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1.
BMC Public Health ; 19(1): 1627, 2019 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-31796007

RESUMO

BACKGROUND: Recommendations on preventive lipid screening among children and adolescents remain controversial. The aim of the study was to assess age and puberty-related changes in serum lipids, including total cholesterol (TC), and high-density (HDL-C) and non-high-density lipoprotein cholesterol (Non-HDL-C). METHODS: Using cross-sectional data from the National Health Interview and Examination Survey for Children and Adolescents in Germany (KiGGS 2003-2006; N = 13,676; 1-17 years), changes in distributions of serum lipids were visualized according to sex, age and maturation. Youth aged 10-17 years were classified as prepubescent, early/mid-puberty, and mature/advanced puberty. Multiple linear regressions were used to quantify the impact of pubertal stage on serum lipid levels, adjusted for potential confounding factors. RESULTS: Among children 1-9 years mean serum lipid measures increased with age, with higher mean TC and Non-HDL-C among girls than boys. Among children 10-17 years, advanced pubertal stage was independently related to lower lipid measures. Adjusted mean TC, HDL-C and Non-HDL-C was 19.4, 5.9 and 13.6 mg/dL lower among mature/advanced puberty compared to prepubescent boys and 11.0, 4.0 and 7.0 mg/dL lower in mature/advanced puberty compared to prepubescent girls. CONCLUSIONS: Lipid concentrations undergo considerable and sex-specific changes during physical growth and sexual maturation and significantly differ between pubertal stages. Screening recommendations need to consider the fluctuations of serum lipids during growth and sexual maturation.

2.
Artigo em Inglês | MEDLINE | ID: mdl-31723976

RESUMO

CONTEXT: No universal waist circumference (WC) percentile cut-offs used have been proposed for screening central obesity in children and adolescents. OBJECTIVE: To develop international WC percentile cut-offs for children and adolescents with normal weight based on data from eight countries in different regions and examine the relation with cardiovascular risk. DESIGN AND SETTING: We used pooled data on WC in 113,453 children and adolescents (males, 50.2%) aged 4-20 years from eight countries in different regions (Bulgaria, China, Iran, Korea, Malaysia, Poland, Seychelles, and Switzerland). We calculated WC percentile cut-offs in samples including or excluding children with obesity, overweight or underweight. WC percentiles were generated using the general additive model for location scale and shape (GAMLSS). We also estimated the predictive power of the WC 90th percentile cut-offs to predict cardiovascular risk using receiver operator characteristics curve analysis based on data from three countries that had available data (China, Iran and Korea). We also examined which WC percentiles connected with WC cut-offs for central obesity in adults (at age of 18 years). MAIN OUTCOME MEASURE: WC measured based on recommendation by the World Health Organization. RESULTS: We validated the performance of the age- and sex- specific 90th percentile WC cut-offs calculated in children and adolescents (6-18 years of age) with normal weight (excluding youth with obesity, overweight or underweight) by linking it with cardiovascular risk (AUC: 0.69 for boys; 0.63 for girls). In addition, WC percentile among normal weight children linked relatively well with established WC cut-offs for central obesity in adults (e.g., AUC in US adolescents: 0.71 for boys; 0.68 for girls). CONCLUSION: The international WC cut-offs developed in this study could be useful to screen central obesity in children and adolescents aged 6-18 years and allow direct comparison of WC distributions between populations and over time.

3.
Artigo em Alemão | MEDLINE | ID: mdl-31529184

RESUMO

BACKGROUND: Health-related quality of life (HRQoL) is increasingly established as an indicator for the subjective health of children and adolescents. The aim of this study was to describe the current HRQoL among children and adolescents in Germany aged between 11 and 17 years taking into account common chronic diseases (bronchial asthma, atopic dermatitis, obesity, ADHD) and mental health problems. METHODS: The analysis is based on information obtained from 6,599 children and adolescents (51.9% girls; 48.1% boys) from KiGGS Wave 2 (2014-2017). HRQoL was measured with the multidimensional KIDSCREEN-27. The chronic diseases and mental health problems under investigation were assessed by several indicators. RESULTS: Differences in HRQoL could be found as a function of age and gender. The HRQoL among girls was lower at an older age across all dimensions. These age-related differences are less pronounced among boys. The HRQoL of children and adolescents with chronic diseases and mental health problems was lower compared to their healthy peer groups. The comparison of the investigated chronic diseases and mental health problems revealed significant differences. Particularly, HRQoL was lower for children and adolescents with obesity and mental health problems. DISCUSSION: The distinction of several dimensions of HRQoL allows a comprehensive understanding of age- and gender-related effects and provides a detailed assessment of the impact of chronic diseases and mental health problems. The present findings underline the importance of HRQoL as an indicator for the subjective health of children and adolescents.


