Nutrition-related prevention of overweight and obesity in childhood and adolescence

Peer-reviewed / Manuscript (Original) received: 16.04.2018 / Revision accepted: 07.08.2018

Strategies, goals, and implementation

Introduction

Overweight and obesity are multifactorial conditions with severe co-morbidities [1]. Their short and long term effects range from psychological distress and stigmatisation to high blood pressure, joint damage and Type II Diabetes [2]. Overweight and obesity develop as a result of the interaction between genetic disposition and various environmental influences, such as the interplay of energy- dense nutrition and low physical activity [3].

According to a nationally representative German survey on child and adolescent health conducted by the Robert Koch Institute (Kinder- und Jugendgesundheitssurvey, KiGGS), 15% of all children and adolescents in Germany have a body mass index (BMI) above the 90th age and gender-specific percentile and are thus considered overweight. With a BMI above the 97th age and gender-specific percentile, a total of 6.3% of German youth are obese [4]. In absolute numbers, 1.9 million 3 to 17 year-olds in Germany are overweight [4]. The nutrition study EsKiMo was conducted as an additional component of the KiGGS follow-up survey in 2006, in order to identify eating habits among 6 to 17 year-olds [5]. This study found that children and adolescents do not eat enough fruit, vegetables and high-fibre foods [5]. The amount of high-energy and high-protein foods, meat products, and sweets consumed by young people exceeded the recommendations of the German Research Institute for Child Nutrition (Forschungsinstitut für Kinderernährung, FKE) used in the study [5].

Abstract

The aim of this study was to identify current international recommendations for nutrition-related prevention strategies for overweight and obesity in childhood and adolescence and to analyse the extent to which these recommendations are integrated into German good practice projects. Therefore, after identifying relevant Cochrane reviews, an additional systematic primary literature search was conducted in PubMed. A third search for specific health projects was carried out the national database of the German cooperation network Equity in Health (Gesundheitliche Chancengleichheit). Two literature reviews, seven primary studies and five health project descriptions were included in this study. The analysed good practice projects rely mainly on the principle of knowledge dissemination using various teaching formats and materials. Our research and subsequent analysis showed that international recommendations are largely integrated into German good practice health projects. Nutrition-related prevention strategies should be based on early, theory-based and long-term interventions. Greater use of structural prevention and intervention multipliers is recommended.

Keywords: nutrition-related prevention strategies, overweight, obesity, childhood, adolescence 

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