Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Paper
  • Published:

First lessons from the Kiel Obesity Prevention Study (KOPS)

International Journal of Obesity volume 29, pages S78–S83 (2005)Cite this article

Abstract

Aims:

Prevention of obesity is a public health agenda. There are only few longitudinal studies on prevention of overweight in children. The Kiel Obesity Prevention Study (KOPS) intends to characterise the determinants of childhood overweight and the effect of preventive measures within schools as well as within families.

Methods:

Between 1996 and 2005, KOPS investigated 4997 German 5–7 and 4487 9–11-y-old children or 41 and 37% of the total population of all first and fourth graders in 32 primary schools in Kiel (248 000 inhabitants), northwest Germany. Main outcome measures were nutritional status, health habits and risk factors of disease. In addition, health promotion was performed each year in three schools for all first graders and their teachers (nutrition education and active school breaks) together with a family-oriented approach in families with obese and preobese children. Up to now, the children were followed for 4 y and were reinvestigated at age 10 y.

Results:

The KOPS population was representative for all 5–7 and 9–11-y-old children in Kiel. The prevalence of overweight/obesity (≥90th/97th BMI reference percentile) was 7.0/5.8 and 11.3/6.3% in 5–7 and 9–11-y-old children, respectively. Parental overweight, a low socio-economic status and a high birth weight were identified as main risk factors for overweight in prepubertal children. The first results of the interventions show that obesity prevention was possible, but there were limited success rates in boys and children from low social class.

Conclusion:

Faced with the environmental contributors to the obesity problem societal rather than individual responsibilities are evident. This idea suggests that dissecting and tackling the obesogenic environment is necessary to complement school- and family-based interventions.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. WHO. Obesity, preventing and managing a global epidemic. Report of a WHO Consultation. WHO Technical Report Series 894, Geneva; 2000.

  2. Kumanyika S, Jeffery RW, Morabia A, Ritenbaugh C, Antipatis VJ . Obesity prevention: the case for action. Int J Obes Relat Metab Disord 2002; 26: 425–436.

    Article  CAS  Google Scholar 

  3. Flodmark CE, Lissau I, Moreno LA, Pietrobelli A, Widhalm K . New insights into the field of children and adolescents' obesity: the European perspective. Int J Obes Relat Metab Disord 2004; 28: 1189–1196.

    Article  Google Scholar 

  4. Guo SS, Roche AF, Cameron Chumlea W, Gardner JD, Siervogel RM . The predictive value of childhood body mass index values for overweight at age 35 y. Am J Clin Nutr 1994; 59: 810–819.

    Article  CAS  Google Scholar 

  5. Must A, Jacques PF, Dallal GE, Bajema CJ, Dietz WH . Long-term morbidity and mortality of overweight adolescents. N Engl J Med 1992; 327: 1350–1355.

    Article  CAS  Google Scholar 

  6. Whitaker RC, Wright JA, Pepe MS, Seidel KD, Dietz WH . Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med 1997; 337: 869–873.

    Article  CAS  Google Scholar 

  7. Parsons TJ, Power C, Logan S, Summerbell CD . Childhood predictors of adult obesity: a systematic review. Int J Obes Relat Metab Disord 1999; 23 (Suppl. 8): 1–107.

    Google Scholar 

  8. Guo SS, Wu W, Chumlea WC, Roche AF . Predicting overweight and obesity in adulthood from body mass index values in childhood and adolescence. Am J Clin Nutr 2002; 76: 653–658.

    Article  CAS  Google Scholar 

  9. Dietz WH . Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics 1998; 101: 518–525.

    CAS  PubMed  Google Scholar 

  10. Power C, Lake IU, Cole TJ . Measurement and long-term health risks of child and adolescent fatness. Int J Obes Relat Metab Disord 1997; 21: 507–526.