Assuntos
Doença Crônica/epidemiologia , Saúde Mental/estatística & dados numéricos , Qualidade de Vida , Adolescente , Saúde do Adolescente , Idoso , Criança , Saúde da Criança , Estudos Transversais , Feminino , Alemanha/epidemiologia , Inquéritos Epidemiológicos , Humanos , Masculino , Inquéritos e Questionários
4.
Artigo em Alemão | MEDLINE | ID: mdl-31529187

RESUMO

BACKGROUND: The German Health Interview and Examination Survey for Children and Adolescents (KiGGS) is an important data source for assessing the occurrence of underweight, overweight and obesity in children and adolescents in Germany. However, to assess trends over time, it must be considered that methodological changes in the calculation of prevalences have been necessary and that the reference system has been revised. OBJECTIVE: Are the effects of the methodological changes in weighting factors and reference systems so important that they significantly influence the available prevalence estimates and statements on trends over time? MATERIALS AND METHODS: The data are based on valid measurements of body height and weight from the KiGGS baseline survey (2003-2006, 7531 boys and 7215 girls) and from KiGGS Wave 2 (2014-2017, 1762 boys and 1799 girls). The participants were aged between 3 and 17 years. Prevalences (%, 95% CI) of underweight, overweight and obesity for the KiGGS baseline survey were calculated depending on the reference system and different weighting factors used. RESULTS: The statements on the temporal trend in the prevalence of underweight, overweight, and obesity remain valid even when methodological changes are taken into account. Only among 16- and especially 17-year-old girls, can a noticeable difference due to the altered reference system be noted. DISCUSSION: With regard to the trend examined here, the methodological changes can be neglected, as long as no small subgroups are analysed. However, this conclusion cannot be generalised; the effects of methodological changes must be re-examined for each study question.


Assuntos
Obesidade Pediátrica/epidemiologia , Magreza/epidemiologia , Adolescente , Índice de Massa Corporal , Criança , Pré-Escolar , Estudos Transversais , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Sobrepeso/epidemiologia , Prevalência
5.
Artigo em Alemão | MEDLINE | ID: mdl-31529189

RESUMO

BACKGROUND: The current results of the "German Health Interview and Examination Survey for Children and Adolescents" (KiGGS Wave 2, 2014-2017) indicate that the prevalence of overweight and obesity among children and adolescents in Germany has hardly changed during this period. OBJECTIVES: What are the current prevalences for the other categories of the BMI distribution (severe underweight, underweight, and extreme obesity) and what changes have occurred between the KiGGS baseline survey (2003-2006) and KiGGS Wave 2 with regard to the BMI categories and the distribution of BMI values? MATERIALS AND METHODS: KiGGS Wave 2 analyses are based on data from 1762 boys and 1799 girls aged 3 to 17 years with valid measurements of height and weight. The KiGGS baseline survey provides information on 7531 boys and 7215 girls for trend evaluations. RESULTS: For underweight prevalence as well as for the prevalence of extreme obesity no change over time can be observed. The BMI percentiles also show only minor differences between the two survey periods with a marginal shift of the upper BMI percentiles downwards before puberty and a slight increase after puberty. There is no clear shift in the BMI distribution towards lower BMI values. DISCUSSION: There are now many activities at the national, regional, and local level that focus on prevention and intervention to reduce overweight and obesity. The marginal shifts in the upper BMI percentiles in the upper BMI percentiles before puberty observed here suggest that some success may have been achieved in obesity prevention among children in Germany.


Assuntos
Índice de Massa Corporal , Obesidade/epidemiologia , Magreza/epidemiologia , Adolescente , Criança , Pré-Escolar , Estudos Transversais , Feminino , Alemanha/epidemiologia , Inquéritos Epidemiológicos , Humanos , Masculino , Prevalência
6.
Artigo em Alemão | MEDLINE | ID: mdl-31529190

RESUMO

BACKGROUND: Even though 36.5% of children and adolescents living in Germany have a migration background (MB), data on the health of this population is scarce. With population-based data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 2, 2014-2017), reliable statements can be given. METHODS: Data from KiGGS Wave 2 is used in order to report on general health status, mental health, and the distribution of allergic diseases among children and adolescents aged 3-17 years (n = 13,568). To determine overweight, standardized measurements of body weight and height (n = 3463) were used. In addition to the MB (none/one-sided/two-sided), the socioeconomic status (SES) is considered. In multivariate analyses among children and adolescents with MB, SES and the parents' duration of stay in Germany were included. RESULTS: Participants with a two-sided MB show lower prevalence of neurodermatitis (3.5% vs. 6.9%) and ADHS (2.0% vs. 5.1%) than those without a migration background and higher prevalence of fair to poor general health status (6.1% vs. 3.9%). Children and adolescents with a two-sided migration background are more often affected by overweight than those without migration background (22.1% vs. 12.2%). After considering SES, the chances of a diagnosed neurodermatitis and ADHS remain higher and the chances for overweight are lower in children and adolescents with a migration background than among those without migration background. If only children with MB are considered, SES and partially the parents' duration of stay in Germany are associated with health outcomes. CONCLUSION: Differences in the general health status of children and adolescents with and without MB vary depending on the observed indicators. The heterogeneity of children and adolescents with MB, e.g. regarding SES and parents' duration of stay, should be considered when planning and implementing measures of health promotion.


