Juvenile Obesity Research Articles

Visfatin in juvenile obesity – the effect of obesity intervention and sex

The association of visfatin, an adipocytokine relevant to the development of inflammation and metabolic disorders, with juvenile obesity needs to be re-established as previously used tests occurred to be nonspecific. To evaluate visfatin association with a metabolic profile of 88 overweight/obese and 26 lean children/adolescents as well as changes in its levels following weight reduction programme (diet + enhanced physical activity ± metformin). A case-control and cohort study. Visfatin was higher in obese than lean and overweight individuals (2·07 vs. 1·53 and 1·47 ng mL(-1) , P = 0·034). Of metabolic syndrome components, central obesity combined with either insulin resistance (IR) or hyperinsulinemia (HI) was associated with increases in circulating visfatin. In girls, visfatin correlated with leptin (r = 0·40, P = 0·009) and thiols (r = -0·36, P = 0·009), which explained 24% in visfatin variability. In boys, visfatin correlated with waist circumference (r = 0·36, P = 0·036), BMI% (r = 0·38, P = 0·025), whole body insulin sensitivity index (r = -0·36, P = 0·036), IL-6 (r = 0·38, P = 0·024) and thiobarbituric acid reactive substances (TBARS) (r = 0·52, P = 0·001), of which IL-6 and TBARS were independent predictors of visfatin elevation, explaining 42% in data variability. Visfatin was significantly lower following weight reduction programme than at baseline (1·43 vs. 1·83 ng mL(-1) , P = 0·033). Visfatin reduction correlated neither with changes in metabolic parameters nor was it affected by metformin. ΔVisfatin correlated exclusively with baseline visfatin (r = 0·612, P < 0·0001), which explained 38% in data variability. Central obesity combined with HI/IR contributes to visfatin elevation. Visfatin association with metabolic/biochemical variables is gender dependent. Diet + enhanced physical activity are effective in visfatin reduction, the degree of which depends on baseline visfatin.

Therapy of juvenile obesity from the sports medicine/science viewpoint

Overweight and obesity in children and adolescents had reached its highest level worldwide. In the development of overweight and within interdisciplinary training programs, physical activity and the avoidance of sedentary habits play an important role. Not only is there an increase in energy consumption, but potential comorbidities (e.g., cardiovascular risk factors) are improved. In addition, positive psychosocial benefits occur, e.g., increasing self-esteem, personal, and social skills. During realization, possible risks (e.g., exercise-induced asthma) and barriers have to be taken into account. In terms of physical activity programs, the child's surroundings have to be integrated, and transfer into daily routine should be promoted. Therefore, in addition to athletic content, daily activities have to be trained and supported, e.g., via pedometers. At least 60, better 90 and more minutes of physical activity per day are recommended; the use of audiovisual media should be reduced to a minimum (max. 120 minutes).

High density lipoprotein cholesterol level is a robust predictor of lipid peroxidation irrespective of gender, age, obesity, and inflammatory or metabolic biomarkers

BackgroundObesity related dyslipidemia, chronic inflammation and oxidative stress were associated with atherosclerotic sequels. We analysed oxidized low-density lipoprotein (oxLDL) plasma levels of 797 participants of the STyrian Juvenile OBesity (STYJOBS) / Early DEteCTion of Atherosclerosis (EDECTA) Study cohort aged from 5 to 50 years. The rationale of STYJOBS/EDECTA is to investigate the preclinical phase of obesity by a well defined cohort of young and middle aged overweight/obese and normal weight subjects. Methods and ResultsPlasma oxLDL was analysed by ELISA (Mercodia, Sweden). In the overweight/obese (OW/OB) study group, oxLDL levels were significantly increased compared to normal weighted controls (p<0.001). Probands with metabolic syndrome (MS) had significantly higher oxLDL levels than probands without MS; between overweight and obese participants, and between females and males, no significant difference was seen. In a multiple stepwise regression analysis including all study subjects, age, gender, anthropometric data, presence of metabolic syndrome, systolic, diastolic blood pressure, carotis communis intima media thickness, lipids, adipokines, metabolic, and inflammatory biomarkers, decreased high-density lipoprotein (HDL-cholesterol) and increased total cholesterol were the best predictors for increased oxLDL levels. ConclusionDecreased HDL-cholesterol is an important determinant of lipid peroxidation irrespective of obesity, age, gender, SAT distribution, and inflammatory/metabolic biomarkers.