    Article  CAS  Google Scholar 

  11. Berenson GS, Srinivasan SR, Bao LN, Newman WP, Tracy RE, Wattigney WA, for the Bogalusa Heart Study. Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. N Engl J Med 1998; 338: 1650–1656.

    Article  CAS  Google Scholar 

  12. Berenson GS, Wattigney WA, Bao W, Srinivasan SR, Radhakrishuamurrthy B . Rationale to study the early natural history of heart disease: The Bogalusa Heart Study. Am J Med Sci 1995; 310 (Suppl 1): 22–28.

    Article  Google Scholar 

  13. Mahoney LT, Burns TL, Stanford W, Thompson BH, Witt ID, Rost CA, Lauer RM . Coronary risk factors measured in childhood and young adults life are associated with coronary artery calcification in young adults: The Muscatine Study. J Am Coll Cardiol 1996; 27: 277–284.

    Article  CAS  Google Scholar 

  14. Vanhala M, Vanhala P, Kumpusalo E, Halonon P, Tallala I . Relation between obesity from childhood to adulthood and the metabolic syndrome: population-based study. BMJ 1998; 317: 319–321.

    Article  CAS  Google Scholar 

  15. Ebbeling CB, Pawlak DB, Ludwig DS . Childhood obesity: public-health crisis, common sense cure. Lancet 2002; 360: 473–482.

    Article  Google Scholar 

  16. Dietz WH, Gortmaker SL . Preventing obesity in children and adolescents. Annu Rev Public Health 2001; 22: 337–353.

    Article  CAS  Google Scholar 

  17. Campbell K, Waters E, O'Meara S, Summmerbell C . Interventions for preventing obesity in childhood. A systematic review. Obes Rev 2001; 2: 149–157 Also published in the Cochrane library (http://www.cochrane.org).

    Article  CAS  Google Scholar 

  18. Mueller MJ, Asbeck I, Mast M, Langnaese K, Grund A . Prevention of obesity—more than an intention. Concept and first results of the Kiel Obesity Prevention Study (KOPS). Int J Obes Relat Metab Disord 2001; 25 (Suppl. 1): S66–S74.

    Article  Google Scholar 

  19. Kromeyer-Hauschild K, Wabitsch M, Kunze D, Geller F, Geiß HC, Hesse V, von Hippel A, Jaeger U, Johnson D, Korte W, Menner K, Müller G, Müller MJ, Niemann-Pilatus A, Remer T, Schaefer F, Wittchen H-U, Zabransky S, Zellner K, Ziegler A, Hebebrand J . Perzentile für den Body-mass-Index für das Kindes- und Jugendalter unter Heranziehung verschiedener deutscher Stichproben. Monatsschrift Kinderheilkunde 2001; 149: 807–818.

    Article  Google Scholar 

  20. Reinken L, Stolley H, Droese W, van Oost G . Longitudinale Körperentwicklung gesunder Kinder. II Größe, Gewicht, Hautfalten von Kindern im Alter von 1,5-16 Jahren. Klin Pädiat 1980; 192: 25–33.

    Article  CAS  Google Scholar 

  21. Danielzik S, Czerwinski-Mast M, Langnäse K, Dilba B, Müller MJ . Parental overweight, socioeconomic status and high birth weight are the major determinants of overweight and obesity in 5-7-y-old children: baseline data of the Kiel Obesity Prevention Study (KOPS). Int J Obes Relat Metab Disord 2004; 28: 1494–1502.

    Article  CAS  Google Scholar 

  22. Körtzinger I . Ernährungserhebung und Ernährungsintervention in der Prävention ernährungsabhängiger Erkrankungen. Dissertationsschrift, Institut für Humanernährung und Lebensmittelkunde der Christian-Albrechts-Universität zu Kiel, Kiel 1999.

  23. Langnäse K, Asbeck I, Mast M, Müller MJ . Influence of socio-economic status on the long-term effect of family-based intervention in prepubertal overweight children. Health Educ 2004; 104: 336–343.

