International journal of public health, Jan 4, 2016
This study was designed to explore the determinants of physical fitness in European children aged... more This study was designed to explore the determinants of physical fitness in European children aged 6-11 years, cross-sectionally and longitudinally. There were sufficient data on 4903 children (50.6 % girls) on measured physical fitness (cardio-respiratory, muscular strength, flexibility, balance, and speed) and possible determinants related to child characteristics, child lifestyle and parental factors. Multivariate and mixed linear regression models were conducted. Age, sex, children's BMI and physical activity were independent and strong determinants of children's fitness. Significant but small effects were found for low maternal BMI, high psychosocial well-being and fruit and vegetable intake as protective determinants. Sleep duration, breakfast intake, parental age and education and paternal BMI did not have a consistently significant effect on physical fitness. The role of determinants depended on children's sex and the specific PF component. Longitudinal analyses e...
Starting from birth, this explorative study aimed to investigate between-country differences in b... more Starting from birth, this explorative study aimed to investigate between-country differences in body mass index (BMI) trajectories and whether early life factors explain these differences. The sample included 7,644 children from seven European countries (Belgium, Cyprus, Germany, Hungary, Italy, Spain, Sweden) participating in the multi-centre IDEFICS study. Information on early life factors and in total 53,409 repeated measurements of height and weight from 0 to <12 years of age were collected during the baseline (2007/2008) and follow-up examination (2009/2010) supplemented by records of routine child health visits. Country-specific BMI growth curves were estimated using fractional polynomial mixed effects models. Several covariates focussing on early life factors were added to the models to investigate their role in the between-countries differences. Large between-country differences were observed with Italian children showing significantly higher mean BMI values at all ages ≥...
During the last two decades, genetic epidemiology has been established in parallel to the area of... more During the last two decades, genetic epidemiology has been established in parallel to the area of classical epidemiology. This paper presents some essentials of the epidemiology of genetic factors. It begins with a discussion of complex diseases that are characterized by an involvement of several genes. The problems that are attached to modeling gene-gene and gene-environment interactions and their integration into causal pathways are elucidated and the role of genetic factors in the etiology of complex diseases is investigated. Classical and new epidemiological study designs that allow an integration of genetic data are introduced. The introduction of this data is partly motivated by the danger of bias due to genetic heterogeneity (population stratification) in classical designs. The problem of replication of study results is discussed and the concept of Mendelian randomization is presented.
Overweight/obesity is an important public health burden worldwide, increasing the risk for the de... more Overweight/obesity is an important public health burden worldwide, increasing the risk for the development of cardiovascular diseases or the metabolic syndrome. This risk may be reduced by a good aerobic fitness (AF) that can be improved by physical activity but is also influenced by genetic factors. The aim of this study was to test for familial aggregation of AF measured by maximal oxygen uptake (VO2max) and to estimate its heritability. Furthermore, an exploratory analysis of the association between overweight/obesity and AF was performed. In contrast to previous studies, all analyses were adjusted for additional environmental and behavioral factors, in particular for objectively measured physical activity (PA) in addition to body mass index (BMI). 79 families (157 parents, 132 children) performed a maximum exercise test (spiroergometry) to assess maximum oxygen uptake. PA was measured by accelerometry. Familial aggregation of AF was determined using a two-step design: AF was adjusted for age, sex and age*sex using linear regression. Afterwards, the residuals were used to determine the intraclass correlation coefficient (ICC) by ANOVA. Heritability and associations were estimated by generalized linear mixed models. Familial aggregation of AF (ICC = 0.22, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) was significant but decreased when adjusted for PA or BMI. Its heritability was estimated as 40% (adjusted for PA) using the mid-parent-offspring design. Relative to the middle quintile of AF residuals, the odds of being overweight/obese were three- to tenfold reduced in the upper quintile (adjusted for age, sex, age*sex, PA). AF clustered in families after controlling for PA, BMI and parental smoking. Heritability was stronger for mother-child pairs as compared to father-child pairs after controlling for PA and BMI. Above average AF was negatively associated with overweight/obesity.
The aim of the study is to investigate the association between educational attainment and the pre... more The aim of the study is to investigate the association between educational attainment and the prevalence of chronic diseases and cardiovascular risk factors for the German population aged 18-29 years. The data source is the Federal Health Survey 1998 (BGS98), which is representative for Germany. The response rate for the survey is 61.4%. Included in the analysis are 616 females and 637 males. Indicator for educational atteinment is the highest achieved school degree ("Abitur" n = 375, "mittlere Reife" n = 566, "Hauptschule" n = 312). For eight of the 43 items for self-reported diseases in the BGS98-questionnaire persons in the age group 18-29 yielded a higher prevalence than older adults. For altogether 11 diseases, which showed a prevalence greater than 3% in the age group 18-29 years, only minor associations with educational attainment were observed. Statistically significantly increased prevalences are observed for allergic disorders in persons with ...
