Intergenerational educational mobility and obesity in adolescence: findings from the cross-sectional German KiGGS study

Aim

The objective of this study is to analyze the meaning of intergenerational educational transmission and intergenerational educational mobility on adolescents’ obesity risk. In particular, the paper investigates if upward social mobility is a protective factor against obesity for children of lower educated parents.

Subject and methods

Representative data was derived from a subsample (12–17 years, n?=?5,111) of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Body height and weight were measured in a standardized way. Obesity (>97th percentile) was defined due to the national reference system that is based upon percentiles of the body mass index (BMI). Intergenerational educational mobility was defined as: stable high (parents and participant have high education), potentially upwardly mobile (participant’s education is higher than parents’ education), potentially downwardly mobile (participant’s education is lower than parents’ education), and stable low (parents and participant have low education).

Results

The highest prevalence of obesity was found in adolescents with a stable low education, the lowest prevalence in adolescents with a stable high education. The educational gradient was steeper in girls than in boys. Compared to the “stable high” reference category, potentially upwardly mobile adolescents had no significant increased risk of obesity, while the risk for potentially downwardly mobile adolescents was only significant in girls (OR 2.32; 95 % CI 1.23–4.37). The obesity risk in boys and girls with a stable low education was significantly elevated (1.68; 1.04–2.73 and 3.06; 1.89–4.94).

Conclusion

Parental education and adolescents’ own educational status have cumulative effects on obesity risk. The fact that potentially upwardly mobile boys and girls are not more likely to be obese than adolescents with a stable high education and less often than adolescents with a stable low education can be interpreted as a protective effect of upward social mobility even though health selection might have played a role.     

临安市中学生自杀行为及态度相关性研究

目的：了解临安市中学生自杀行为发生情况,探讨自杀行为与自杀态度之间的关系,为预防干预提供依据。方法：采用分层整群随机抽样方法,对临安市6所中学6个年级36个班共1693名学生进行了问卷调查;并对数据进行描述性分析和统计推断。结果：1693名学生中有440人（26．0％）曾经有过自杀意念,有自杀意念的440人中46人（10．5％）有过自杀未遂行为。1693名学生中对自杀行为、自杀者、自杀者家属和安乐死持肯定或理解态度的学生分别占7．3％、26．4％、56．5％和25．30／00。多因素logistic回归分析显示,对自杀行为的态度、对自杀者的态度以及对安乐死的态度是产生自杀意念的重要影响因素。结论：自杀意念在临安市中学生中较为常见,对自杀行为持肯定支持者不在少数,预防中学生自杀行为应以健康教育及心理疏导为主。     

Predictors of overweight and obesity in five to seven-year-old children in Germany: Results from cross-sectional studies

Background  

Childhood obesity is a serious public health problem and epidemiological studies are important to identify predictive factors. It is the aim of this study to analyse factors associated with overweight/obesity in samples of German children.     

Age and time trends in sugar intake among children and adolescents: results from the DONALD study

To describe age and time trends in added sugar, free sugar and total sugar intake among German 3–18-year-olds. Overall, 10,761 3-day dietary records kept between 1985 and 2016 by 1312 DONALD participants (660 boys, 652 girls) were analysed (%E) using polynomial mixed-effects regression models. TS intake decreased with age (♂: linear, quadratic and cubic trend all p < 0.0098; ♀: linear trend p < 0.0001). While the oldest children had the lowest FS intake (linear, quadratic trend: p < 0.0001), the youngest children had the lowest AS intake (linear, quadratic trend p < 0.0001, cubic trend p = 0.0004). In terms of time trends, TS (♂: cubic trend p = 0.0052; ♀: quadratic trend p = 0.0608, cubic trend p = 0.0014) and FS (quadratic trend p = 0.0163, cubic trend p < 0.0001) intake increased between 1985 and 2005 and decreased thereafter, most notably since 2010. AS intake decreased between 1985 and 1995, increased slightly until 2005 and decreased thereafter, most notably since 2010 (linear, quadratic, cubic trend p < 0.0001). FS intake exceeded 10%E/day throughout the 30-year study period. Our results do not support the common assumptions that sugar intake is on the rise and generally higher among adolescents than among younger children. Of note, TS, AS and FS intakes have decreased in the last decade among all age groups. Nevertheless, FS intake still exceeds the intake level recommended by the WHO.     

Socio-economic inequalities in physical activity practice among Italian children and adolescents: a cross-sectional study

Aim  

The aim of the study was to evaluate whether socio-economic inequalities in the practice of physical activity existed among children and adolescents, using different indicators of socio-economic status (SES).     

