Influencing factors of obesity in school-age children and adolescents - A systematic review of the literature in the context of obesity monitoring.

Around 15% of children and adolescents in Germany are overweight or obese. To support the planning, implementation and evaluation of preventive activities, the Robert Koch Institute (RKI) has developed a population-wide monitoring of influencing factors relevant to the development of obesity during childhood (AdiMon). AdiMon is a web-based indicator system providing population-wide meaningful and regularly updated data on factors that influence obesity in kindergarten-age girls and boys (0- to 6-years-old). Towards the end of 2020, the RKI will expand the indicator system to also cover the 7- to 17-year-old age group. To this end, a systematic review of the literature was conducted, a process which served to identify over 80 relevant factors that influence the development of obesity. These factors have been attributed to the categories behaviour, environment, biology, pre- and postnatal, psychosocial factors and context. Compared to a previous literature review for kindergarten-age children, around one tenth of the influencing factors now identified are new, including 'peer group influences' and 'bullying'. As the results highlight, an array of influencing factors must be considered when expanding the monitoring system, ranging from individual health behaviour to the social framework conditions and environmental factors.