A small number of confirmed major genes for human obesity has been identified by molecular geneti... more A small number of confirmed major genes for human obesity has been identified by molecular genetic studies; mutations of these have a strong influence on the development of excessive body weight. However, the underlying mutations are rare and do not explain the current obesity epidemic. The genetic predisposition to common obesity most likely has a polygenic basis, and each single gene variant has only a small influence on body weight. The introduction of genome-wide association scans (GWAS) offers new opportunities for the study of complex diseases. The receptor variant with the amino acid isoleucin (wildtype: valine) at position 103 of the melanocortin-4 receptor (MC4R) represents the first confirmed polygenic variant with an influence on body mass index; additional polymorphisms located 188 kb at the 3&#39; end of the MC4R have also been shown to have an effect on body weight. Variants in the first intron of the &quot;fat mass and obesity associated&quot; gene (FTO) confer the most pronounced polygenic effect on obesity (+0.4 kg/m(2) per allele); these variants were originally detected in 2007 in GWAS pertaining to type 2 diabetes mellitus. Recently, additional SNPs with a polygenic effect on obesity have been identified in three large GWAS. By December 2009, 17 solidly confirmed polygenes for body weight regulation have been reported.
Zusammenfassung Hintergrund Die größte Herausforderung bei der Entwicklung von Programmen der Pr... more Zusammenfassung Hintergrund Die größte Herausforderung bei der Entwicklung von Programmen der Primärprävention ist die Übertragung evidenzbasierter Interventionsmodule in die Praxis und die Erreichung ihrer Nachhaltigkeit. Alle Schritte werden anhand einer epidemiologischen Interventionsstudie lebensstilbedingter Erkrankungen bei Kindern veranschaulicht. Methode Ausgehend von dem interessierenden Gesundheitsproblem wird eine geeignete und zugängliche Zielgruppe identifiziert, in der die stärksten Effekte erwartet werden. Modifizierbare Risikofaktoren und realistische Ziele der Intervention werden spezifiziert. Ergebnisse Diese bestimmen die Hauptzielgrößen zum Nachweis der Wirksamkeit der Intervention und bilden die Eckpfeiler des Studiendesigns und der Definition der Vergleichsgruppen. Beinhaltet die Intervention eine aktive Teilnahme, sollte sie partizipativ und unter Berücksichtigung des soziokulturellen Umfelds gestaltet werden. Schlussfolgerung Das zentrale Element zur Beurteilung von Struktur und Prozess sowie zur Bewertung der Effekte nach strengen wissenschaftlichen Kriterien ist die Evaluation.
International journal of public health, Jan 4, 2016
This study was designed to explore the determinants of physical fitness in European children aged... more This study was designed to explore the determinants of physical fitness in European children aged 6-11 years, cross-sectionally and longitudinally. There were sufficient data on 4903 children (50.6 % girls) on measured physical fitness (cardio-respiratory, muscular strength, flexibility, balance, and speed) and possible determinants related to child characteristics, child lifestyle and parental factors. Multivariate and mixed linear regression models were conducted. Age, sex, children's BMI and physical activity were independent and strong determinants of children's fitness. Significant but small effects were found for low maternal BMI, high psychosocial well-being and fruit and vegetable intake as protective determinants. Sleep duration, breakfast intake, parental age and education and paternal BMI did not have a consistently significant effect on physical fitness. The role of determinants depended on children's sex and the specific PF component. Longitudinal analyses e...
Starting from birth, this explorative study aimed to investigate between-country differences in b... more Starting from birth, this explorative study aimed to investigate between-country differences in body mass index (BMI) trajectories and whether early life factors explain these differences. The sample included 7,644 children from seven European countries (Belgium, Cyprus, Germany, Hungary, Italy, Spain, Sweden) participating in the multi-centre IDEFICS study. Information on early life factors and in total 53,409 repeated measurements of height and weight from 0 to <12 years of age were collected during the baseline (2007/2008) and follow-up examination (2009/2010) supplemented by records of routine child health visits. Country-specific BMI growth curves were estimated using fractional polynomial mixed effects models. Several covariates focussing on early life factors were added to the models to investigate their role in the between-countries differences. Large between-country differences were observed with Italian children showing significantly higher mean BMI values at all ages ≥...
During the last two decades, genetic epidemiology has been established in parallel to the area of... more During the last two decades, genetic epidemiology has been established in parallel to the area of classical epidemiology. This paper presents some essentials of the epidemiology of genetic factors. It begins with a discussion of complex diseases that are characterized by an involvement of several genes. The problems that are attached to modeling gene-gene and gene-environment interactions and their integration into causal pathways are elucidated and the role of genetic factors in the etiology of complex diseases is investigated. Classical and new epidemiological study designs that allow an integration of genetic data are introduced. The introduction of this data is partly motivated by the danger of bias due to genetic heterogeneity (population stratification) in classical designs. The problem of replication of study results is discussed and the concept of Mendelian randomization is presented.
