Potential determinants of obesity among children and adolescents in Germany: results from the cross-sectional KiGGS Study

Abstract

Background: Obesity among children and adolescents is a growing public health problem. The aim of the present paper is to identify potential determinants of obesity and risk groups among 3- to 17-year old children and adolescents to provide a basis for effective prevention strategies.

Methods: Data were collected in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), a nationally representative and comprehensive data set on health behaviour and health status of German children and adolescents. Body height and weight were measured and body mass index (BMI) was classified according to IOTF cut-off points. Statistical analyses were conducted on 13,450 non-underweight children and adolescents aged 3 to 17 years. The association between overweight, obesity and several potential determinants was analysed for this group as well as for three socio-economic status (SES) groups. A multiple logistic regression model with obesity as the dependent variable was also calculated.

Results: The strongest association with obesity was observed for parental overweight and for low SES. Furthermore, a positive association with both overweight (including obesity) and obesity was seen for maternal smoking during pregnancy, high weight gain during pregnancy (only for mothers of normal weight), high birth weight, and high media consumption. In addition, high intakes of meat and sausages, total beverages, water and tea, total food and beverages, as well as energy-providing food and beverages were significantly associated with overweight as well as with obesity. Long sleep time was negatively associated with obesity among 3- to 10-year olds. Determinants of obesity occurred more often among children and adolescents with low SES.

Conclusion: Parental overweight and a low SES are major potential determinants of obesity. Families with these characteristics should be focused on in obesity prevention.

Figure 1

Association of food intake and weight status. Frequency of overweight (including obesity) and obesity by lowest and highest tertiles of intake of selected food groups. N = 12,792 3- to 17- year olds (underweight participants excluded). p-value for lowest vs. highest tertile from univariable regression models with overweight or obesity as independent variable, adjusted for age and gender. n.s. = not significant; * = p < 0.05; ** = p < 0.01;*** = p < 0.001.