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Original Article

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Sociocultural Influence on Obesity and Lifestyle in Children: A Study of Daily Activities, Leisure Time Behavior, Motor Skills, and Weight Status

Hilpert M.a · Brockmeier K.b, c · Dordel S.d · Koch B.a, e · Weiß V.f · Ferrari N.a, c · Tokarski W.g · Graf C.a, c

Author affiliations

aInstitute of Movement and Neurosciences, German Sport University, Cologne, Germany; bPediatric Cardiology, Heart Center, University Hospital of Cologne, Cologne, Germany; cCologne Center of Prevention in Childhood and Adolescence, Heart Center, University Hospital of Cologne, Cologne, Germany; dInstitute of School Sports and School Development, German Sport University, Cologne, Germany; eBremen-City Center for Obesity Therapy (ZABS), Bremen, Germany; fInstitute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany; gInstitute of European Sport Development and Leisure Studies, German Sport University, Cologne, Germany

Corresponding Author

Prof. Dr. Dr. Christine Graf

Institute of Movement and Neurosciences

German Sport University, Cologne

Am Sportpark Müngersdorf 6, 50933 Köln, Germany

c.graf@dshs-koeln.de

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Obes Facts 2017;10:168-178

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Abstract

Background: Juvenile overweight is increasing, and effective preventive measures are needed. After years of arbitrarily assigning these measures disregarding socioeconomic and/or cultural differences, it has become necessary to tailor interventions more specific to these target groups. Providing data for such an intervention is the objective of this study. Methods: Influencing variables on children's weight status, motor skills and lifestyle have been analyzed among 997 first graders (53.2% male) involved in the Children's Health InterventionaL Trial (CHILT). Results: Median age was 6.9 years; 7.3% were obese, 8.8% were overweight. Children with low socioeconomic status (SES) were more likely to be obese (p = 0.029). Low SES (p ˂ 0.001), migration background (p = 0.001) and low sports activity levels (p = 0.007) contributed most to an increased consumption of television. Migration background (p = 0.003) and male gender (p < 0.001) were the strongest factors in predicting a greater consumption of computer/video games. Children with higher SES (p = 0.02), lower BMI (p = 0.035), and males (p = 0.001) performed better in motor tests. Conclusion: Children with a low SES and migration background were more likely to exhibit unfavorable health behavior patterns, higher BMI scores, and poorer motor skills. Interventions should integrate motivational and targeting strategies and consider cultural and educational differences to address these vulnerable groups.

© 2017 The Author(s) Published by S. Karger GmbH, Freiburg


References

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  3. Lampert T, Sygusch R, Schlack R: Use of electronic media in adolescence. Results of the German health interview and examination survey for children and adolescents (KIGGS) (in German). Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 2007;50:643-652.
  4. Lampert T, Mensink GB, Romahn N, Woll A:Physical activity among children and adolescents in Germany. Results of the German health interview and examination survey for children and adolescents (KIGGS) (in German). Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 2007;50:634-642.
  5. Marshall SJ, Biddle SJ, Gorely T, Cameron N, Murdey I: Relationships between media use, body fatness and physical activity in children and youth: a meta-analysis. Int J Obes Relat Metab Disord 2004;28:1238-1246.
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    External Resources
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  31. Colquitt JL, Loveman E, O'Malley C, Azevedo LB, Mead E, Al-Khudairy L, Ells LJ, Metzendorf MI, Rees K: Diet, physical activity, and behavioural interventions for the treatment of overweight or obesity in preschool children up to the age of 6 years. Cochrane Database Syst Rev 2016;3:CD012105.
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    External Resources
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  34. Lange D, Plachta-Danielzik S, Landsberg B, Muller MJ: Social inequality, migration, and healthy environments as determinants of overweight of children and adolescents. Results of the Kiel Obesity Prevention Study (KOPS) (in German. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 2010;53:707-715.
  35. Nagel G, Wabitsch M, Galm C, Berg S, Brandstetter S, Fritz M, Klenk J, Peter R, Prokopchuk D, Steiner R, Stroth S, Wartha O, Weiland SK, Steinacker J: Determinants of obesity in the Ulm Research on Metabolism, Exercise and Lifestyle in Children (URMEL-ICE). Eur J Pediatr 2009;168:1259-1267.
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Article / Publication Details

