Ledergerber M, Steffen Th
Kinder- und Jugendgesundheitsdienst, Abteilung Gesundheitsförderung und Prävention Basel-Stadt.
Gesundheitswesen. 2011 Jan;73(1):46-53. doi: 10.1055/s-0030-1268447. Epub 2011 Jan 31.
A cross-sectional study over a period of 30 years was used to investigate the development of overweight and obesity in school children. Of particular interest is the question of whether the overweight epidemic is continuing to increase, as often postulated, or whether a stagnation point or the start of a reversal of the trend has already been reached.
School medical examinations take place at three school levels in the city of Basel. 94,004 student files from these examinations from the school years 1977/78 and 1978/79, as well as from 1989/90 to 2008/09, have been subjected to a secondary analysis. The overweight and obesity prevalences were calculated for eleven 2-year cohorts according to the standards of the International Obesity Taskforce IOTF. A more in-depth analysis followed, differentiated by school grade, gender and nationality.
The percentage of overweight and obese children and young people has increased strongly in the last 3 decades. Whereas every 11th child was overweight 30 years ago (9.3%), it now amounts to every 5th child (20.9%). The proportion of obese children has increased from 1.2% to 5.4%. The large increase in overweight and obesity prevalences mainly took place in the 1990s. Since the millennium change, the number of overweight and obese school children among those examined has only increased slightly, or has at least no longer increased. This general development was observed in all school grades and was independent of gender and nationality, although foreign children are always twice as likely to be affected by overweight and obesity. The stabilisation can be seen at its earliest and the change in trend is clearest in the kindergarten, which could indicate a "year's cohort effect".
The development over the last 10 years is welcome from a public health point of view. The continued high prevalence still represents a significant health problem, however, and the prevention efforts being made against the overweight epidemic must be further strengthened.
采用一项为期30年的横断面研究来调查学龄儿童超重和肥胖的发展情况。特别令人关注的问题是，超重流行情况是否如人们通常所假定的那样持续增加，还是已经达到停滞点或开始出现趋势逆转。
巴塞尔市在三个学校级别开展学校体检。对1977/78学年和1978/79学年以及1989/90至2008/09学年这些体检的94,004份学生档案进行了二次分析。根据国际肥胖特别工作组（IOTF）的标准，计算了11个2年队列的超重和肥胖患病率。随后进行了更深入的分析，按年级、性别和国籍进行区分。
在过去30年中，超重和肥胖儿童及青少年的比例大幅增加。30年前每11个孩子中有1个超重（9.3%），现在每5个孩子中就有1个超重（20.9%）。肥胖儿童的比例从1.2%增至5.4%。超重和肥胖患病率的大幅增加主要发生在20世纪90年代。自千禧年以来，受检超重和肥胖学龄儿童数量仅略有增加，或至少不再增加。在所有年级都观察到了这种总体发展情况，且与性别和国籍无关，不过外国儿童受超重和肥胖影响的可能性总是本国儿童的两倍。在幼儿园最早可看到稳定情况，趋势变化也最明显，这可能表明存在“出生队列效应”。
从公共卫生角度看，过去10年的发展情况是值得欢迎的。然而，持续的高患病率仍然是一个重大的健康问题，必须进一步加强针对超重流行情况的预防措施。