Assuntos
Nível de Saúde , Classe Social , Adolescente , Saúde do Adolescente , Criança , Saúde da Criança/estatística & dados numéricos , Pré-Escolar , Estudos Transversais , Alemanha , Inquéritos Epidemiológicos , Humanos , Prevalência , Fatores Socioeconômicos
7.
PLoS One ; 14(9): e0222218, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31498839

RESUMO

BACKGROUND: The combined impact of multiple healthy behaviors on health exceeds that of single behaviors. This study aimed to estimate trends in the prevalence of a healthy lifestyle among adults in Germany. METHODS: A data set of 18,058 adults aged 25-69 years from three population-based national health examination surveys 1990-92, 1997-99 and 2008-11 with complete information for five healthy behavior factors was used. A 'daily intake of both fruits and vegetables, 'sufficient physical exercise', 'no current smoking' and 'no current risk drinking' were assessed with self-reports and 'normal body weight' was calculated based on measured body weight and height. A dichotomous 'healthy lifestyle' indicator was defined as meeting at least four out of five healthy behaviors. Age-standardized prevalence was calculated stratified by sex, age groups (25-34, 35-44, 45-54 and 55-69 years) and education level (low, medium and high). Trends were expressed in relative change (RC) between 1990-92 and 2008-11. RESULTS: In Germany, the overall prevalence of healthy lifestyle increased from 9.3% in 1990-92 to 13.5% in 1997-99 and to 14.7% in 2008-11 (RC: +58.1%). The prevalence increased among men and women and in all age groups, with the exception of men aged 45-54 years. The RC of increasing healthy lifestyle prevalence between 1990-92 and 2008-11 was stronger albeit on a higher level among women compared to men. Therefore, the gender difference in healthy lifestyle has increased, but age-related differences have overall decreased in this period. Among high educated men the prevalence of a healthy lifestyle increased between 1990-92 and 2008-11 from 10.6% to 16.3% (p = 0.01) and among high educated women from 16.4% to 30.3% and also among medium educated women (10.9 to 16.6, p<0.01), but no significant increase in healthy lifestyle prevalence was observed among men with low and medium education and among women with low education level. CONCLUSIONS: The prevalence of a lifestyle with at least four out of five healthy behaviors markedly increased from 1990-92 to 2008-11. Nevertheless, additional health promotion interventions are needed to improve the number of combined healthy behavior factors and the awareness in the population that each additional healthy behavior factor leads to a further improvement in health, especially in men in the age-range 45 to 54 years, and among persons with low education level.

8.
Obes Facts ; 12(3): 344-356, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31167203

RESUMO

OBJECTIVE: Despite extensive study of the obesity epidemic, research on whether obesity has risen faster in lower or in higher socioeconomic groups is inconsistent. This study examined secular trends in obesity prevalence by socioeconomic position and the resulting obesity inequalities in the German adult population. METHODS: Data were drawn from three national examination surveys conducted in 1990-1992, 1997-1999 and 2008-2011 (n = 18,541; age range: 25-69 years). Obesity was defined by a body mass index ≥30 kg/m2 using standardised measurements of body height and weight. Education and equivalised household disposable income were used as indicators of socioeconomic position. Time trends in socioeconomic inequalities in obesity were examined using linear probability and log-binomial regression models. RESULTS: In each survey period, the highest socioeconomic groups had the lowest prevalence of obesity. The low and medium socioeconomic groups showed increases in obesity prevalence, whereas no such trend was observed in the high socioeconomic groups. Absolute inequalities in obesity by income increased by an average of 0.53 percentage points per year (95% confidence interval [CI] 0.01-1.05, p = 0.047) among men and 0.47 percentage points per year (95% CI 0.05-0.90, p = 0.029) among women. Absolute inequalities in obesity by education increased on average by 0.64 percentage points per year (95% CI 0.19-1.08, p = 0.005) among women but not among men (0.33 percentage points, 95% CI -0.27 to 0.92, p = 0.283). CONCLUSIONS: These findings suggest a widening obesity gap between the top and the bottom of the socioeconomic spectrum. This has the potential to have adverse consequences for population health and health inequalities in coming decades. Interventions that are effective in preventing and reducing obesity in socially disadvantaged groups are needed.

9.
Nutrients ; 11(5)2019 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-31083548

RESUMO

A balanced diet and sufficient physical activity are essential for the healthy growth of children and adolescents and for obesity prevention. Data from the second wave of the population-based German Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 2; 2014-2017) were used to analyse the association between food intake and physical activity among 6- to 17-year-old children and adolescents (n = 9842). Physical exercise (PE) and recommended daily physical activity (RDPA) were assessed with self-administered questionnaires and food intake by a semi-quantitative food frequency questionnaire. Multivariable logistic regression was used to analyse the association between food group intake (dependent variable) and level of PE or RDPA. High levels of physical activity (PE or RDPA) were associated with higher consumption of juice, water, milk, dairy products, fruits, and vegetables among both boys and girls, and among boys with a higher intake of bread, potatoes/pasta/rice, meat, and cereals. Higher PE levels were also less likely to be associated with a high soft drink intake. High levels of RDPA were associated with high intake of energy-dense foods among boys, which was not observed for PE. This study indicates that school-aged children and adolescents with higher levels of physical activity consume more beneficial foods and beverages compared to those with lower physical activity levels.