The probiotic Bifidobacterium lactis (Bb12) modulates adipocyte size in pig model of juvenile obesity

The probiotic <i>Bifidobacterium lactis</i> (Bb12) modulates adipocyte size in pig model of juvenile obesity

The conflicting effects of maternal nutrient restriction and early-life obesity on renal health

Epidemiological and animal studies have demonstrated that early-life nutrition alters the metabolic responses and generates structural changes in complex tissues, such as the kidneys, which may lead to a reduction in the offspring lifespan. Independently, obesity induces a spontaneous low-grade chronic inflammatory response by modulating several of the major metabolic pathways that ultimately compromise long-term renal health. However, the combined effects of maternal nutrition and early-life obesity in the development of renal diseases are far from conclusive. Previous results, using the ovine model, demonstrated that the combination of a reduction in fetal nutrition and juvenile obesity induced a series of adaptations associated with severe metabolic syndrome in the heart and adipose tissue. Surprisingly, exposure to an obesogenic environment in the kidney of those offspring produced an apparent reduction in glomerulosclerosis in relation to age- and weight-matched controls. However, this reduction in cellular apoptosis was accompanied by a rise in glomerular filtration rate and blood pressure of equal intensity when compared with obese controls. The intention of this review is to explain the adaptive responses observed in this model, based on insights into the mechanism of renal fetal programming, and their potential interactions with some of the metabolic changes produced by obesity.

Circulating adipocyte fatty acid-binding protein, juvenile obesity, and metabolic syndrome

Adipocyte fatty acid-binding protein (A-FABP) links obesity and metabolic syndrome (MetS) and might be targeted in future therapies. Its utility as a MetS biomarker has been suggested in adults but has not been examined in children/adolescents. Our objectives were to identify metabolic parameters associated with A-FABP elevation in children and adolescents and to evaluate the effect of obesity intervention and A-FABP diagnostic utility. A-FABP and anthropometric, metabolic, and inflammatory indices were measured in 31 lean and 114 overweight/obese children and adolescents and reassessed after obesity intervention (1 year; diet and enhanced physical activity, with or without metformin). A-FABP was significantly higher in overweight/ obese than lean individuals, where it correlated with insulin, waist circumference (WC), and 2-h glucose independent of body mass index (BMI), age, gender, and developmental stage. The pattern of A-FABP associations differed between sexes. As a MetS indicator, A-FABP had 68% accuracy. The weight reduction program was effective in reducing A-FABP, BMI%, WC, triglycerides, and cholesterol. In conclusion, elevation in A-FABP is associated with MetS components independent of BMI status and can be reduced by diet and enhanced physical activity. A-FABP as a single MetS biomarker has a moderate accuracy.

Serum Neopterin Is Not Increased in Obese Juveniles

Objective. Cardiovascular disease is associated with inflammation and immune activation, concentrations of immune activation markers like neopterin predict outcome in adults. Methods. Serum neopterin concentrations and early metabolic and pre-atherosclerotic symptoms were analyzed in 295 obese juveniles and 101 normal weight controls of similar age. Additionally, the influence of a 12 months weight reduction program on neopterin levels was investigated in 31 obese juveniles. Results. Intima-media thickness of common carotid arteries (IMT) and the concentrations of C-reactive protein (CRP) were increased in the obese juveniles (P < .001). Also triglycerides, oxidized LDL, fasted insulin levels, HOMA-index, leptin, liver transaminases and uric acid were increased compared to the controls. However, serum neopterin was decreased in the obese versus non-obese juveniles (P < .03). The intervention consisting of regular sports, nutritional devices, and a psychologic attendance led after 12 months to an increase of neopterin concentration (P < .05; paired test). Conclusions. Neopterin concentrations in juvenile obesity behaved considerably different from what was demonstrated in adults, levels did not correlate with metabolic and pre-atherosclerotic symptoms found in early phases although early vascular burden and chronic low grade inflammation was indicated by increased IMT and CRP. Neopterin concentrations increased after a 12 months intervention program.

