Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

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)

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

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Lobstein TJ, Frelut M-L . Prevalence of overweight children in Europe. Obes Rev 2003; 4: 195–200.

    Article  CAS  PubMed  Google Scholar 

  2. Livingstone B . Epidemiology of childhood obesity in Europe. Eur J Pediatr 2000; 159 (Suppl 1): S14–S34.

    Article  PubMed  Google Scholar 

  3. 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.

    Google Scholar 

  4. 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.

    Article  CAS  PubMed  Google Scholar 

  5. 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.

    Article  CAS  PubMed  Google Scholar 

  6. 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.

    Article  CAS  PubMed  Google Scholar 

  7. 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.

    Google Scholar 

  8. Dietz WH . Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics 1998; 101: 518–525.

    CAS  PubMed  Google Scholar 

  9. 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.

    Article  CAS  PubMed  Google Scholar 

  10. 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.

    Article  CAS  PubMed  Google Scholar 

  11. 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.

    Article  Google Scholar 

  12. 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.

    Article  CAS  PubMed  Google Scholar 

  13. 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.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. 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.

    Article  CAS  PubMed  Google Scholar 

  15. 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.

    Article  PubMed  Google Scholar 

  16. Gortmaker SL, Dietz WH, Cheung BWY . Inactivity, diet, and the fattening of America. J Am Diet Assoc 1990; 90: 1247–1255.

    CAS  PubMed  Google Scholar 

  17. 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.

    Article  PubMed  Google Scholar 

  18. Mast M, Körtzinger I, Müller MJ . Ernährungsverhalten und Ernährungszustand von 5-7-jährigen Kindern in Kiel. Akt Ernährungsmedizin 1999; 23: 1–6.

    Google Scholar 

  19. 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.

    Article  Google Scholar 

  20. 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.

  21. 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.

    Article  Google Scholar 

  22. 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.

  23. Obesity, Preventing and managing a global epidemic. Report of a WHO Consultation. WHO Technical Report Series 894, WHO, Geneva, 2000.

  24. Kersting M, Chada C, Schöch G . Optimierte Mischkost als Präventionsernährung für Kinder und Jugendliche. Ernährungs-Umschau 1993; 4: 164–168.

    Google Scholar 

  25. 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.

    Article  Google Scholar 

  26. von Kries R, Toschke A, Koletzko B, Slikker W . Maternal smoking during pregnancy and childhood obesity. Am J Epidemiol 2002; 156: 954–961.

    Article  PubMed  Google Scholar 

  27. Strauss RS, Knight J . Influence of the home environment on the development of obesity in children. Pediatrics 1999; 103: e85.

    Article  CAS  PubMed  Google Scholar 

  28. 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.

    Article  CAS  PubMed  Google Scholar 

  29. 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.

    Article  CAS  PubMed  Google Scholar 

  30. Hediger ML, Overpeck MD, Kuczmarski RJ, Ruan WJ . Association between infant breastfeeding and overweight in young children. JAMA 2001; 285: 2453–2460.

    Article  CAS  PubMed  Google Scholar 

  31. 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.

    CAS  PubMed  Google Scholar 

  32. Poston II WSC, Foreyt JP . Obesity is an environmental issue. Atherosclerosis 1999; 146: 201–209.

    Article  Google Scholar 

  33. Hill JO, Peters JC . Environmental contributions to the obesity epidemic. Science 1998; 280: 1371–1374.

    Article  CAS  PubMed  Google Scholar 

  34. 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.

    CAS  PubMed  Google Scholar 

  35. 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.

    Google Scholar 

  36. 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.

    Article  PubMed  Google Scholar 

  37. 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.

    Article  PubMed  Google Scholar 

  38. 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.

  39. 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.

    Article  CAS  PubMed  Google Scholar 

  40. 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.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. 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.

    Article  CAS  PubMed  Google Scholar 

  42. Remer T, Dimitriou T, Kersting M . Does fat intake explain fatness in children? Eur J Clin Nutr 2002; 56: 1046–1047.

    Article  CAS  PubMed  Google Scholar 

  43. 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.

    Article  CAS  PubMed  Google Scholar 

  44. 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.

    Article  CAS  PubMed  Google Scholar 

  45. 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.

    Google Scholar 

  46. 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.

    PubMed  Google Scholar 

  47. 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.

    Article  CAS  PubMed  Google Scholar 

  48. Robinson TN . Reducing children's television viewing to prevent obesity. A randomized controlled trial. JAMA 1999; 282: 1561–1567.

    Article  CAS  PubMed  Google Scholar 

  49. 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.

    Article  CAS  PubMed  Google Scholar 

  50. Dietz WH . The obesity epidemic in young children: reduce television viewing and promote playing. BMJ 2001; 322: 313–314.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. 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.

    Article  CAS  PubMed  Google Scholar 

  52. 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.

    Article  PubMed  Google Scholar 

Download references

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

Authors

Corresponding author

Correspondence to M J Müller.

Rights and permissions

Reprints 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

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijo.0802756

Keywords

This article is cited by

Search

Quick links