Assuntos
Comportamento do Adolescente , Comportamento Infantil , Dieta , Exercício , Comportamento Alimentar , Comportamentos Relacionados com a Saúde , Estilo de Vida , Adolescente , Bebidas , Criança , Estudos Transversais , Ingestão de Alimentos , Ingestão de Energia , Feminino , Alemanha , Inquéritos Epidemiológicos , Humanos , Modelos Logísticos , Masculino , Obesidade/prevenção & controle , Comportamento Sedentário , Fatores Sexuais
10.
BMJ Open ; 8(5): e021940, 2018 05 09.
Artigo em Inglês | MEDLINE | ID: mdl-29743332

RESUMO

OBJECTIVES: To investigate individual, interpersonal and environmental baseline factors predicting regular aerobic physical activity (PA) participation among older adults in Germany at follow-up 12 years later. DESIGN: Population-based cohort study. SETTING: Cluster-randomised general population sample selected based on population registry address information from 130 nationally distributed sample points collected from 1997 to 1999 and re-evaluated 12 years later from 2008 to 2011. PARTICIPANTS: 1184 adults, aged 65 years or older at follow-up with complete data at baseline and follow-up, were included in the final study sample. OUTCOME MEASURE: Regular 'aerobic PA ≥1 day/week' assessed based on self-reported information. RESULTS: At follow-up, 53.2% of the participants engaged in aerobic PA ≥1 day/week. Participants aged 50 to 60 years at baseline were more likely to engage in aerobic PA ≥1 day/week than participants aged 61 to 78 years; OR 1.88, 95% CI 1.46 to 2.40. Participants with middle and high socioeconomic status (SES) were more likely to engage in aerobic PA ≥1 day/week than participants with low SES; OR middle SES 2.08, 1.33 to 3.25; high SES 3.44, 2.11 to 5.60. Participants with high social support were more likely to engage in aerobic PA ≥1 day/week at follow-up than participants with low social support; OR 1.98, 1.26 to 3.12. Furthermore, participants who engaged in leisure time PA at least once per week at baseline were more likely to engage in aerobic PA ≥1 day/week at follow-up than those who engaged less than once per week; OR 1.95, 1.46 to 2.60. CONCLUSIONS: Several influencing factors assessed at baseline predicted regular aerobic PA participation 12 years later. These factors should be considered when planning interventions to prevent physical inactivity in older adults. There is great potential to increase aerobic PA participation in older adults in Germany, in particular among those with low SES and low social support.


Assuntos
Exercício , Avaliação Geriátrica/métodos , Inquéritos Epidemiológicos/métodos , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Seguimentos , Avaliação Geriátrica/estatística & dados numéricos , Alemanha , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Atividades de Lazer , Masculino , Classe Social , Apoio Social
11.
Health Qual Life Outcomes ; 15(1): 122, 2017 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-28601090

RESUMO

BACKGROUND: This study examined sex-specific differences in physical health-related quality of life (HRQoL) across subgroups of metabolic health and obesity. We specifically asked whether (1) obesity is related to lower HRQoL independent of metabolic health status and potential confounders, and (2) whether associations are similar in men and women. METHODS: We used cross-sectional data from the German Health Interview and Examination Survey 2008-11. Physical HRQoL was measured using the Short Form-36 version 2 physical component summary (PCS) score. Based on harmonized ATPIII criteria for the definition of the metabolic health and a body mass index ≥ 30 kg/m2 to define obesity, individuals were classified as metabolically healthy non-obese (MHNO), metabolically unhealthy non-obese (MUNO), metabolically healthy obese (MHO), and metabolically unhealthy obese (MUO). Sex-specific analyses including multivariable linear regression analyses were based on PCS as the dependent variable, metabolic health and obesity category as the independent variable with three categories and MHNO as the reference, and age, education, lifestyle and comorbidities as confounders. RESULTS: This study included 6860 participants (3298 men, 3562 women). Compared to MHNO, all other metabolic health and obesity categories had significantly lower PCS in both sexes. As reflected by the beta coefficients [95% confidence interval] from bivariable linear regression models, a significant inverse association with PCS was strongest for MUO (men: -7.0 [-8.2; -5.8]; women: -9.0 [-10.2; -7.9]), intermediate for MUNO (men: -4.2 [-5.3; -3.1]; women: -5.6 [-6.8; -4.4]) and least pronounced for MHO (men: -2.2 [-3.6; -0.8]; women -3.9 [-5.4; -2.5]). Differences in relation to MHNO remained statistically significant for all groups after adjusting for confounders, but decreased in particular for MUNO (men:-1.3 [-2.3; -0.3]; women: -1.5 [-2.7; -0.3]. CONCLUSIONS: Obesity was significantly related to lower physical HRQoL, independent of metabolic health status. Potential confounders including age, educational status, health-related behaviors, and comorbidities explained parts of the inverse relationship. Associations were evident in both sexes and consistently more pronounced among women than men.