Stéatohépatite non alcoolique chez une adolescente obèse : une biopsie hépatique discutable

The growing epidemic of juvenile obesity has prompted pediatricians to investigate obesity-related conditions in obese teenagers. We report a clinical case of severe hepatic fibrosis in an adolescent with severe and recent obesity. Because of elevated serum aminotransferase levels, abnormal hepatic ultrasonography and insulin resistance (impaired glucose tolerance), we suspected nonalcoholic steatohepatitis (NASH). Disease activity and fibrosis were confirmed on liver biopsy. Considering the risk of progression toward cirrhosis and its complications, and the pathological liver lesions, we started long-term medical monitoring and drug therapy to control weight loss. At present, although biopsy is the only validated way to establish the diagnosis of NASH, there is no consensus on its indication when NASH is suspected. Noninvasive strategies are attractive but require validation in children.

Suboptimal maternal nutrition, during early fetal liver development, promotes lipid accumulation in the liver of obese offspring

Maternal nutrition during the period of early organ development can modulate the offspring's ability to metabolise excess fat as young adults when exposed to an obesogenic environment. This study examined the hypothesis that exposing offspring to nutrient restriction coincident with early hepatogenesis would result in endocrine and metabolic adaptations that subsequently lead to increased ectopic lipid accumulation within the liver. Pregnant sheep were fed either 50 or 100% of total metabolisable energy requirements from 30 to 80 days gestation and 100% thereafter. At weaning, offspring were made obese, and at ∼1 year of age livers were sampled. Lipid infiltration and molecular indices of gluconeogenesis, lipid metabolism and mitochondrial function were measured. Although hepatic triglyceride accumulation was not affected by obesity per se, it was nearly doubled in obese offspring born to nutrient-restricted mothers. This adaptation was accompanied by elevated gene expression for peroxisome proliferator-activated receptor γ (PPARG) and its co-activator PGC1α, which may be indicative of changes in the rate of hepatic fatty acid oxidation. In contrast, maternal diet had no influence on the stimulatory effect of obesity on gene expression for a range of proteins involved in glucose metabolism and energy balance including glucokinase, glucocorticoid receptors and uncoupling protein 2. Similarly, although gene expressions for the insulin and IGF1 receptors were suppressed by obesity they were not influenced by the prenatal nutritional environment. In conclusion, excess hepatic lipid accumulation with juvenile obesity is promoted by suboptimal nutrition coincident with early development of the fetal liver.

Gender-specific association of serum uric acid with metabolic syndrome and its components in juvenile obesity

Hyperuricemia has been implicated in the pathogenesis of obesity and related metabolic abnormalities. Studies on the association between serum uric acid (sUA) and metabolic syndrome (MetS) in juvenile obesity are scant. The effect of gender has not been evaluated. sUA (uricase method), anthropometric and biochemical indices were measured in gender-stratified children/adolescents consisting of 113 overweight/obese and 71 lean individuals. In males, sUA was significantly elevated in overweight as well as obese patients. sUA was strongly associated with obesity indices and reflected sexual development, decreases in high density lipoprotein-cholesterol, and moderately, the number of MetS components. Waist circumference (WC) and Tanner stage explained 40% of sUA variability. Controlling for body mass index (BMI) and other MetS components, sUA was associated with abdominal obesity, explaining 30% of variability in WC. In females, sUA was significantly increased in obesity, high blood pressure (BP), and MetS and corresponded with the number of MetS components, indices of glucose metabolism, triglycerides (TG), and the atherogenecity index. Insulin-resistance (IR) (homeostasis model assessment; HOMA) and high BP explained 29% of sUA variability, whereas sUA, while controlling for BMI, age, and other MetS components, was associated with hypertriglyceridemia, hyperglycemia, high BP, and abdominal obesity. IR mediated the associations with high TG and glucose. The association between sUA and MetS components in juvenile obesity is gender-specific, with females being related more closely and to more metabolic abnormalities. It may explain why, despite its lower concentrations, sUA is an independent predictor of mortality from all causes and from vascular diseases exclusively in females. Our findings may help in identifying metabolic abnormalities which may possibly be targeted by reducing sUA in males and females.

