Background
Methods
Study design
Outcome variables: overweight and obesity
Exposure variables
Nationality of the child
Education
Living space > 75 m2
Number of persons living in the child's living place
Single child
Attendance of day nursery or being otherwise looked after
Smoking in the living place
Passive smoking during the first three years of life
Smoking during pregnancy
Breastfeeding for more than three months
Preterm delivery
Birth weight
Year of study
Study region
Study location
Statistical analysis
Results
Characteristic | Mean | SD |
---|---|---|
Age [years] | 6.28 | 0.34 |
Weight [kg] | 22.85 | 4.11 |
Height [cm] | 120.05 | 5.53 |
BMI [kg/m2] | 15.77 | 2.03 |
No of persons in the child's living place (N = 34,997) | 3.91 | 1.06 |
N
|
%
| |
Overweight | 35,434 | 15.48 |
Obese | 35,434 | 4.33 |
Male sex | 35,434 | 50.89 |
Age group | 35,434 | |
5.0 – < 5.5 years | 0.23 | |
5.5 – < 6.0 years | 23.98 | |
6.0 – < 6.5 years | 47.91 | |
6.5 – < 7.0 years | 26.15 | |
7.0 – < 7.5 years | 1.42 | |
7.5 – < 8.0 years | 0.32 | |
German nationality | 35,146 | 92.22 |
Study region: East | 35,434 | 67.73 |
Study location: Urban | 35,434 | 76.14 |
Parental educational level: | 33,984 | |
< 10 years of schooling | 11.48 | |
10 years of schooling | 44.82 | |
> 10 years of schooling | 43.69 | |
Living space > 75 m2
| 34,095 | 49.51 |
Single child | 34,997 | 33.86 |
Attendance of day nursery | 33,826 | 56.49 |
Smoking in the living place | 33,208 | 45.00 |
Passive smoking during the first 3 years of life | 34,693 | 31.95 |
Smoking during pregnancy | 34,578 | 13.72 |
Breastfeeding > 3 months | 33,106 | 31.63 |
Preterm delivery | 34,540 | 6.45 |
Birth weight | 34,809 | |
< 2500 g | 5.76 | |
2500 – < 3000 | 17.00 | |
3000 – < 3500 | 38.32 | |
3500 – < 4000 | 29.45 | |
> 4000 | 9.47 |
Univariate associations
Variables | Prevalence of overweight (%) | P value | Odds Ratio [OR] |
---|---|---|---|
Sex | |||
Male | 13.77 (N = 18,032) | < 0.0001 | Female vs Male 1.31 (1.23–1.38) |
Female | 17.25 (N = 17,402) | ||
Age group | |||
5.0 – < 5.5 | 17.50 (N = 80) | 0.02 | Per unit increase in age group: 1.04 (1.00 – 1.08) |
5.5 – < 6.0 | 14.53 (N = 8,498) | ||
6.0 – < 6.5 | 15.77 (N = 16,977) | ||
6.5 – < 7.0 | 15.92 (N = 9,265) | Per unit increase in age: 1.12 (1.03 – 1.22) | |
7.0 – < 7.5 | 12.35 (N = 502) | ||
7.5 – < 8.0 | 18.75 (N = 112) | ||
Nationality | |||
German | 14.85 (N = 32,413) | < 0.0001 | Other than German vs German 1.68 (1.52 – 1.84) |
Other than German | 22.61 (N = 2,733) | ||
Study region | |||
East | 14.34 (N = 23,998) | < 0.0001 | East vs West 0.77 (0.72–0.82) |
West | 17.87 (N = 11,436) | ||
Study location | |||
Urban | 15.86 (N = 26,981) | 0.0004 | Urban vs Rural 1.13 (1.06–1.22) |
Rural | 14.26 (N = 8,453) | ||
Parental educational level | |||
< 10 years of schooling | 19.43 (N = 3,902) | < 0.0001*** | Per unit increase in educational level 0.79 (0.75–0.82) |