Assuntos
Nível de Saúde , Obesidade/epidemiologia , Qualidade de Vida , Adulto , Comorbidade , Estudos Transversais , Feminino , Alemanha/epidemiologia , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Inquéritos e Questionários
12.
Z Evid Fortbild Qual Gesundhwes ; 122: 22-31, 2017 May.
Artigo em Alemão | MEDLINE | ID: mdl-28511896

RESUMO

BACKGROUND: Evidence-based guideline recommendations on lipid lowering drug treatment, in particular statin treatment, play an essential role in the management of dyslipidemias and in the prevention of cardiovascular disease events. In Germany, statutory health insurance data provide information on time trends in the prescription of lipid lowering drugs. However, population-based data regarding changes in user prevalence according to socio-demographic and health-related characteristics are lacking. Based on data from national health interview and examination surveys for adults in Germany 1997-1999 (GNHIES98) and 2008-2010 (DEGS1), the present analysis aims to close this information gap with a particular focus on the use of statins. METHODS: The study population consisted of 7,099 participants (GNHIES98) and 7,091 participants (DEGS1) aged 18 to 79 years at the time of the respective surveys. Primary data on medication use within 7 days prior to the survey were collected using standardized medication interviews and brown-bag drug review. Unique product identifiers on original drug containers were scanned and coded according to the latest version of the Anatomical Therapeutic Chemical (ATC) classification system. Medical history was obtained in computer-assisted personal interviews. A history of stroke or coronary heart disease (CHD) was assessed among persons aged 40 to 79 years only, and previous stroke or CHD were defined as cardiovascular disease. Obesity was defined as a body mass index (BMI) of ≥ 30kg/m2) based on calculation from standardized measures of body weight and height. Information on socio-demographic variables and type of health insurance was collected using standardized self-administered questionnaires. In cross-sectional descriptive analyses we calculated the prevalence of statin use (ATC codes: C10AA, C10BA, C10BX) by survey as well as the changes between surveys stratified according to relevant preexisting diseases and other co-variables. The association between survey period and statin use was analyzed in multivariable binary logistic regression models among persons aged 40 to 79 years. All results were weighted and standardized for the population of 2010. RESULTS: Between the two survey periods 1997-1999 and 2008-2011, the prevalence of statin use increased from 3.2 % to 8.8 %. The increase was most pronounced for the age group 65 to 79 years (7.2 % vs. 26.9 %) and among persons with relevant preexisting conditions, such as CHD (19.1 % vs. 54.9 %), stroke (17.1 % vs. 50.1 %), diabetes mellitus (10.5 % vs. 33.2 %), and dyslipidemia (12.6 % vs. 27.8 %). Among persons aged 40 to 79 years, the prevalence of statin use significantly increased between the two surveys, independent of co-variables (Odds Ratio: 3.70; 95 % confidence interval [CI]: 2.92 to 4.70). This applied to persons with cardiovascular disease (5.17; 3.50 to 7.64) and without cardiovascular disease (2.76; 2.07 to 3.67). CONCLUSION: The increase in the prevalence of statin use in Germany between the two national health surveys (1997-1999 and 2008-2011) reflects the implementation of current guideline recommendations without evidence for inequalities according to gender, education, type of health insurance or region of residence. These population-based data add to information on statin prescription obtained from statutory health insurance data. Limitations of survey-based information derive from potential misclassification and selection bias as well as large time gaps between the survey periods. Further studies are needed to examine why the observed prevalence of statin use among persons with cardiovascular morbidity lags behind current guideline recommendations for secondary cardiovascular prevention.


Assuntos
Uso de Medicamentos/tendências , Inquéritos Epidemiológicos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Alemanha , Humanos , Masculino , Pessoa de Meia-Idade , Padrões de Prática Médica , Prevalência , Adulto Jovem
13.
Eur J Pediatr ; 176(4): 547-551, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28132095

RESUMO

The nationwide 'German Health Interview and Examination Survey for Children and Adolescents' (KiGGS), conducted in 2003-2006, showed an increase in the prevalence rates of overweight and obesity compared to the early 1990s, indicating the need for regular monitoring. Recently, a follow-up-KiGGS Wave 1 (2009-2012)-was carried out as a telephone-based survey, providing parent-reported height and weight from 5155 children aged 4-10 years. Since parental reports lead to a bias in prevalence rates of weight status, a correction is needed. From a subsample of KiGGS Wave 1 participants, measurements for height and weight were collected in a physical examination. In order to correct prevalence rates derived from parent reports, weight status categories based on parent-reported and measured height and weight were used to estimate a correction formula according to an established procedure. The corrected prevalence rates derived from KiGGS Wave 1 for overweight, including obesity, in children aged 4-10 years in Germany showed that stagnation is reached compared to the KiGGS baseline study (2003-2006). CONCLUSION: The rates for overweight, including obesity, in Germany have levelled off. However, they still remain at a high level, indicating a need for further public health action. What is Known: • In the last decades, prevalence of overweight and obesity has risen. Now a days, the prevalence seems to be stagnating. • In Germany, prevalence estimates of overweight and obesity are only available from regional or non-representative studies. What is New: • This article gives an update for prevalence rates of overweight and obesity amongst children aged 4-10 years in Germany based on a nationwide and representative sample. • Results show that stagnation in prevalence rates for overweight in children in Germany is reached.