Overweight and obesity at school entry among migrant and German children: a cross-sectional study

Background  

Overweight and obesity have become a global epidemic and are increasing rapidly in both childhood and adolescence. Obesity is linked both to socioeconomic status and to ethnicity among adults. It is unclear whether similar associations exist in childhood. The aim of the present study was to assess differences in overweight and obesity in migrant and German children at school entry.     

Cancer awareness among adolescents in Britain: a cross-sectional study

ABSTRACT: BACKGROUND: Little is known about adolescents' cancer awareness and help-seeking behaviour in Britain. This study assessed adolescents': awareness of cancer symptoms, common cancers, and the relationship between cancer and age; anticipated delay and perceived barriers to seeking medical advice; and examined variation by age, gender, ethnicity and whether individuals knew someone with cancer. METHODS: A survey was conducted using a modified paper version of the Cancer Awareness Measure (CAM). The sample included 478 adolescents (male: n=250, 52.3%) aged 11-17 years old (mean=13.8, SD=1.24) recruited from four British schools between August and October 2011. RESULTS: Adolescents' cancer awareness was low. Half of all adolescents did not know the most common childhood (51%) or teenage (49%) cancers and most (69%) believed cancer was unrelated to age. Awareness of cancer symptoms was significantly higher among older adolescents (aged 13-17 years) (p=0.003) and those who knew someone with cancer (p<0.001). Three-quarters (74%) of adolescents indicated they would seek help for a symptom they thought might be cancer within 3 days, and half (48%) within 24 hours. The most endorsed barriers to help-seeking were 'worry about what the doctor might find' (72%), being 'too embarrassed' (56%), 'too scared' (54%) and 'not feeling confident to talk about symptoms' (53%). Endorsement of these emotional barriers was significantly higher among females (p[less than or equal to]0.001). CONCLUSION: There are certain groups of adolescents with poor cancer awareness. Cancer messages need to be targeted and tailored to particular groups to prevent the emergence of health inequalities in adulthood. Interventions to raise adolescents' cancer awareness have the potential for a life-long impact on encouraging early diagnosis and survival.     

Seasonal variation in objectively assessed physical activity among children and adolescents in Norway: a cross-sectional study

Background  

The literature on seasonality in children and youth's physical activity participation is inconsistent. The aims of this study were to: 1) compare physical activity across seasons and describe activity patterns within seasons, and 2) to determine compliance with current physical activity recommendations across seasons among 9- and 15-year-olds living in a climatically diverse country.     

Relations between obesity and hypertension: preliminary data from a cross-sectional study in primary schoolchildren: the children study

OBJECTIVE: To record the prevalence of overweight, obesity and hypertension in primary schoolchildren living in one of the poorest regions in Europe and furthermore to identify certain behavioural, lifestyle and physiological parameters associated with body mass index (BMI) and blood pressure (BP). DESIGN: Cross-sectional study. SETTING: Nineteen primary schools within the county of Ioannina, Greece. SUBJECTS AND METHODS: Demographic, dietary and physical activity data as well as anthropometrical, BP and cardiorespiratory fitness measurements were obtained from a representative sample of 312 school children (153 boys and 159 girls) attending 5th grade. Inclusion of subjects in the study was voluntary. One-way analysis of variance and multiple linear regression analysis were mainly applied for the evaluation of the tested hypotheses. RESULTS: The prevalence of overweight and obesity was 29.4 and 11.8% for boys and 39.0 and 7.5% for girls. The prevalence of systolic and diastolic hypertension was 28.1 and 7.8% for boys and 26.4 and 17.0% for girls. Furthermore, BMI and BP (systolic and diastolic) were positively related to frequency of fast food meals (rho: + 0.28, P = 0.033, rho: + 1.09, P = 0.03 and rho: +0.86, P = 0.014, respectively) but negatively to leisure time physical activity (rho: -5.55, P = 0.005, rho: -3.32 x 10(-2), P < 0.001 and rho: -2.08 x 10(-2), P < 0.001, respectively). CONCLUSIONS: The current study revealed an increased prevalence of overweight, obesity and hypertension among schoolchildren in Ioannina, indicating the need for early preventive measures in one of the less privileged regions of Europe.     

