Abstract
To identify the major risk factors of overweight and obesity in prepubertal children. Cross-sectional study. In all, 32 primary schools in Kiel (248 000 inhabitants), northwest Germany. A total of 2631 5-7-y-old German children and their parents. 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. 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. 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.
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