Metabolic responses to submaximal treadmill walking and cycle ergometer pedalling in obese adolescents

Physical activity is essential in obesity management because of the impact of exercise-related energy expenditure (EE) and fat oxidation (Fox) rate on a daily balance, but the specific physiological effects of different exercise modalities are scarcely known in obese individuals. The objective of the study was to compare the metabolic responses to treadmill (TM) and cycle ergometer (CE) exercise in obese adolescents. Gas exchange, heart rate (HR), blood lactate (LA) concentration, EE and Fox were determined at different intensity levels (up to about 85% of maximal oxygen uptake) during TM and CE in 14 pubertal (Tanner stage: >3) obese (BMI SDS: 2.15-3.86) male adolescents (age: 13-18 years). At comparable HR, oxygen uptake, EE and Fox were higher, and LA lower, during TM than CE (P<0.05-0.001), suggesting that cycling imposes a metabolic involvement at the level of the single active muscles greater than walking. Therefore, due to different physiological responses to TM and CE, walking was more convenient than cycling in obese adolescents, permitting to attain the same EE at lower HR, with lower blood LA concentration and with greater Fox. These conclusions seem clinically relevant when using exercise as a part of multidisciplinary treatment for juvenile obesity and amelioration of related metabolic disturbances.

Western diet changes cardiac acyl-CoA composition in obese rats: a potential role for hepatic lipogenesis

The "lipotoxic footprint" of cardiac maladaptation in diet-induced obesity is poorly defined. We investigated how manipulation of dietary lipid and carbohydrate influenced potential lipotoxic species in the failing heart. In Wistar rats, contractile dysfunction develops at 48 weeks on a high-fat/high-carbohydrate "Western" diet, but not on low-fat/high-carbohydrate or high-fat diets. Cardiac content of the lipotoxic candidates--diacylglycerol, ceramide, lipid peroxide, and long-chain acyl-CoA species--was measured at different time points by high-performance liquid chromatography and biochemical assays, as was lipogenic capacity in the heart and liver by qRT-PCR and radiometric assays. Changes in membranes fluidity were also monitored using fluorescence polarization. We report that Western feeding induced a 40% decrease in myocardial palmitoleoyl-CoA content and a similar decrease in the unsaturated-to-saturated fatty acid ratio. These changes were associated with impaired cardiac mitochondrial membrane fluidity. At the same time, hepatic lipogenic capacity was increased in animals fed Western diet (+270% fatty acid elongase activity compared with high-fat diet), while fatty acid desaturase activity decreased over time. Our findings suggest that dysregulation of lipogenesis is a significant component of heart failure in diet-induced obesity.

A unique genetic defect on chromosome 3 is responsible for juvenile obesity in the Berlin Fat Mouse

This study aimed at the mapping and estimation of genetic and sex effects contributing to the obese phenotype of the Berlin Fat Mouse Inbred line 860 (BFMI860). This mouse line is predisposed for juvenile obesity. BFMI860 mice accumulate 24% total fat mass at 10 weeks of age under a standard maintenance diet. A total of 471 mice of a (BFMI860 x C57BL/6NCrl) F₂ intercross population were fed a standard maintenance diet and were analysed for body composition at 10 weeks when they finished their rapid growth phase. The most striking result was the identification of a novel obesity locus on chromosome 3 (Chr 3) at 40 Mb, explaining 39% of the variance of total fat mass in the F₂ population under a standard diet. This locus was named jObes1 (juvenile obesity 1). The BFMI860 allele effect was recessive. Males and females homozygous at jObes1 had on average 3.0 and 3.3 g more total fat mass at 10 weeks than the other two genotype classes, respectively. The effect was evident in all white adipose tissues, brown adipose tissue and also in liver. The position of the Chr 3 effect is syntenic to an obesity locus in humans. Additional loci for total fat mass and different white adipose tissue weights with minor effects were detected on mouse Chr 5 and 6. Another locus on Chr 4 had influence especially on liver weight. Many loci including jObes1 affected males and females to a different extent. The major locus on Chr 3 for juvenile obesity and its interaction with sex is unique and makes the BFMI860 mice an interesting resource for the discovery of novel genetic factors predisposing obesity, which might also contribute to obesity in humans. The results suggested that metabolic and regulatory pathways differed between the sexes.