Assuntos
Obesidade Pediátrica/epidemiologia , Viés , Criança , Pré-Escolar , Estudos Transversais , Feminino , Seguimentos , Alemanha/epidemiologia , Inquéritos Epidemiológicos , Humanos , Masculino , Pais , Obesidade Pediátrica/classificação , Prevalência , Distribuição por Sexo , Telefone
14.
Eur J Public Health ; 27(4): 768-774, 2017 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-28013243

RESUMO

Background: A risk-targeted prevention strategy may efficiently utilize limited resources available for prevention of overweight and obesity. Likewise, more efficient intervention trials could be designed if selection of subjects was based on risk. The aim of the study was to develop a risk score predicting substantial weight gain among German adults. Methods: We developed the risk score using information on 15 socio-demographic, dietary and lifestyle factors from 32 204 participants of five population-based German cohort studies. Substantial weight gain was defined as gaining ≥10% of weight between baseline and follow-up (>6 years apart). The cases were censored according to the theoretical point in time when the threshold of 10% baseline-based weight gain was crossed assuming linearity of weight gain. Beta coefficients derived from proportional hazards regression were used as weights to compute the risk score as a linear combination of the predictors. Cross-validation was used to evaluate the score's discriminatory accuracy. Results: The cross-validated c index (95% CI) was 0.71 (0.67-0.75). A cutoff value of ≥475 score points yielded a sensitivity of 71% and a specificity of 63%. The corresponding positive and negative predictive values were 10.4% and 97.6%, respectively. Conclusions: The proposed risk score may support healthcare providers in decision making and referral and facilitate an efficient selection of subjects into intervention trials.


Assuntos
Obesidade/etiologia , Adolescente , Adulto , Idoso , Estudos de Coortes , Dieta/efeitos adversos , Dieta/estatística & dados numéricos , Feminino , Alemanha/epidemiologia , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Obesidade/prevenção & controle , Sobrepeso/etiologia , Sobrepeso/prevenção & controle , Modelos de Riscos Proporcionais , Fatores de Risco , Ganho de Peso , Adulto Jovem
15.
PLoS One ; 11(11): e0167159, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27880828

RESUMO

OBJECTIVE: The study examined potential changes in the proportion of metabolic health according to body size categories over time and across strata of sex and age, varying definitions of metabolic health. METHODS: We analysed data from national health interview and examination surveys 1997-99 and 2008-11 for adults aged 18-79 years (GNHIES98: N = 6,565; DEGS1: 6,860). Metabolic health as defined by ATPIII criteria was examined across body mass index categories. The Plourde and Karelis criteria were applied in relation to abdominal obesity. RESULTS: Proportions of adults with metabolic health by body size categories were largely stable over time, except for an increasing proportion of metabolically healthy persons with pre-obesity and metabolically healthy women without abdominal obesity. In both surveys proportions of adults meeting ATPIII criteria ranged from approximately 30% among men and women with obesity, to about two thirds of those with pre-obesity to about 93% among those with normal weight. According to Plourde and Karelis criteria proportions ranged from almost 30% among men and women without abdominal obesity to less than 10% among those with abdominal obesity. Proportions were consistently higher among younger than older age groups and less consistently higher among women than men. CONCLUSIONS: Proportions of adults with metabolic health by body size categories were largely stable over time, except for an increasing proportion of metabolically healthy women without abdominal obesity. There is no evidence that metabolic health among adults with obesity increased in Germany over a period of ten years.


Assuntos
Tamanho Corporal , Obesidade/patologia , Obesidade/fisiopatologia , Adolescente , Adulto , Fatores Etários , Idoso , Feminino , Seguimentos , Alemanha/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Estudos Retrospectivos , Fatores Sexuais
16.
Dtsch Arztebl Int ; 113(42): 712-719, 2016 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-27866566

RESUMO

BACKGROUND: Data from three representative health examination surveys in Germany were analyzed to examine secular trends in the prevalence and magnitude of cardiometabolic risk factors. METHODS: The target variables were the following cardiometabolic risk factors: lack of exercise, smoking, obesity, systolic blood pressure, total cholesterol, serum glucose, self-reported high blood pressure, hyperlipidemia, and diabetes, and the use of antihypertensive, cholesterol-lowering, and antidiabetic drugs. 9347 data sets from men and 10 068 from women were analyzed. The calculated means and prevalences were standardized to the age structure of the German population as of 31 December 2010 and compared across the three time periods of the surveys: 1990-1992, 1997-1999, and 2008-11. RESULTS: Over the entire period of observation (1990-2011), the mean systolic blood pressure fell from 137 to 128 mmHg in men and from 132 to 120 mmHg in women; the mean serum glucose concentration fell from 5.6 to 5.3 mmol/L in men and from 5.4 to 5.0 mmol/l in women; and the mean total cholesterol level fell from 6.2 to 5.3 mmol/L in both sexes. In men, smoking and lack of exercise became less common. On the other hand, the prevalence of use of antidiabetic, cholesterol-lowering, and antihypertensive drugs rose over the same time period, as did that of self-reported diabetes. The first of the three surveys (1990-1992) revealed differences between persons residing in the former East and West Germany in most of the health variables studied; these differences became less marked over time, up to the last survey in 2008-2011. CONCLUSION: The cardiometabolic risk profile of the German adult population as a whole improved over a period of 20 years. Further in-depth analyses are now planned.