First-Page Preview
Abstract of Original Article

Received: December 21, 2016
Accepted: February 09, 2017
Published online: May 20, 2017
Issue release date: June 2017

Number of Print Pages: 11
Number of Figures: 0
Number of Tables: 0

ISSN: 1662-4025 (Print)
eISSN: 1662-4033 (Online)

For additional information: https://www.karger.com/OFA

References

  1. Pate RR, Mitchell JA, Byun W, Dowda M: Sedentary behaviour in youth. Br J Sports Med 2011;45:906-913.
  2. Sisson SB, Church TS, Martin CK, Tudor-Locke C, Smith SR, Bouchard C, Earnest CP, Rankinen T, Newton RL, Katzmarzyk PT: Profiles of sedentary behavior in children and adolescents: the US National Health and Nutrition Examination Survey, 2001-2006. Int J Pediatr Obes 2009;4:353-359.
  3. Lampert T, Sygusch R, Schlack R: Use of electronic media in adolescence. Results of the German health interview and examination survey for children and adolescents (KIGGS) (in German). Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 2007;50:643-652.
  4. Lampert T, Mensink GB, Romahn N, Woll A:Physical activity among children and adolescents in Germany. Results of the German health interview and examination survey for children and adolescents (KIGGS) (in German). Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 2007;50:634-642.
  5. Marshall SJ, Biddle SJ, Gorely T, Cameron N, Murdey I: Relationships between media use, body fatness and physical activity in children and youth: a meta-analysis. Int J Obes Relat Metab Disord 2004;28:1238-1246.
  6. Graf C, Dordel S: Therapy of juvenile obesity from the sports medicine/science viewpoint (in German). Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 2011;54:541-547.
  7. Data Resource Center for Child and Adolescent Health: Child and Adolescent Health Measurement Initiative. 2007 National Survey of Children's Health. www.childhealthdata.org/browse/survey?s=2 (last accessed April 27, 2017).
  8. Ahrens W, Pigeot I, Pohlabeln H, De Henauw S, Lissner L, Molnar D, Moreno LA, Tornaritis M, Veidebaum T, Siani A, consortium I: Prevalence of overweight and obesity in European children below the age of 10. Int J Obes (Lond) 2014;38(suppl 2):S99-107.
  9. Kurth BM, Schaffrath Rosario A: The prevalence of overweight and obese children and adolescents living in Germany. Results of the German health interview and examination survey for children and adolescents (KIGGS) (in German). Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 2007;50:736-743.
  10. Kleiser C, Schaffrath Rosario A, Mensink GB, Prinz-Langenohl R, Kurth BM: Potential determinants of obesity among children and adolescents in Germany: Results from the cross-sectional KIGGS study. BMC Public Health 2009;9:46.
  11. Yach D, Stuckler D, Brownell KD: Epidemiologic and economic consequences of the global epidemics of obesity and diabetes. Nat Med 2006;12:62-66.
  12. Kursawe R, Santoro N: Metabolic syndrome in pediatrics. Adv Clin Chem 2014;65:91-142.
    External Resources
  13. Nagel G, Rapp K, Wabitsch M, Buchele G, Kroke A, Zollner I, Weiland SK, Koenig W: Prevalence and cluster of cardiometabolic biomarkers in overweight and obese schoolchildren: results from a large survey in southwest Germany. Clin Chem 2008;54:317-325.
  14. Tomkinson GR: Global changes in anaerobic fitness test performance of children and adolescents (1958-2003). Scand J Med Sci Sports 2007;17:497-507.
  15. Myers J, Prakash M, Froelicher V, Do D, Partington S, Atwood JE: Exercise capacity and mortality among men referred for exercise testing. N Engl J Med 2002;346:793-801.
  16. Tomkinson G: Aerobic fitness thresholds for cardio metabolic health in children and adolescents. Br J Sports Med 2011;45:686-687.
  17. Twisk JW, Kemper HC, van Mechelen W: Tracking of activity and fitness and the relationship with cardiovascular disease risk factors. Med Sci Sports Exerc 2000;32:1455-1461.
    External Resources
