OBJECTIVE: Calculation of attributable risks (ARs) of childhood overweight
to estimate effectiveness of prevention strategies.
METHODS: We used pooled data of 4 population-based German studies
including 34 240 children and adolescents aged 3 to 18 years to
calculate the impact of familial, social, “early life”, and lifestyle
factors on overweight. ARs (joint for all determinants as well as
partial risks) were calculated.
RESULTS: The prevalence of childhood overweight was 13.4%. Successfully
tackling all determinants can reduce overweight by 77.7% (ie,
from 13.4% to 3.0%; = joint AR) with partial effects of treating parental
overweight (42.5%); improving social status (14.3%); reducing media
time to ,1 hour per day (11.4%); and not smoking during pregnancy,
low weight gain during pregnancy, and breastfeeding (together 9.5%),
respectively. Improving all preventable risk factors (ie, early life factors
and lifestyle) the effect is 9.2%. Media time has the strongest
effect.
CONCLUSIONS: The determinants identified explained 78% of the prevalence
of overweight. Taking into account the partial ARs, the effectiveness
of lifestyle interventions to prevent overweight in children is
limited. Our data argue in favor of interventions aimed at families
and social environments, with a major focus on promoting a lower
screen time and computer use in children. Pediatrics 2012;130:
e865–e871
OBJECTIVE: Calculation of attributable risks (ARs) of childhood overweight
to estimate effectiveness of prevention strategies.
METHODS: We used pooled data of 4 population-based German studies
including 34 240 children and adolescents aged 3 to 18 years to
calculate the impact of familial, social, “early life”, and lifestyle
factors on overweight. ARs (joint for all determinants as well as
partial risks) were calculated.
RESULTS: The prevalence of childhood overweight was 13.4%. Successfully
tackling all determinants can reduce overweight by 77.7% (ie,
from 13.4% to 3.0%; = joint AR) with partial effects of treating parental
overweight (42.5%); improving social status (14.3%); reducing media
time to ,1 hour per day (11.4%); and not smoking during pregnancy,
low weight gain during pregnancy, and breastfeeding (together 9.5%),
respectively. Improving all preventable risk factors (ie, early life factors
and lifestyle) the effect is 9.2%. Media time has the strongest
effect.
CONCLUSIONS: The determinants identified explained 78% of the prevalence
of overweight. Taking into account the partial ARs, the effectiveness
of lifestyle interventions to prevent overweight in children is
limited. Our data argue in favor of interventions aimed at families
and social environments, with a major focus on promoting a lower
screen time and computer use in children. Pediatrics 2012;130:
e865–e871
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