Assuntos
Glicemia , Pressão Sanguínea , Doenças Cardiovasculares/epidemiologia , Colesterol/sangue , Adulto , Idoso , Feminino , Alemanha , Humanos , Hipertensão , Masculino , Pessoa de Meia-Idade , Prevalência , Valores de Referência , Fatores de Risco
17.
Obes Facts ; 9(5): 332-343, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27701174

RESUMO

AIM: This study aims to quantify longitudinal changes in waist circumference (WC) among adults aged 45-64 years in Germany. METHODS: Data of 15,444 men and 17,207 women from one nationwide and six regional prospective German cohort studies were analyzed. The sex-specific mean change in WC per year of follow-up was assessed for each study separately. Findings from the cohort-by-cohort analysis were combined by applying meta-analytic methods. Progression to central obesity (WC ≥ 102 cm in men and ≥ 88 cm in women) within a standardized period of 10 years was described for each study. RESULTS: The estimated mean change in WC per year of follow-up for all cohorts combined was 0.53 (95% confidence interval 0.29-0.76) cm/year for men and 0.63 (0.48-0.77) cm/year for women, but varied between the included studies. Within 10 years, about 20% of individuals with low WC (<94 cm in men; <80 cm in women) and about 50% of individuals with intermediate WC (94-102 cm in men; 80-88 cm in women) progressed to central obesity. CONCLUSION: The increase in mean WC with aging along with a profound increase of central adiposity is obviously and may have several adverse health effects. Obesity prevention programs should also focus on abdominal obesity.


Assuntos
Envelhecimento , Obesidade Abdominal/patologia , Circunferência da Cintura , Índice de Massa Corporal , Feminino , Seguimentos , Alemanha , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Obesidade Abdominal/etiologia , Estudos Prospectivos , Fatores de Risco , Distribuição por Sexo , Fatores Sexuais , Fatores de Tempo
18.
BMC Public Health ; 16: 939, 2016 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-27600666

RESUMO

BACKGROUND: Organised sports (OS) participation is an important health behaviour but it seems to decline from childhood to adolescence. The aim of this study was to investigate OS participation patterns from childhood to adolescence and potential determinants for those patterns. METHODS: Data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) cohort study with a 6 year follow-up period were used (KiGGS0: 2003-06, KiGGS1: 2009-12). Participants aged 6-10 years at KiGGS0, who were aged 12-16 at KiGGS1, were included (n = 3790). The outcome variable was 'OS participation' between KiGGS0 and KiGGS1 with the categories 'maintenance' (reference), 'dropout', 'commencement' and 'nonparticipation'. Relative risk ratios (RRRs) were calculated using multinomial logistic regression to identify potential predictors for OS patterns. Socio-demographic, family-related, health-related, behavioural and environmental factors were considered as independent variables. RESULTS: 48.5 % maintained OS, 20.5 % dropped out, 12.3 % commenced OS between KiGGS0 and KiGGS1 and 18.7 % did not participate at both times. The RRRs for dropout rather than maintenance were 0.6 (95 % Cl 0.5-0.7) for boys versus girls, 1.5 (1.3-1.9) for the age group 8-10 versus 6-7 years, 0.7 (0.5-0.9) for high versus intermediate parental education, 1.4 (1.1-1.8) for low versus middle household income, 1.4 (1.0-1.8) for below-average versus average motor fitness. The RRRs for commencement rather than maintenance were 0.6 (0.5-0.8) for boys versus girls, 0.6 (0.5-0.8) for the age group 8-10 versus 6-7 years, 1.5 (1.1-2.1) for low versus intermediate parental education, 1.5 (1.1-2.0) for low versus middle household income, 0.7 (0.5-1.0) for no single-parent versus single parent family, 1.8 (1.3-2.5) for below-average and 0.6 (0.4-0.8) for above-average versus average motor fitness, and 1.4 (1.1-1.9) for high versus middle screen-based media use. The RRRs for abstinence rather than maintenance were 0.6 (0.4-0.7) for boys versus girls, 1.5 (1.1-2.0) for low versus intermediate parental education, 2.2 (1.7-2.8) for low and 0.6 (0.5-0.8) for high versus middle household income, 1.6 (1.2-2.1) for psychopathological problems versus no problems, 1.7 (1.3-2.2) for below-average and 0.4 (0.3-0.6) for above-average versus average motor fitness, and 1.6 (1.0-2.6) for rural versus metropolitan residential area. CONCLUSIONS: OS participation rates among all children living in Germany need to be improved. More tailored offerings are needed which consider the preferences and interests of adolescents as well as a cooperation between public health actors to reduce barriers to OS.