10 years of schooling | 16.29 (N = 15,233) | 0.81 (0.74–0.88)* | |
> 10 years of schooling | 13.13 (N = 14,849) | 0.63 (0.57–0.69)* | |
Living space | |||
<= 75 m2
| 16.74 (N = 17,213) | < 0.0001 | >75 m2 vs <= 75 m2 0.82 (0.77 – 0.87) |
> 75 m2
| 14.13 (N = 16,882) | ||
No. of persons in the child's living place | < 0.0001 *** | Per unit increase in no. of persons: 0.91 (0.88–0.94) | |
Single child | |||
No | 14.42 (N = 23,148) | < 0.0001 | Yes vs No: 1.26 (1.19 – 1.34) |
Yes | 17.49 (N = 11,849) | ||
Attendance of day nursery | |||
No | 15.87 (N = 14,718) | 0.02 | Yes vs No: 0.93 (0.88 – 0.99) |
Yes | 14.98 (N = 19,108) | ||
Smoking in the living place | |||
No | 14.14 (N = 18,266) | < 0.0001 | Yes vs No: 1.28 (1.21–1.36) |
Yes | 17.45 (N = 14,942) | ||
Passive smoking during the first three years of life | |||
No | 14.74 (N = 11,084) | < 0.0001 | Yes vs No: 1.17 (1.10 – 1.25) |
Yes | 16.84 (N = 23,609) | ||
Smoking during pregnancy | |||
No | 15.04 (N = 29,833) | < 0.0001 | Yes vs No: 1.26 (1.16 – 1.36) |
Yes | 18.19 (N = 4,745) | ||
Breastfeeding for more than three months | |||
No | 15.79 (N = 22,634) | < 0.0001 | Yes vs No: 0.86 (0.81 – 0.92) |
Yes | 13.94 (N = 10,472) | ||
Preterm delivery | |||
No | 15.63 (N = 32,313) | 0.01 | Yes vs No: 0.85 (0.75 – 0.96) |
Yes | 13.56 (N = 2,227) | ||
Birth weight | |||
< 2500 g | 9.77 (N = 2,006) | < 0.0001*** | Per unit increase in birth weight category 1.31 (1.27 – 1.35) |
2500 – < 3000 g | 11.92 (N = 5,916) | 1.25 (1.06 – 1.48)** | |
3000 – < 3500 g | 14.12 (N = 13,340) | 1.52 (1.30 – 1.77)** | |
3500 – < 4000 g | 17.58 (N = 10,251) | 1.97 (1.69 – 2.30)** | |
> 4000 g | 24.09 (N = 3,296) | 2.93 (2.48 – 3.47)** |
Variables | Prevalence of obesity (%) | P value | Odds Ratio [OR] |
---|---|---|---|
Sex | |||
Male | 4.01 (N = 18,032) | 0.003 | Female vs Male 1.17 (1.06–1.30) |
Female | 4.66 (N = 17,402) | ||
Age group | |||
5.0 – < 5.5 | 2.50 (N = 80) | 0.18 | Per unit increase in age group: 0.96 (0.90–1.03) |
5.5 – < 6.0 | 4.55 (N = 8,498) | ||
6.0 – < 6.5 | 4.37 (N = 16,977) | ||
6.5 – < 7.0 | 4.04 (N = 9,265) | Per unit increase in age: 1.00 (0.86–1.16) | |
7.0 – < 7.5 | 3.98 (N = 502) | ||
7.5 – < 8.0 | 8.04 (N = 112) | ||
Nationality | |||
German | 4.04 (N = 32,413) | < 0.0001 | Other than German vs German 1.95 (1.68 – 2.28) |
Other than German | 7.61 (N = 2,733) | ||
Study region | |||
East | 3.88 (N = 23,998) | < 0.0001 | East vs West 0.73 (0.66–0.81) |
West | 5.26 (N = 11,436) | ||
Study location | |||
Urban | 4.53 | 0.001 | Urban vs Rural 1.24 (1.09–1.41) |
Rural | 3.69 | ||
Parental educational level | |||
< 10 years of schooling | 6.23 (N = 3,902) | < 0.0001 *** | Per unit increase in educational level 0.68 (0.63 – 0.73) |
10 years of schooling | 4.87 (N = 15,233) | 0.77 (0.66 – 0.90)* | |