Progenitor cell number is correlated to physical performance in obese children and young adolescents

Juvenile obesity is associated with cardiovascular risk factors. In adults, cardiovascular risk factors and obesity are associated with a decreased number of endothelial progenitor cells. Higher physical fitness correlates with a lower cardiovascular morbidity and increased endothelial progenitor cells. CD34 positive, KDR/CD34, CD133/CD34, and CD117/CD34 double positive progenitor cells were measured in 24 obese children and adolescents - 15 female; age: 12.5 plus or minus 2.1 years, body mass index standard deviation score: 2.5 plus or minus 0.5, waist: 88.6 plus or minus 15.0 centimetre, body fat: 24.6 plus or minus 2.2% - participating in the CHILT III programme. Percentage body fat was assessed by skinfold thickness. Peak of oxygen uptake and the respiratory quotient were determined by spiroergometry. No gender differences were found. CD34 positive and CD117 positive/CD34 positive cells correlated with maximum relative watt performance, r is equal to 0.429 and 0.462; p-value less than 0.05. The peak of oxygen uptake correlated with CD34 positive and CD133 positive/CD34 positive cells, r is equal to 0.458 and 0.456; p-value less than 0.05, while no correlations were found between parameters of weight, body composition, and respiratory quotient with progenitor cells. A higher physical fitness, but not less body fat or body mass index is associated with a higher number of endothelial progenitor cells. These results support the hypothesis that physical fitness and cardiovascular risk in high-risk populations are inversely related. Further research is warranted to clarify the strength of this association and longitudinal effects of a comprehensive obesity programme.

Morbid obesity: Pregnancy risks, birth risks and status of the newborn

In perinatal medicine, severe obesity of the mother occurs in approximately 1% of cases. This is a problem of increasing importance because of the rising prevalence of juvenile obesity. Our retrospective cohort study aimed at characterising high-risk pregnancies associated with morbid obesity (body mass index [BMI]≥40). This is of interest not only from an epidemiological perspective and for developing guidelines for clinical care but also from an anthropological point of view. We analysed the German perinatal statistics of the years 1998–2000 with data from more than 500,000 pregnancies. Pregnant women with coexistent morbid obesity were compared to a normal weight reference sample with regard to gestational, perinatal and neonatal risks. Birth weight percentiles were used to classify the neonates according to size (hypotrophy if <10th, hypertrophy/foetal macrosomia if >90th). The obtained risk profile for morbidly obese pregnant women primarily showed pregnancy related diseases, such as hypertension, pre-eclampsia and gestational diabetes. Hypertension and signs of foetal hypoxaemia occurred at higher frequencies with morbid obesity. Hypertrophic neonates were born 3.3 times more often to obese mothers than to mothers of the normal weight. At a BMI ≥40 the rates of complications such as pre-eclampsia, gestational diabetes, impending foetal hypoxaemia, foetal macrosomia, as well as neonatal infections and hyperbilirubinaemia were significantly higher. Obesity and maternal comorbidities, accounted for a higher rate of caesarean sections of up to 38.4% at a BMI ≥45. All differences were highly significant. Preconceptionally, the therapeutic approach should be weight reduction.

Prevenção primária de doenças cardiovasculares na obesidade infantojuvenil: efeito anti-inflamatório do exercício físico

A pandemia da obesidade juvenil e do sedentarismo está relacionada com o maior risco de doenças cardiovasculares no futuro. Ambas com fisiopatologia inflamatória, essas condições têm atraído significativa atenção científica. O início dos eventos que agridem o endotélio vascular pode ocorrer na infância, porém, sinais clínicos da aterosclerose geralmente só aparecem na fase adulta. O tecido adiposo é hoje reconhecido por seu papel ativo, induzindo a produção de citocinas pró e anti-inflamatórias, como o fator de necrose tumoral-alfa, as interleucinas 1, 6 e 10, a proteína C-reativa e outras. Há várias evidências de que os níveis sanguíneos dessas citocinas se encontram mais altos em indivíduos com excesso de peso, inclusive crianças e adolescentes. A prevenção precoce, desde a infância, apresenta-se como a melhor maneira de evitar os danos da obesidade na fase adulta, enquanto o potencial da prática regular de exercícios físicos tem se mostrado surpreendente. Sua ação anti-inflamatória se manifesta através de menores concentrações séricas de interleucina 6, de proteína C-reativa e leptina, além de aumentos na adiponectina. Observa-se escassez de estudos randomizados e controlados avaliando as relações entre obesidade, inflamação e exercícios para a população jovem. Com resultados às vezes controversos, a maioria das conclusões é procedentede estudos com adultos. O objetivo desta revisão é avaliar o papel anti-inflamatório, e assim cardioprotetor, da atividade física regular na obesidade infantojuvenil.