Prevalence and determinants of chronic malnutrition among preschool children: a cross-sectional study in Dhaka City, Bangladesh

Chronic malnutrition is one of the major causes of morbidity and mortality among preschool children and the future productivity of nations. To understand the prevalence of chronic malnutrition and to identify the factors affecting height-for-age z-score (HAZ) among preschool children, a cross-sectional study was conducted among 380 randomly-selected children aged less than five years in Dhaka city, Bangladesh. Results of analysis of this study data revealed that the prevalence of stunting among preschool children in Dhaka city was 39.5%, with 25% severely stunted and 14% moderately stunted (p<0.001). Results of bivariate analysis revealed that socioeconomic and demographic factors were most significantly associated with the stunting of children. Children were found to be well-nourished if their parents had a tertiary-level education or higher and if the mother held a job and had good knowledge of nutrition. Well-nourishment of the children were also associated with the height of mothers (above 148 cm), good family educational background, normal birthweight, greater frequency of food intake (more than six times/day), and fewer fever episodes in the last six months. Results of multivariate linear regression models showed that height of mothers, birthweight of children, education of fathers, knowledge of mothers on nutrition, and frequency of feeding were the most significant factors that had an independent and direct influence on the stunting of children. To achieve the Millennium Development Goal target of 34% malnutrition prevalence by 2015, it is important to have specific government intervention to focus on the causes that directly influence the stunting of children.     

Educational, economic and dietary determinants of obesity in Portuguese adults: a cross-sectional study

In industrialized countries, studies have shown that lower socioeconomic status is generally associated with higher rates of obesity. Furthermore, poorer eating habits with insufficient intake of low energy-dense and micronutrient rich foods may increase the risk of obesity. The aim of this study was to evaluate the importance of educational, economic and dietary factors in determining obesity risk in a representative sample of the Portuguese general adult population. Study design was cross-sectional in a representative sample of Portuguese adults (20,977 women and 18,663 men). Participants were distributed in categories according to years of education (< or =4, 5-9, 10-12, and >12), income (< or =314 euros, 315-547 euros, 548-815 euros, and >815 euros), and dietary intake (vegetable soup, vegetable, fruit, bread and starchy foods). Logistic regression models were fitted to estimate the magnitude of the association between obesity and education/income, and food groups, adjusting for confounders. In women and men, the odds favouring obesity decreased with increasing education (p-value for trend <0.001) being the odds ratios, respectively, 0.19 (0.14-0.27), and 0.40 (0.30-0.54) for those having >12 years of education compared to those with < or =4 years vegetable; soup consumption also decreased the risk of obesity in both genders (odds ratios were very similar in women and men, being respectively, 0.86 and 0.89). The odds favouring obesity in women also decreased with consumption of fruit and starchy foods, being the odds ratios, respectively, 0.77 (0.64-0.92), and 0.65 (0.55-0.78). In conclusion, educational attainment and vegetable intake decreased significantly the risk of obesity in Portuguese adults from both genders; fruits and starchy foods consumption also decreased the risk of obesity in women.     

Sero-epidemiology of measles-specific IgG antibodies and predictive factors for low or missing titres in a German population-based cross-sectional study in children and adolescents (KiGGS)

Background and objective

In the European Region, measles elimination is now targeted to 2015. To measure progress towards elimination age-group specific susceptibility targets have been defined. Age-specific measles susceptibility in children and adolescents was evaluated in Germany. Taking into account a broad range of socio-demographic, health- and vaccination status related variables, populations for vaccination campaigns were identified.

Method

We analysed data from children aged 1-17 years in the representative German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Measles immunoglobulin G antibodies were measured in 13,977 participants by enzyme immunoassay (ELISA). Bivariate and multivariate logistic regression analyses were used to determine parental and infant related factors associated with measles susceptibility.

Results

The overall prevalence of seronegativity in children tested for measles IgG aged 1-17 years was 10.0% (95% CI 9.4-10.7). The prevalence of seronegativity in the German population was below the WHO targets for measles elimination in children aged 2-9 year-olds but exceeded the target for 10-17 year-olds. Age differences in the level of seronegativity were found to be mainly due to differences in vaccination coverage. A higher level of susceptibility was observed if parents did not comply with the request to present the child's vaccination card. In vaccinated children, immigration, male gender, very young age at first vaccination and a longer time period since last vaccination were associated with a higher level of susceptibility.

Conclusion

Further increase of the two-dose vaccination coverage is necessary in order to achieve the WHO targets. Catch up vaccination campaigns should focus on adolescents and immigrants.     

Influence of the family nucleus on obesity in children from northeastern Brazil: a cross-sectional study

Background  

Obesity is considered to be caused by a combination of heredity and environmental factors with typical onset during childhood. The aim of this study was to identify family risk factors for the development of obesity in children from Brazil.     