> 10 years of schooling | 3.06 (N = 14,849) | 0.48 (0.41 – 0.56)* | |
Living space | |||
<= 75 m2
| 4.92 (N = 17,213) | > 75 m2 vs <= 75 m2 0.75 (0.67–0.83) | |
> 75 m2
| 3.73 (N = 16,882) | ||
Number of persons in the child's living place | < 0.0001 *** | Per unit increase in no of persons: 0.90 (0.86–0.95) | |
Single child | |||
No | 3.95 (N = 23,148) | < 0.0001 | Yes vs No: 1.30 (1.17–1.45) |
Yes | 5.08 (N = 11,849) | ||
Attendance of day nursery | |||
No | 4.59 (N = 14,718) | 0.01 | Yes vs No: 0.88 (0.79–0.98) |
Yes | 4.05 (N = 19,108) | ||
Smoking in the living place | |||
No | 3.65 (N = 18,266) | < 0.0001 | Yes vs No: 1.46 (1.32–1.63) |
Yes | 5.25 (N = 14,942) | ||
Passive smoking during the first three years of life | |||
No | 3.92 (N = 23,609) | < 0.0001 | Yes vs No: 1.33 (1.19 – 1.48) |
Yes | 5.14 (N = 11,084) | ||
Smoking during pregnancy | |||
No | 4.06 (N = 29,833) | < 0.0001 | Yes vs No: 1.47 (1.29 – 1.68) |
Yes | 5.86 (N = 4,745) | ||
Breastfeeding for more than three months | |||
No | 4.48 (N = 22,634) | < 0.0001 | Yes vs No: 0.76 (0.68 – 0.86) |
Yes | 3.46 (N = 10,472) | ||
Preterm delivery | |||
No | 4.42 (N = 32,313) | < 0.001 | Yes vs No: 0.64 (0.50 – 0.83) |
yes | 2.87 (N = 2,227) | ||
Birth weight | |||
< 2500 g | 1.94 (N = 2,006) | < 0.0001*** | Per unit increase in birth weight category 1.35 (1.28 – 1.42) |
2500 – < 3000 g | 3.26 (N = 5,916) | 1.70 (1.20 – 2.41)** | |
3000 – < 3500 g | 3.91 (N = 13,340) | 2.05 (1.48 – 2.85)** | |
3500 – < 4000 g | 4.88 (N = 10,251) | 2.59 (1.86 – 3.59)** | |
> 4000 g | 7.62 (N = 3,296) | 4.16 (2.95 – 5.85)** |
Multivariable models for overweight and obesity
Overweight OR (95% CI) | Obesity OR (95% CI) | |
---|---|---|
Female Sex | 1.45 (1.35–1.55) | 1.30 (1.15–1.47) |
Age | 1.05 (0.95–1.17) | 0.86 (0.72–1.04) |
Other than German nationality | 1.52 (1.39–1.84) | 1.60 (1.26–2.03) |
Study region (East/West) | 0.96 (0.87–1.06) | 1.02 (0.86–1.22) |
Study location (urban/rural) | 0.97 (0.90–1.06) | 1.08 (0.92–1.26) |
Study year | 1.06 (1.05–1.08) | 1.10 (1.07–1.12) |
Educational level* | 0.87 (0.82–0.92) | 0.80 (0.73–0.89) |
Living space > 75 m2
| 0.86 (0.80–0.93) | 0.80 (0.69–0.92) |
Number of persons | 0.91 (0.86–0.96) | 0.91 (0.83–1.00) |
Single child | 1.16 (1.04–1.29) | 1.13 (0.93–1.37) |
Attendance of day nursery | 0.97 (0.90–1.05) | 0.87 (0.76–1.01) |
Smoking in the living place | 1.32 (1.21–1.43) | 1.46 (1.26–1.70) |
Passive smoking during the first three years of life | 1.02 (0.94–1.11) | 1.13 (0.98–1.32) |
Smoking during pregnancy | 1.11 (1.00–1.23) | 1.13 (0.95–1.36) |
Breastfeeding for more than three months | 0.88 (0.81–0.95) | 0.82 (0.71–0.95) |
Preterm delivery | 1.53 (1.30–1.80) | 1.16 (0.84–1.62) |
Birth weight** | 1.43 (1.38–1.49) | 1.49 (1.39–1.59) |
Association of predicted probabilities and observed responses (p-value***) | 0.15 | 0.53 |