Assuntos
Comportamento Infantil , Características da Família , Comportamentos Relacionados com a Saúde , Esportes/estatística & dados numéricos , Adolescente , Criança , Estudos de Coortes , Feminino , Alemanha/epidemiologia , Humanos , Modelos Logísticos , Masculino , Razão de Chances , Fatores Socioeconômicos , Inquéritos e Questionários
19.
PLoS One ; 11(6): e0157733, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27322650

RESUMO

OBJECTIVE: Our study aims to identify metabolic markers associated with either a gain in abdominal (measured by waist circumference) or peripheral (measured by hip circumference) body fat mass. METHODS: Data of 4 126 weight-gaining adults (18-75 years) from three population-based, prospective German cohort studies (EPIC, KORA, DEGS) were analysed regarding a waist-gaining (WG) or hip-gaining phenotype (HG). The phenotypes were obtained by calculating the differences of annual changes in waist minus hip circumference. The difference was displayed for all cohorts. The highest 10% of this difference were defined as WG whereas the lowest 10% were defined as HG. A total of 121 concordant metabolite measurements were conducted using Biocrates AbsoluteIDQ® kits in EPIC and KORA. Sex-specific associations with metabolite concentration as independent and phenotype as the dependent variable adjusted for confounders were calculated. The Benjamini-Hochberg method was used to correct for multiple testing. RESULTS: Across studies both sexes gained on average more waist than hip circumference. We could identify 12 metabolites as being associated with the WG (n = 8) or HG (n = 4) in men, but none were significant after correction for multiple testing; 45 metabolites were associated with the WG (n = 41) or HG (n = 4) in women. For WG, n = 21 metabolites remained significant after correction for multiple testing. Respective odds ratios (OR) ranged from 0.66 to 0.73 for tryptophan, the diacyl-phosphatidylcholines (PC) C32:3, C36:0, C38:0, C38:1, C42:2, C42:5, the acyl-alkyl-PCs C32:2, C34:0, C36:0, C36:1, C36:2, C38:0, C38:2, C40:1, C40:2, C40:5, C40:6, 42:2, C42:3 and lyso-PC C17:0. CONCLUSION: Both weight-gaining men and women showed a clear tendency to gain more abdominal than peripheral fat. Gain of abdominal fat seems to be related to an initial metabolic state reflected by low concentrations of specific metabolites, at least in women. Thus, higher levels of specific PCs may play a protective role in gaining waist circumference.


Assuntos
Biomarcadores/metabolismo , Metaboloma , Circunferência da Cintura/fisiologia , Ganho de Peso/fisiologia , Adulto , Idoso , Estudos de Coortes , Feminino , Humanos , Masculino , Metanálise como Assunto , Pessoa de Meia-Idade , Fenótipo , Relação Cintura-Quadril
20.
BMC Public Health ; 16: 240, 2016 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-26956524

RESUMO

BACKGROUND: Monitoring of serum lipid concentrations at the population level is an important public health tool to describe progress in cardiovascular disease risk control and prevention. Using data from two nationally representative health surveys of adults 18-79 years, this study identified changes in mean serum total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) in relation to changes in potential determinants of serum lipids between 1997-99 and 2008-11 in Germany. METHODS: Sex-specific multivariable linear regression analyses were performed with serum lipids as dependent variables and survey wave as independent variable and adjusted for the following covariables: age, fasting duration, educational status, lifestyle, and use of medication. RESULTS: Mean TC declined between the two survey periods by 13 % (5.97 mmol/l vs. 5.19 mmol/l) among men and by 12 % (6.03 mmol/l vs. 5.30 mmol/l) among women. Geometric mean TG decreased by 14 % (1.66 mmol/l vs. 1.42 mmol/l) among men and by 8 % (1.20 mmol/l vs. 1.10 mmol/l) among women. Mean HDL-C remained unchanged among men (1.29 mmol/l vs. 1.27 mmol/l), but decreased by 5 % among women (1.66 mmol/l vs. 1.58 mmol/l). Sports activity and coffee consumption increased, while smoking and high alcohol consumption decreased only in men. Processed food consumption increased and wholegrain bread consumption decreased in both sexes, and obesity increased among men. The use of lipid-lowering medication, in particular statins nearly doubled over time in both sexes. Among women, hormonal contraceptive use increased and postmenopausal hormone therapy halved over time. The changes in lipid levels between surveys remained significant after adjusting for covariables. CONCLUSION: Serum TC and TG considerably declined over one decade in Germany, which can be partly explained by increased use of lipid-lowering medication and improved lifestyle among men. The decline in serum lipids among women, however, remains unexplained.


Assuntos
Lipídeos/sangue , Adolescente , Adulto , Idoso , Doenças Cardiovasculares/prevenção & controle , Colesterol/sangue , HDL-Colesterol/sangue , Feminino , Alemanha , Inquéritos Epidemiológicos , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Triglicerídeos/sangue , Adulto Jovem
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