Social determinants of disparities in weight among US children and adolescents

PurposeTo explore whether contextual variables attenuate disparities in weight among 18,639 US children and adolescents aged 2 to 18 years participating in the National Health and Nutrition Examination Survey, 2001 to 2010.MethodsDisparities were assessed using the Symmetrized Rényi Index, a new measure that summarizes disparities in the severity of a disease, as well as the prevalence, across multiple population groups. Propensity score subclassification was used to ensure covariate balance between racial and ethnic subgroups and account for individual-level and contextual covariates.ResultsBefore propensity score subclassification, significant disparities were evident in the prevalence of overweight and/or obesity and the degree of excess weight among overweight/obese children and adolescents. After propensity score subclassification, racial/ethnic disparities in the prevalence and severity of excess weight were completely attenuated within matched groups, indicating that racial and ethnic differences were explained by social determinants such as neighborhood socioeconomic and demographic factors.ConclusionsThe limited overlap in covariate distributions between various racial/ethnic subgroups warrants further attention in disparities research. The attenuation of disparities within matched groups suggests that social determinants such as neighborhood socioeconomic factors may engender disparities in weight among US children and adolescents.     

我国儿童青少年睡眠不足与肥胖的关联性研究

目的 分析我国9～18岁汉族儿童青少年睡眠不足与肥胖和中心性肥胖的关系。方法 选取参加2014年全国学生体质与健康调研的睡眠时间和体格检查资料完整的172 710名学生作为研究对象。根据美国睡眠医学学会推荐睡眠量判定睡眠不足，依照中国肥胖问题工作组和我国卫生行业标准判定儿童青少年肥胖和中心性肥胖。采用t检验或χ²检验比较组间差异。采用logistic回归分析睡眠不足与肥胖和中心性肥胖的关系。结果 2014年我国9～18岁汉族儿童青少年睡眠不足人数为133 410人（77.2%），肥胖学生有11 145人（6.5%），中心性肥胖检出人数为12 603人（17.8%）。睡眠不足学生中肥胖者有8 358人（6.3%），中心性肥胖者有12 244人（17.9%）。睡眠不足者中肥胖和中心性肥胖检出率男生高于女生。小学生睡眠不足肥胖和中心性肥胖检出率最高。控制潜在的混杂因素后，与睡眠充足组学生相比，睡眠不足组学生发生肥胖的风险增加14.5%（OR=1.145， 95% CI：1.092～1.200），发生中心性肥胖的风险增加12.7%（OR=1.127，95% CI：1.078～1.178）。与每日睡眠时间<6 h者相比，每天睡眠时间7～10 h可明显降低学生肥胖和中心性肥胖的发生风险。结论 睡眠不足可显著增加儿童青少年肥胖和中心性肥胖的发生风险，保障学生每日7～10 h的充足睡眠可降低肥胖和中心性肥胖的发生风险。     

青少年不良行为的现况研究

目的：了解开化县青少年不良行为的相关情况。方法通过多阶段整群随机抽样方法,采用自我管理式问卷方法对开化县10所中学,17个班级的741名初一至高三的中学生进行集中调查。结果开化县中学生中感觉自身健康状况好或非常好占46.96％,15.38％有自杀意念,2.29％有自杀行为。34.55％有吸烟史,9.45％从不吃早餐,46.15％有喝牛奶的习惯,仅有50.88％吃东西之前洗手,60.32％便后洗手,88.08％有刷牙习惯,5.24％没有进行过60 min以上高强度体育活动,上网主要是玩游戏和聊天,艾滋病传播途径知晓率59.32％。暴力行为率11.47％,校园暴力行为率8.91％,有校园被偷经历占18.08％,回答有性行为的占3.37％。结论青少年中,吸烟、上网玩游戏、校园暴力、卫生习惯差等不良行为存在,应针对性地加强青少年素质教育。     

Physical activity in sports clubs of children and adolescents in Germany: results from a nationwide representative survey

Aim

A substantial proportion of children’s and adolescent’s physical activity takes place in organised sports clubs in Germany. The purpose of this study was to describe (1) the proportion of children and adolescents who are members of sports clubs and the amount of moderate to vigorous physical activity (MVPA) performed in these clubs, and to identify socio-demographic predictors of (2) membership and (3) the amount of MVPA in sports clubs in Germany.

Subjects and methods

The sample consisted of 4,529 boys (50.5 %) and girls (49.5 %) aged between 4 and 17 years (M?=?11.3; SD?=?4.1). MVPA was assessed by a questionnaire. Socioeconomic status, immigration background, and residential area were assessed using a parent questionnaire.

Results

52.0 % of the girls and 63.1 % of the boys were members in sports clubs who exercised on average for 4 h per week with moderate to high intensity. The logistic regression analyses showed that gender, socioeconomic status, migration background and residential area were significant predictors of membership in sports clubs. The amount of MVPA was only significantly predicted by age, gender and residential area.

Conclusion

The results of this study imply that sports clubs have a high potential for implementation of strategies to increase general levels of physical activity.