Overweight/obesity is an important public health burden worldwide, increasing the risk for the de... more Overweight/obesity is an important public health burden worldwide, increasing the risk for the development of cardiovascular diseases or the metabolic syndrome. This risk may be reduced by a good aerobic fitness (AF) that can be improved by physical activity but is also influenced by genetic factors. The aim of this study was to test for familial aggregation of AF measured by maximal oxygen uptake (VO2max) and to estimate its heritability. Furthermore, an exploratory analysis of the association between overweight/obesity and AF was performed. In contrast to previous studies, all analyses were adjusted for additional environmental and behavioral factors, in particular for objectively measured physical activity (PA) in addition to body mass index (BMI). 79 families (157 parents, 132 children) performed a maximum exercise test (spiroergometry) to assess maximum oxygen uptake. PA was measured by accelerometry. Familial aggregation of AF was determined using a two-step design: AF was adjusted for age, sex and age*sex using linear regression. Afterwards, the residuals were used to determine the intraclass correlation coefficient (ICC) by ANOVA. Heritability and associations were estimated by generalized linear mixed models. Familial aggregation of AF (ICC = 0.22, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) was significant but decreased when adjusted for PA or BMI. Its heritability was estimated as 40% (adjusted for PA) using the mid-parent-offspring design. Relative to the middle quintile of AF residuals, the odds of being overweight/obese were three- to tenfold reduced in the upper quintile (adjusted for age, sex, age*sex, PA). AF clustered in families after controlling for PA, BMI and parental smoking. Heritability was stronger for mother-child pairs as compared to father-child pairs after controlling for PA and BMI. Above average AF was negatively associated with overweight/obesity.
The aim of the study is to investigate the association between educational attainment and the pre... more The aim of the study is to investigate the association between educational attainment and the prevalence of chronic diseases and cardiovascular risk factors for the German population aged 18-29 years. The data source is the Federal Health Survey 1998 (BGS98), which is representative for Germany. The response rate for the survey is 61.4%. Included in the analysis are 616 females and 637 males. Indicator for educational atteinment is the highest achieved school degree ("Abitur" n = 375, "mittlere Reife" n = 566, "Hauptschule" n = 312). For eight of the 43 items for self-reported diseases in the BGS98-questionnaire persons in the age group 18-29 yielded a higher prevalence than older adults. For altogether 11 diseases, which showed a prevalence greater than 3% in the age group 18-29 years, only minor associations with educational attainment were observed. Statistically significantly increased prevalences are observed for allergic disorders in persons with ...
A small number of confirmed major genes for human obesity has been identified by molecular geneti... more A small number of confirmed major genes for human obesity has been identified by molecular genetic studies; mutations of these have a strong influence on the development of excessive body weight. However, the underlying mutations are rare and do not explain the current obesity epidemic. The genetic predisposition to common obesity most likely has a polygenic basis, and each single gene variant has only a small influence on body weight. The introduction of genome-wide association scans (GWAS) offers new opportunities for the study of complex diseases. The receptor variant with the amino acid isoleucin (wildtype: valine) at position 103 of the melanocortin-4 receptor (MC4R) represents the first confirmed polygenic variant with an influence on body mass index; additional polymorphisms located 188 kb at the 3&#39; end of the MC4R have also been shown to have an effect on body weight. Variants in the first intron of the &quot;fat mass and obesity associated&quot; gene (FTO) confer the most pronounced polygenic effect on obesity (+0.4 kg/m(2) per allele); these variants were originally detected in 2007 in GWAS pertaining to type 2 diabetes mellitus. Recently, additional SNPs with a polygenic effect on obesity have been identified in three large GWAS. By December 2009, 17 solidly confirmed polygenes for body weight regulation have been reported.
Zusammenfassung Hintergrund Die größte Herausforderung bei der Entwicklung von Programmen der Pr... more Zusammenfassung Hintergrund Die größte Herausforderung bei der Entwicklung von Programmen der Primärprävention ist die Übertragung evidenzbasierter Interventionsmodule in die Praxis und die Erreichung ihrer Nachhaltigkeit. Alle Schritte werden anhand einer epidemiologischen Interventionsstudie lebensstilbedingter Erkrankungen bei Kindern veranschaulicht. Methode Ausgehend von dem interessierenden Gesundheitsproblem wird eine geeignete und zugängliche Zielgruppe identifiziert, in der die stärksten Effekte erwartet werden. Modifizierbare Risikofaktoren und realistische Ziele der Intervention werden spezifiziert. Ergebnisse Diese bestimmen die Hauptzielgrößen zum Nachweis der Wirksamkeit der Intervention und bilden die Eckpfeiler des Studiendesigns und der Definition der Vergleichsgruppen. Beinhaltet die Intervention eine aktive Teilnahme, sollte sie partizipativ und unter Berücksichtigung des soziokulturellen Umfelds gestaltet werden. Schlussfolgerung Das zentrale Element zur Beurteilung von Struktur und Prozess sowie zur Bewertung der Effekte nach strengen wissenschaftlichen Kriterien ist die Evaluation.
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