 23 (Suppl 8): 1–107.
Dietz WH . Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics 1998; 101: 518–525.
Power C, Lake IU, Cole TJ . Measurement and long-term health risks of child and adolescent fatness. Int J Obes Relat Metab Disord 1997; 21: 507–526.
Berenson GS, Srinivasan SR, Bao LN, Newman WP, Tracy RE, Wattigney WA, for the Bogalusa Heart Study. Association between multiple cardiovascular risk factors and atherosklerosis in children and young adults. N Engl J Med 1998; 338: 1650–1656.
Berenson GS, Wattigney WA, Bao W, Srinivasan SR, Radhakrishuamurrthy B . Rationale to study the early natural history of heart disease: The Bogalusa Heart Study. Am J Med Sci 1995; 310 (Suppl 1): 22–28.
Mahoney LT, Burns TL, Stanford W, Thompson BH, Witt ID, Rost CA, Lauer RM . Coronary risk factors measured in childhood and young adults life are associated with coronary artery calcification in young adults: The Muscatine Study. J Am Coll Cardiol 1996; 27: 277–284.
Vanhala M, Vanhala P, Kumpusalo E, Halonon P, Tallala I . Relation between obesity from childhood to adulthood and the metabolic syndrom: population-based study. BMJ 1998; 317: 319–321.
Bar-Or O, Foreyt J, Bouchard C, Brownell KD, Dietz WH, Ravussin E, Salbe AD, Schwenger S, Jeor SSt, Torun B . Physical activity, genetic and nutritional considerations in childhood weight management. Med Sci Sports Exerc 1998; 30: 2–10.
Müller MJ, Mast M, Körtzinger I, Grund A, Langnäse K . Physical activity and diet in 5 to 7 years old children. Public Health Nutr 1999; 2: 443–444.
Gortmaker SL, Dietz WH, Cheung BWY . Inactivity, diet, and the fattening of America. J Am Diet Assoc 1990; 90: 1247–1255.
Molnar D, Livingstone B . Physical activity in relation to overweight and obesity in children and adolescents. Eur J Pediatr 2000; 159 (Suppl 1): S45–S55.
Mast M, Körtzinger I, Müller MJ . Ernährungsverhalten und Ernährungszustand von 5-7-jährigen Kindern in Kiel. Akt Ernährungsmedizin 1999; 23: 1–6.
Mueller MJ, Asbeck I, Mast M, Langnaese K, Grund A . Prevention of obesity—more than an intention. Concept and first results of the Kiel Obesity Prevention Study (KOPS). Int J Obes Relat Metab Disord 2001; 25 (Suppl 1): S66–S74.
Danielzik S . Epidemiologie von Übergewicht und Adipositas bei Kindern in Kiel: Daten der ersten Querschnittuntersuchung der Kieler Adipositas-Präventionsstudie (KOPS), Dissertationsschrift, Institut für Humanernährung und Lebensmittelkunde der Christian-Albrechts-Universität zu Kiel, Kiel, 2003.
Kromeyer-Hauschild K, Wabitsch M, Kunze D, Geller F, Geiß HC, Hesse V, von Hippel A, Jaeger U, Johnson D, Korte W, Menner K, Müller G, Müller MJ, Niemann-Pilatus A, Remer T, Schaefer F, Wittchen H-U, Zabransky S, Zellner K, Ziegler A, Hebebrand J . Perzentile für den Body-mass-Index für das Kindes- und Jugendalter unter Heranziehung verschiedener deutscher Stichproben. Monatsschrift Kinderheilkunde 2001; 149: 807–818.
Becker C . Formulierung populationsspezifischer Algorithmen zur Bestimmung der Körperfettmasse von Kindern, Jugendlichen und Erwachsenen, basierend auf Feldmethoden mit Air Displacement Plethysmography als Referenz, Dissertationsschrift, Institut für Humanernährung und Lebensmittelkunde der Christian-Albrechts-Universität zu Kiel, Kiel, 2002.
Obesity, Preventing and managing a global epidemic. Report of a WHO Consultation. WHO Technical Report Series 894, WHO, Geneva, 2000.
Kersting M, Chada C, Schöch G . Optimierte Mischkost als Präventionsernährung für Kinder und Jugendliche. Ernährungs-Umschau 1993; 4: 164–168.
Mast M, Aerne G, Stübing K, Krawinkel M, Müller MJ . Langzeiterfolge ambulanter und stationärer Rehabilitation adipöser Kinder und Jugendlicher. Prävent Rehabil 2003; 15: 24–33.
von Kries R, Toschke A, Koletzko B, Slikker W . Maternal smoking during pregnancy and childhood obesity. Am J Epidemiol 2002; 156: 954–961.
Strauss RS, Knight J . Influence of the home environment on the development of obesity in children. Pediatrics 1999; 103: e85.
Fogelholm M, Nuutinen O, Pasanen M, Myöhänen E, Säätel T . Parent–child relationship of physical activity patterns and obesity. Int J Obes Relat Metab Disord 1999; 23: 1262–1268.
Maffeis C, Talamini G, Tatò l . Influence of diet, physical activity and parents' obesity on children's adiposity: a four-year longitudinal study. Int J Obes Relat Metab Disord 1998; 22: 758–764.
Hediger ML, Overpeck MD, Kuczmarski RJ, Ruan WJ . Association between infant breastfeeding and overweight in young children. JAMA 2001; 285: 2453–2460.
Allison DB, Kaprio J, Korkeila M, Koskenvuo M, Neale MC, Hayakawa K . The heritability of body mass index among an international sample of monozygotic twins reared apart. Int J Obes Relat Metab Disord 1996; 20: 501–506.