  18. Pan Y, Pratt CA: Metabolic syndrome and its association with diet and physical activity in US adolescents. J Am Diet Assoc 2008;108:276-286; discussion 286.
  19. Dobbins M, Husson H, DeCorby K, LaRocca RL: School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18. Cochrane Database Syst Rev 2013;2:CD007651.
  20. Oude Luttikhuis H, Baur L, Jansen H, Shrewsbury VA, O'Malley C, Stolk RP, Summerbell CD: Interventions for treating obesity in children. Cochrane Database Syst Rev 2009:CD001872.
  21. Graf C, Koch B, Falkowski G, Jouck S, Christ H, Staudenmaier K, Tokarski W, Gerber A, Predel HG, Dordel S: School-based prevention: effects on obesity and physical performance after 4 years. J Sports Sci 2008;26:987-994.
  22. Graf C, Dordel S: The CHILT I project (Children's Health Interventional Trial). A multicomponent intervention to prevent physical inactivity and overweight in primary schools (in German). Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 2011;54:313-321.
  23. Graf C, Koch B, Kretschmann-Kandel E, Falkowski G, Christ H, Coburger S, Lehmacher W, Bjarnason-Wehrens B, Platen P, Tokarski W, Predel HG, Dordel S: Correlation between BMI, leisure habits and motor abilities in childhood (CHILT-project). Int J Obes Relat Metab Disord 2004;28:22-26.
  24. Kromeyer-Hauschild K, Wabitsch M, Kunze D: Perzentile für den Body Mass Index für das Kindes- und Jugendalter unter Heranziehung verschiedener deutscher Stichproben. Monatsschr Kinderheilkd 2001;149:807-818.
    External Resources
  25. Landsberg B, Plachta-Danielzik S, Much D, Johannsen M, Lange D, Müller MJ: Associations between active commuting to school, fat mass and lifestyle factors in adolescents: The Kiel Obesity Prevention Study (KOPS). Eur J Clin Nutr 2008;62:739-747.
  26. Schenk L, Ellert U, Neuhauser H: Children and adolescents in Germany with a migration background. Methodical aspects in the German health interview and examination survey for children and adolescents (KIGGS) (in German). Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 2007;50:590-599.
  27. Schilling F: Körperkoordinationstest für Kinder. KTK. Manual. Weinheim, Beltz, 1974.
  28. Beck J, Bös K: Normwerte der motorischen Leistungsfähigkeit. Köln, Sport und Buch Straß, 1995.
  29. Bös K: Motorische Tests, 2nd ed. Göttingen, Hogrefe, 2001.
  30. Timmons BW, Naylor PJ, Pfeiffer KA: Physical activity for preschool children - how much and how? Can J Public Health 2007;98(suppl 2):S122-134.
  31. Colquitt JL, Loveman E, O'Malley C, Azevedo LB, Mead E, Al-Khudairy L, Ells LJ, Metzendorf MI, Rees K: Diet, physical activity, and behavioural interventions for the treatment of overweight or obesity in preschool children up to the age of 6 years. Cochrane Database Syst Rev 2016;3:CD012105.
  32. Klein D, Manz K, Ferrari N, Struder H, Graf C: Effects of health promotion projects in preschools on body mass index and motor abilities. J Sports Med Phys Fitness 2015;55:103-112.
    External Resources
  33. Lampert T, Kurth BM: Sozialer Status und Gesundheit von Kindern und Jugendlichen. Ergebnisse des Kinder- und Jugendgesundheitssurveys (KIGGS). Dtsch Ärztebl 2007;104:A2944-A2040.
  34. Lange D, Plachta-Danielzik S, Landsberg B, Muller MJ: Social inequality, migration, and healthy environments as determinants of overweight of children and adolescents. Results of the Kiel Obesity Prevention Study (KOPS) (in German. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 2010;53:707-715.
  35. Nagel G, Wabitsch M, Galm C, Berg S, Brandstetter S, Fritz M, Klenk J, Peter R, Prokopchuk D, Steiner R, Stroth S, Wartha O, Weiland SK, Steinacker J: Determinants of obesity in the Ulm Research on Metabolism, Exercise and Lifestyle in Children (URMEL-ICE). Eur J Pediatr 2009;168:1259-1267.
  36. Kuepper-Nybelen J, Lamerz A, Bruning N, Hebebrand J, Herpertz-Dahlmann B, Brenner H: Major differences in prevalence of overweight according to nationality in preschool children living in Germany: determinants and public health implications. Arch Dis Child 2005;90:359-363.
