Institut für Humanernährung und Lebensmittelkunde, Christian-Albrechts-Universität zu Kiel, Düsternbrooker Weg 17, D-24105 Kiel, Germany.
Public Health Nutr. 2010 Nov;13(11):1870-81. doi: 10.1017/S1368980010000583. Epub 2010 Mar 26.
To systematically analyse determinants of overweight prevalence and incidence in children and adolescents, as a basis of treatment and prevention.
Cross-sectional and longitudinal data of the Kiel Obesity Prevention Study (KOPS).
Schools in Kiel, Germany.
Cross-sectional data from 6249 students aged 5-16 years and 4-year longitudinal data from 1087 children aged 5-11 years. Weight status of students was assessed and familial factors (weight status of parents and siblings, smoking habits), social factors (socio-economic status, nationality, single parenting), birth weight as well as lifestyle variables (physical activity, media time, nutrition) were considered as independent variables in multivariate logistic regression analyses to predict the likelihood of the student being overweight.
The cross-sectional data revealed the prevalence of overweight as 18·3 % in boys and 19·2 % in girls. In both sexes determinants of overweight prevalence were overweight and obese parents, overweight siblings, parental smoking, single parenthood and non-German nationality. High birth weight and low physical activity additionally increased the risk in boys. High media time and low parental education were significant determinants in girls. Effect of media time was mediated by maternal weight status in boys as well as by socio-economic status and age in girls. From the longitudinal data, the 4-year cumulative incidence of overweight was 10·0 % in boys and 8·2 % in girls. Parental obesity, parental smoking and low physical activity were determinants of overweight incidence in boys, whereas paternal obesity increased the risk in girls.
Treatment and prevention should address family and social determinants with a focus on physical activity and media use.
系统分析儿童和青少年超重患病率和发病率的决定因素，为治疗和预防提供依据。
基尔肥胖预防研究（KOPS）的横断面和纵向数据。
德国基尔的学校。
6249 名 5-16 岁学生的横断面数据和 1087 名 5-11 岁儿童的 4 年纵向数据。通过多变量逻辑回归分析评估学生的体重状况和家庭因素（父母和兄弟姐妹的体重状况、吸烟习惯）、社会因素（社会经济地位、国籍、单亲家庭）、出生体重以及生活方式变量（体力活动、媒体时间、营养），以预测学生超重的可能性。
横断面数据显示，男孩超重率为 18.3%，女孩为 19.2%。在男孩和女孩中，超重和肥胖父母、超重和肥胖兄弟姐妹、父母吸烟、单亲家庭和非德国国籍是超重患病率的决定因素。高出生体重和低体力活动也增加了男孩的患病风险。高媒体时间和低父母教育程度是女孩的重要决定因素。媒体时间的影响在男孩中通过母亲的体重状况以及在女孩中通过社会经济地位和年龄来介导。从纵向数据来看，男孩的 4 年超重累积发病率为 10.0%，女孩为 8.2%。父母肥胖、父母吸烟和低体力活动是男孩超重发病率的决定因素，而父亲肥胖则增加了女孩的患病风险。
治疗和预防应针对家庭和社会决定因素，重点关注体力活动和媒体使用。
