PT Unknown
AU Gätjens, I
TI Impact of socioeconomic status and early growth patterns on overweight and obesity in children and adolescents of the Kiel Obesity Prevention Study (KOPS)
PY 2021
PU Christian-Albrechts-Universität zu Kiel
WP https://macau.uni-kiel.de/receive/macau_mods_00001408
LA en
DE overweight; obesity; children; adolescents; prevention
AB Childhood overweight and obesity have been steadily increasing over the last 50 years and belong to the most important public health challenges of the early 21st century. The manifestation of overweight and obesity is associated with many chronic diseases in later life. Obesity is described as a complex, multifactorial disease determined by genetic, behavioral, socioeconomic and environmental factors. The knowledge about interacting factors and mechanism are still insufficient and of particular importance for future prevention strategies. The socioeconomic status (SES) has been identified as a major determinant for the development of overweight and obesity, with the highest prevalence rates observed in children and adolescents with low SES. Our mediation analyses aimed to gain further insight into the mechanistic pathways that link socioeconomic inequalities to increased rates of overweight and obesity in 5 to 16-year-old children and adolescents. Consistent for both sexes, the relationship between SES and fat mass (FM) was fully (5-7 and 9-11 years) or partly (13-16 years) mediated by parental body mass index (BMI), parental smoking habits, children’s and adolescents ́ media consumption and physical activity as well as shared meals within families. Overall, these variables resulted in a total mediating effect of 77.8% (5-7 years), 82.4% (9-11 years), and 70.6% (13-16 years). Our results may reveal targets for future obesity prevention in socially disadvantaged individuals and indicate that interventions require changes of an unfavorable lifestyle within the family environment as well as high levels of parental involvement. There is also compelling evidence that fetal life and infancy are critical periods that impact obesity and health risks during the later life-course. It can be assumed that early growth patterns resulting in extreme birth weights and postnatal disproportionate weight gain lead to long-term metabolic adaptations resulting in an unfavorable partitioning of fat and lean tissues. In our study, a disproportionately high or low FM or fat free mass (FFM) in 5 to 7-year-old children with small or large for gestational age birth weights (SGA, LGA) was therefore evaluated by comparison with children born appropriate for gestational age (AGA) of the same BMI using Hattori`s body composition charts. Our results revealed that SGA-children were associated with a higher FFM per BMI, whereas FM per BMI was normal. LGA-children had a low FFM per BMI and, thus, an early manifestation of sarcopenic obesity. The understanding of obesity as metabolic disease, that is programmed through epigenetic plasticity during early development can substantially extend the previous focus beyond the obvious areas of excess high-caloric intake and sedentary lifestyle and creates the potential for effective approaches to disease prevention and the optimization of maternal and child health.
PI Kiel
ER