  37. Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM: Prevalence of overweight and obesity in the United States, 1999-2004. JAMA 2006;295:1549-1555.
  38. Besharat Pour M, Bergstrom A, Bottai M, Kull I, Wickman M, Hakansson N, Wolk A, Moradi T: Effect of parental migration background on childhood nutrition, physical activity, and body mass index. J Obes 2014;2014:406529.
  39. Fredriks AM, Van Buuren S, Sing RA, Wit JM, Verloove-Vanhorick SP: Alarming prevalences of overweight and obesity for children of Turkish, Moroccan and Dutch origin in the Netherlands according to international standards. Acta Paediatr 2005;94:496-498.
  40. Saxena S, Ambler G, Cole TJ, Majeed A: Ethnic group differences in overweight and obese children and young people in England: CROSS sectional survey. Arch Dis Child 2004;89:30-36.
    External Resources
  41. Lange M, Kamtsiuris P, Lange C, Schaffrath Rosario A, Stolzenberg H, Lampert T: Sociodemographic characteristics in the German health interview and examination survey for children and adolescents (KIGGS) - operationalisation and public health significance, taking as an example the assessment of general state of health (in German). Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 2007;50:578-589.
  42. Boos-Nünning U, Karakaşoğlu Y: Kinder und Jugendliche mit Migrationshintergrund im Sport; in Schmidt W, Hartmann-Tews I, Brettschneider W-D (eds): Erster deutscher Kinder- und Jugendsportbericht. Schorndorf, Hofmann, 2003, pp 319-338.
  43. Woll A, Kurth BM, Opper E, Worth A, Bos K: The ‘Motorik-Modul' (MoMo): physical fitness and physical activity in German children and adolescents. Eur J Pediatr 2011;170:1129-1142.
  44. Hamer M, Chida Y: Active commuting and cardiovascular risk: a meta-analytic review. Prev Med 2008;46:9-13.
  45. Klesges LM, Baranowski T, Beech B, Cullen K, Murray DM, Rochon J, Pratt C: Social desirability bias in self-reported dietary, physical activity and weight concerns measures in 8- to 10-year-old African-American girls: results from the Girls Health Enrichment Multisite Studies (GEMS). Prev Med 2004;38(suppl):S78-87.
  46. Westerterp KR: Assessment of physical activity: a critical appraisal. Eur J Appl Physiol 2009;105:823-828.
  47. Bryant MJ, Lucove JC, Evenson KR, Marshall S: Measurement of television viewing in children and adolescents: a systematic review. Obes Rev 2007;8:197-209.
  48. Klitsie T, Corder K, Visscher TL, Atkin AJ, Jones AP, van Sluijs EM: Children's sedentary behaviour: descriptive epidemiology and associations with objectively-measured sedentary time. BMC Public Health 2013;13:1092.
  49. Stephens J, Allen J: Mobile phone interventions to increase physical activity and reduce weight: a systematic review. J Cardiovasc Nurs 2013;28:320-329.
  50. Gilmore LA, Duhe AF, Frost EA, Redman LM: The technology boom: a new era in obesity management. J Diabetes Sci Technol 2014;8:596-608.
  51. Dunton GF, Dzubur E, Kawabata K, Yanez B, Bo B, Intille S: Development of a smartphone application to measure physical activity using sensor-assisted self-report. Front Public Health 2014;2:12.
  52. Shrewsbury V, Wardle J: Socioeconomic status and adiposity in childhood: a systematic review of cross-sectional studies 1990-2005. Obesity (Silver Spring) 2008;16:275-284.
  53. Sobal J: Obesity and socioeconomic status: a framework for examining relationships between physical and social variables. Med Anthropol 1991;13:231-247.
  54. Yan T, Curtin R, Matthew Jans M: Trends in income nonresponse over two decades. J Off Stat 2010;26:145-164.
  55. Dobbins M, De Corby K, Robeson P, Husson H, Tirilis D: School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6-18. Cochrane Database Syst Rev 2009; 1:CD007651.
  56. Golan M, Kaufman V, Shahar DR: Childhood obesity treatment: targeting parents exclusively v. parents and children. Br J Nutr 2006;95:1008-1015.
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