High Energy Digestion Efficiency and Altered Lipid Metabolism Contribute to Obesity in BFMI Mice

To constitute a valuable resource to identify individual genes involved in the development of obesity, a novel mouse model, the Berlin Fat Mouse Inbred line 860 (BFMI860), was established. In order to characterize energy intake and energy expenditure in obese BFMI860 mice, we performed two independent sets of experiments in male BFMI860 and B6 control mice (10 per line). In experiment 1, we analyzed body fat content noninvasively by dual-energy X-ray absorptiometry and measured resting metabolic rate at thermoneutrality (RMRt) and respiratory quotient (RQ) in week 6, 10, and 18. In a second experiment, energy digested (energy intake minus fecal energy loss) was determined by bomb calorimetry from week 6 through week 12. BFMI860 mice were heavier and had higher fat mass (final body fat content was 24.7% compared with 14.6% in B6). They also showed fatty liver syndrome. High body fat accumulation in BFMI860 mice was restricted to weeks 6-10 and was accompanied by hyperphagia, higher energy digestion, higher RQs, and abnormally high blood triglyceride levels. Lean mass-adjusted RMRt was not altered between lines. These results indicate that in BFMI860 mice, the excessive accumulation of body fat is associated with altered lipid metabolism, high energy intake, and energy digestion. Assuming that BFMI860 mice and their obese phenotypes are of polygenic nature, this line is an excellent model for the study of obesity in humans, especially for juvenile obesity and hyperlipidemia.

Fat feeding of rats during pubertal growth leads to neuroendocrine alterations in adulthood.

Juvenile obesity is a rising epidemic due largely to consumption of caloric dense, fat-enriched foods. Nevertheless, literature on fat-induced neuroendocrine and metabolic disturbances during adolescence, preceding obesity, is limited. This study aimed to examine early events induced by a fat diet (45% calories from saturated fat) in male rats fed the diet during the pre- and post-pubertal period. The neuroendocrine endpoints studied were the levels of circulating leptin, insulin and corticosterone, as well as their receptors in the hypothalamus and hippocampus. Hormonal levels were determined by radioimmunoassay and receptors' levels by western blot analysis. Leptinemia was increased in pubertal rats and in adult rats fed the fat diet from weaning to adulthood, but not in those fed from puberty to adulthood. Modifications in the developmental pattern from puberty to adulthood were observed for most of the brain receptors studied. In adult animals fed the fat diet from weaning onwards, the levels of leptin receptors in the hypothalamus and glucocorticoid receptors in the hippocampus were decreased compared to chow-fed controls. Switching from fat to normal chow at puberty onset restored the diet-induced alterations on circulating leptin, but not on its hypothalamic receptors. These data suggest that when a fat-enriched diet, resembling those consumed by many teenagers, provided in rats during pubertal growth, it can longitudinally influence the actions of leptin and corticosterone in the brain. The observed alterations at a preobese state may constitute early signs of the disturbed energy balance toward overweight and obesity.

O-4: Cloning and mutational analysis of the ob gene in juvenile onset obesity

O-4: Cloning and mutational analysis of the <i>ob</i> gene in juvenile onset obesity

Adipositas bei bayerischen Jugendlichen: Prävalenz im Trend, soziodemografische Strukturmerkmale und subjektive Gesundheit

The World Health Organization counts the increase in obesity as one of the most important public health challenges of the 21 (st) century. In Germany the prevention of obesity among children and adolescents currently holds a high priority on the political public health agenda. There is, however, relatively little empirical evidence for the development of obesity prevalence among adolescents. The objective of this work is to analyse data relating to juvenile obesity in Bavaria and to study its relevance for the health of adolescents. The basis for this work is a representative survey among adolescents in the age group 12-24 years. Available are data from three time periods (1995, 2000, 2005). The data were calculated descriptively as well as in relation to the impact of obesity on general health with multiple binary logistic regression analysis. The obesity prevalence among Bavarian adolescents of the age group 12-24 years has steadily increased from 1995 (2.1%) to 2000 (3.1%) and to 2005 (4%). The obesity prevalence grows with age; it shows a clear social gradient which has become stronger from 2000 to 2005. Obesity as well as the feeling of being overweight emerges from the regression analysis as independent factors influencing the general health. Data from medical checks at primary school enrolment in various German regions indicate that obesity in children of that age is no longer increasing. Among adolescents, however, obesity is still growing. This would recommend an age-specific monitoring of this development.