gms | German Medical Science

Introduction/Background: Epidemiologic studies have yielded conflicting results with respect to predictive factors of childhood obesity. Monitoring trends is important to inform public health policy. It is the aim of this study to analyse predictive factors and time trends in overweight and obesity from 1991 to 2000 in German children, and to test the hypothesis of a trend difference between East and West.

Material and methods: 35434 five to seven year-old children participated in cross-sectional studies between 1991 and 2000 in several rural and urban areas in East and West Germany. Weight and height were measured and BMI (body mass index) was calculated. International cut-off points were used to classify overweight and obesity. Predictive modelling was performed to analyse independently associated factors. Trend analyses for East and West were performed and a difference in trends was tested using logistic regression.

Results: Female sex, other than German nationality, smoking in the living place and increasing birth weight were found to increase the odds of overweight and obesity, while increasing educational level, living space >75m² and breastfeeding for more than three months were inversely associated, suggesting protective effects. From 1991 to 2000, the prevalence of overweight increased from 10,0% to 17,5% in the East and from 14,8% to 22,2% in the West. The prevalence of obesity increased from 2,1% to 5,7% in the East and from 3,6% to 7,6% in the West. There was no evidence for a trend difference between East and West.

Discussion/Conclusions: The transition process after Germany’s reunification has obviously resulted in a rapid adoption of a Western lifestyle in the East, as witnessed by increasing prevalences of overweight and obesity. The findings add to the evidence informing public health action, both through health promotion strategies (e.g. promoting breastfeeding) and wider societal change management (e.g. addressing children from migrant families).