Poston II WSC, Foreyt JP . Obesity is an environmental issue. Atherosclerosis 1999; 146: 201–209.
Hill JO, Peters JC . Environmental contributions to the obesity epidemic. Science 1998; 280: 1371–1374.
Vogler GP, Sorensen TIA, Stunkard AJ, Srinivasan MR, Rao DC . Influences of genes and shared family environment on adult body mass index assessed in an adoption study by a comprehensive path model. Int J Obes Relat Metab Disord 1995; 19: 40–45.
Müller MJ, Langnäse K, Danielzik S, Spethmann C, Mast M . Childhood obesity: the genetic–environmental interface. In: Palou A, Bonet ML, Serra F (eds) Study on ‘Obesity and functional foods in Europe’. Cost Actin 918: Brussels, Belgium; 2002. p 193.
Langnäse K, Mast M, Müller MJ . Social class differences in overweight of prepubertal children in northwest Germany. Int J Obes Relat Metab Disord 2002; 26: 566–572.
Langnäse K, Mast M, Danielzik S, Spethmann C, Müller MJ . Socioeconomic gradients in body weight of German children—reverse direction between ages 2 and 6 years. J Nutr 2003; 133: 789–796.
Langnäse K . Einfluss sozialer Faktoren auf die Manifestation und Prävention der Adipositas bei Kindern, Dissertationsschrift, Institut für Humanernährung und Lebensmittelkunde der Christian-Albrechts-Universität zu Kiel, Kiel, 2001.
Hulman S, Kushner H, Katz S, Falkner B . Can cardiovascular risk be predicted by newborn, childhood and adolescent body size? An examination of longitudinal data in urban African Americans. J Pediatr 1998; 132: 90–97.
Ong KKL, Ahmed ML, Emmett PM, Preece MA, Dunger DB, the Avon Longitudinal Study of Pregnancy and Childhood Study Team. Association between postnatal catch-up growth and obesity in childhood: prospective cohort study. BMJ 2000; 320: 967–971.
Maffeis C, Provera S, Filippi L, Sidoti G, Schena S, Pinelli L, Tat L . Distribution of food intake as a risk factor for childhood obesity. Int J Obes Relat Metab Disord 2000; 24: 75–80.
Remer T, Dimitriou T, Kersting M . Does fat intake explain fatness in children? Eur J Clin Nutr 2002; 56: 1046–1047.
Magarey AM, Daniels LA, Boulton TJC, Cockington RA . Does fat intake predict adiposity in healthy children and adolescents aged 2–15 y? A longitudinal analysis. Eur J Clin Nutr 2001; 55: 471–481.
McGloin AF, Livingstone MBE, Greene LC, Webb SE, Gibson JMA, Jebb SA, Cole TJ, Coward WA, Wright A, Prentice AM . Energy and fat intake in obese and lean children at varying risk of obesity. Int J Obes Relat Metab Disord 2002; 26: 200–207.
Dietz jr WH, Gortmaker SL . Do we fatten our children at the television set? Obesity and television viewing in children and adolescents. Pediatrics 1985; 75: 805–812.
Krassas GE, Tzotzas T, Tsametis C, Konstantinidis T . Determinants of body mass index in Greek children and adolescents. J Pediatr Endocrinol Metab 2001; 14 (Suppl 5): 1327–1333.
Epstein LH, Valoski AM, Vara LS, McCurley J, Wisniewski L, Kakarchian MA, Klein KR, Shrager LR . Effects of decreasing sedentary behavior and increasing activity on weight change in obese children. Health Psychol 1995; 14: 109–115.
Robinson TN . Reducing children's television viewing to prevent obesity. A randomized controlled trial. JAMA 1999; 282: 1561–1567.
Grund A, Krause H, Siewers M, Rieckert H, Müller MJ . Is TV viewing an index of physical activity and fitness in overweight and normal weight children? Public Health Nutr 2001; 4: 1245–1251.
Dietz WH . The obesity epidemic in young children: reduce television viewing and promote playing. BMJ 2001; 322: 313–314.
Wardle J, Guthrie C, Sanderson S, Birch L, Plomin R . Food and activity preferences in children of lean and obese parents. Int J Obes Relat Metab Disord 2001; 25: 971–977.
Danielzik S, Langnäse K, Mast M, Spethmann C, Müller MJ . Impact of parental BMI on the manifestation of overweight 5–7 year old children. Eur J Nutr 2002; 41: 132–138.
Acknowledgements
This work was supported by grants from Deutsche Forschungsgemeinschaft (DFG Mü 5-1, 5-2, 5-3), Wirtschaftliche Vereinigung Zucker, Precon, Danone Stiftung and WCRF UK.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Danielzik, S., Czerwinski-Mast, M., Langnäse, K. et al. Parental overweight, socioeconomic status and high birth weight are the major determinants of overweight and obesity in 5–7 y-old children: baseline data of the Kiel Obesity Prevention Study (KOPS). Int J Obes 28, 1494–1502 (2004). https://doi.org/10.1038/sj.ijo.0802756
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.ijo.0802756
Keywords
This article is cited by
-
Being a scientist
European Journal of Clinical Nutrition (2023)
-
Interpregnancy weight gain and childhood obesity: analysis of a UK population-based cohort
International Journal of Obesity (2022)
-
Associations of community, famliy and early individual factors with body mass index z-scores trajectories among Chinese children and adolescents
Scientific Reports (2021)
-
Exposure to parental smoking and children being overweight: residence as an effect modifier
Journal of Public Health (2021)
-
Maternal diet intervention before pregnancy primes offspring lipid metabolism in liver
Laboratory Investigation (2020)