    Article  Google Scholar 

  24. Müller MJ, Danielzik S, Pust S . School- and family-based interventions to prevent overweight in children. Proc Nutr Soc 2005; 64: 249–254.

    Article  Google Scholar 

  25. Barker DJP, Blundell JE, Dietz WH, Epstein LH, Jeffry RW, Remschmidt H, Rolls BJ, Rössner S, Saris WHM . Group report: what are the Bio-behavioral determinants of body weight regulation?. In: Bouchard C, Bray GA (eds). Regulation of body weight Dahlem workshop reports, Life Sciences Research Report 57, Wiley Johnsons: Chichester; 1996. pp 159–177.

    Google Scholar 

  26. Lobstein T, Baur L, Uauy R, IASO. Obesity in children and young people. A crisis in public health. Obes Rev 2004; 5 (Suppl 1): 4–104.

    Article  Google Scholar 

  27. James WPT, Gill TP . Prevention of obesity. In: Bray GA, Bouchard C (eds). Handbook of obesity, clinical applications 2nd edn Marcel Decker: New York; 2004. pp 75–96.

    Google Scholar 

  28. Müller MJ, Danielzik S, Spethmann C . Prevention of overweight and obesity. In Obesity in childhood and adolescence Kiess W, Marcus C, Wabitsch M (eds) Karger: Basel; 2004; 243–263.

    Chapter  Google Scholar 

  29. Gortmaker SL, Peterson K, Wiecha J, Sobol AM, Dixit S, Fox MK, Laird N . Reducing obesity via school-based interdisciplinary intervention among youth. Planet Health Arch Pediatr Adolesc Med 1999; 153: 409–418.

    Article  CAS  Google Scholar 

  30. Wang LV, Yang Q, Lowry R, Wechsler H . Economic analysis of a school-based obesity prevention program. Obes Res 2003; 11: 1313–1324.

    Article  Google Scholar 

  31. Epstein L, Valoski A, Wing RR, McCurley J . Ten-year follow-up of behavioral family-based treatment of obese children. JAMA 1990; 264: 2519–2523.

    Article  CAS  Google Scholar 

  32. Epstein LH, Valoski A, Wing RR, Mc Curley I . Ten year outcomes of behavioral family-based treatment for childhood obesity. Health Psychol 1994; 13: 373–383.

    Article  CAS  Google Scholar 

  33. Flodmark CE, Ohlsson T, Ryden O, Sveger T . Prevention of progression to severe obesity in a group of obese Schoolchildren treated with family therapy. Pediatrics 1993; 91: 880–884.

    CAS  PubMed  Google Scholar 

  34. Egger G, Swinburn B . ‘An ecological’ approach to the obesity pandemic. Br Med J 1997; 315: 477–480.

    Article  CAS  Google Scholar 

  35. Egger G, Swinburn B, Rossner S . Dusting off the epidemiological triad: could it work with obesity? Obes Rev 2003; 4: 115–119.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This work was supported by grants from Deutsche Forschungsgemeinschaft (DFG Mü 5-1, 5-2, 5-3, 5-5), Wirtschaftliche Vereinigung Zucker, Precon and WCRF UK.

Author information

Authors and Affiliations

  1. Institut für Humanernährung und Lebensmittelkunde, Christian-Albrechts-Universität zu Kiel, Kiel, Germany

    S Danielzik, S Pust, B Landsberg & M J Müller

Authors
  1. S Danielzik
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S Pust
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. B Landsberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M J Müller
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M J Müller.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Danielzik, S., Pust, S., Landsberg, B. et al. First lessons from the Kiel Obesity Prevention Study (KOPS). Int J Obes 29 (Suppl 2), S78–S83 (2005). https://doi.org/10.1038/sj.ijo.0803099

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijo.0803099

Keywords

This article is cited by

Search

Advanced search

Quick links