TY - JOUR A1 - Lehmann, Andreas A1 - Floris, Joël A1 - Woitek, Ulrich A1 - Ruehli, Frank J. A1 - Staub, Kaspar T1 - Temporal trends, regional variation and socio-economic differences in height, BMI and body proportions among German conscripts, 1956-2010 JF - Public Health Nutrition N2 - Objective: We analyse temporal trends and regional variation among the most recent available anthropometric data from German conscription in the years 2008-2010 and their historical contextualization since 1956. Design/setting/subjects: The overall sample included German conscripts (N 13 857 313) from 1956 to 2010. Results: German conscripts changed from growing in height to growing in breadth. Over the analysed 54 years, average height of 19-year-old conscripts increased by 6.5 cm from 173.5 cm in 1956 (birth year 1937) to 180.0 cm in 2010 (birth year 1991). This increase plateaued since the 1990s (1970s birth years). The increase in average weight, however, did not lessen during the last two decades but increased in two steps: at the end of the 1980s and after 1999. The weight and BMI distributions became increasingly right-skewed, the prevalence of overweight and obesity increased from 11.6 % and 2.1 % in 1984 to 19.9 % and 8.5 % in 2010, respectively. The north-south gradient in height (north = taller) persisted during our observations. Height and weight of conscripts from East Germany matched the German average between the early 1990s and 2009. Between the 1980s and the early 1990s, the average chest circumference increased, the average difference between chest circumference when inhaling and exhaling decreased, as did leg length relative to trunk length. Conclusions: Measuring anthropometric data for military conscripts yielded year-by-year monitoring of the health status of young men at a proscribed age. Such findings contribute to a more precise identification of groups at risk and thus help with further studies and to target interventions. KW - Stature KW - Obesity KW - Secular height trend Y1 - 2017 U6 - https://doi.org/10.1017/S1368980016002408 SN - 1368-9800 SN - 1475-2727 VL - 20 IS - 3 SP - 391 EP - 403 PB - Cambridge Univ. Press CY - Cambridge ER - TY - JOUR A1 - Warschburger, Petra T1 - SRT-Joy - computer-assisted self-regulation training for obese children and adolescents: study protocol for a randomized controlled trial JF - Trials N2 - Background: Obesity is not only a highly prevalent disease but also poses a considerable burden on children and their families. Evidence is increasing that a lack of self-regulation skills may play a role in the etiology and maintenance of obesity. Our goal with this currently ongoing trial is to examine whether training that focuses on the enhancement of self-regulation skills may increase the sustainability of a complex lifestyle intervention. Methods/Design: In a multicenter, prospective, parallel group, randomized controlled superiority trial, 226 obese children and adolescents aged 8 to 16 years will be allocated either to a newly developed computer-training program to improve their self-regulation abilities or to a placebo control group. Randomization occurs centrally and blockwise at a 1:1 allocation ratio for each center. This study is performed in pediatric inpatient rehabilitation facilities specialized in the treatment of obesity. Observer-blind assessments of outcome variables take place at four times: at the beginning of the rehabilitation (pre), at the end of the training in the rehabilitation (post), and 6 and 12 months post-rehabilitation intervention. The primary outcome is the course of BMI-SDS over 1 year after the end of the inpatient rehabilitation. Secondary endpoints are the self-regulation skills. In addition, health-related quality of life, and snack intake will be analyzed. Discussion: The computer-based training programs might be a feasible and attractive tool to increase the sustainability of the weight loss reached during inpatient rehabilitation. KW - Obesity KW - Randomized-controlled trial KW - Computer-assisted self-regulation training KW - Children KW - Adolescents KW - Weight Y1 - 2015 U6 - https://doi.org/10.1186/s13063-015-1078-2 SN - 1745-6215 VL - 16 PB - BioMed Central CY - London ER - TY - JOUR A1 - Warschburger, Petra A1 - Kuhne, Daniela T1 - Psychosocial determinants of quality of life in parents of obese children seeking inpatient treatment JF - Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation N2 - To examine and identify predictors of parental health-related quality of life (HRQoL) in a sample of obese and very obese children participating in an inpatient program for treating obesity. KW - Health-related quality of life KW - Obesity KW - Parents KW - Children KW - Self-efficacy Y1 - 2014 U6 - https://doi.org/10.1007/s11136-014-0659-y SN - 0962-9343 SN - 1573-2649 VL - 23 IS - 7 SP - 1985 EP - 1995 PB - Springer CY - Dordrecht ER - TY - JOUR A1 - Caliendo, Marco A1 - Gehrsitz, Markus T1 - Obesity and the labor market: A fresh look at the weight penalty JF - Inorganics : open access journal KW - Obesity KW - Wages KW - Employment KW - Semiparametric regression KW - Gender differences Y1 - 2016 U6 - https://doi.org/10.1016/j.ehb.2016.09.004 SN - 1570-677X SN - 1873-6130 VL - 23 SP - 209 EP - 225 PB - Elsevier CY - Amsterdam ER - TY - JOUR A1 - Warschburger, Petra A1 - Kröller, Katja T1 - Loss to follow-up in a randomized controlled trial study for pediatric weight management (EPOC) JF - BMC pediatrics N2 - Background Attrition is a serious problem in intervention studies. The current study analyzed the attrition rate during follow-up in a randomized controlled pediatric weight management program (EPOC study) within a tertiary care setting. Methods Five hundred twenty-three parents and their 7–13-year-old children with obesity participated in the randomized controlled intervention trial. Follow-up data were assessed 6 and 12 months after the end of treatment. Attrition was defined as providing no objective weight data. Demographic and psychological baseline characteristics were used to predict attrition at 6- and 12-month follow-up using multivariate logistic regression analyses. Results Objective weight data were available for 49.6 (67.0) % of the children 6 (12) months after the end of treatment. Completers and non-completers at the 6- and 12-month follow-up differed in the amount of weight loss during their inpatient stay, their initial BMI-SDS, educational level of the parents, and child’s quality of life and well-being. Additionally, completers supported their child more than non-completers, and at the 12-month follow-up, families with a more structured eating environment were less likely to drop out. On a multivariate level, only educational background and structure of the eating environment remained significant. Conclusions The minor differences between the completers and the non-completers suggest that our retention strategies were successful. Further research should focus on prevention of attrition in families with a lower educational background. KW - Attrition KW - Obesity KW - Child KW - Predictors KW - Weight management trial Y1 - 2016 U6 - https://doi.org/10.1186/s12887-016-0727-2 SN - 1471-2431 VL - 16 PB - BioMed Central CY - London ER - TY - JOUR A1 - Warschburger, Petra A1 - Kröller, Katja T1 - Loss to follow-up in a randomized controlled trial study for pediatric weight management (EPOC) JF - BMC PEDIATRICS N2 - Background: Attrition is a serious problem in intervention studies. The current study analyzed the attrition rate during follow-up in a randomized controlled pediatric weight management program (EPOC study) within a tertiary care setting. Methods: Five hundred twenty-three parents and their 7-13-year-old children with obesity participated in the randomized controlled intervention trial. Follow-up data were assessed 6 and 12 months after the end of treatment. Attrition was defined as providing no objective weight data. Demographic and psychological baseline characteristics were used to predict attrition at 6- and 12-month follow-up using multivariate logistic regression analyses. Conclusions: The minor differences between the completers and the non-completers suggest that our retention strategies were successful. Further research should focus on prevention of attrition in families with a lower educational background. KW - Attrition KW - Obesity KW - Child KW - Predictors KW - Weight management trial Y1 - 2016 U6 - https://doi.org/10.1186/s12887-016-0727-2 SN - 1471-2431 VL - 16 PB - BioMed Central CY - London ER - TY - JOUR A1 - Hauffe, Robert A1 - Rath, Michaela A1 - Schell, Mareike A1 - Ritter, Katrin A1 - Kappert, Kai A1 - Deubel, Stefanie A1 - Ott, Christiane A1 - Jähnert, Markus A1 - Jonas, Wenke A1 - Schürmann, Annette A1 - Kleinridders, André T1 - HSP60 reduction protects against diet-induced obesity by modulating energy metabolism in adipose tissue JF - Molecular Metabolism N2 - Objective Insulin regulates mitochondrial function, thereby propagating an efficient metabolism. Conversely, diabetes and insulin resistance are linked to mitochondrial dysfunction with a decreased expression of the mitochondrial chaperone HSP60. The aim of this investigation was to determine the effect of a reduced HSP60 expression on the development of obesity and insulin resistance. Methods Control and heterozygous whole-body HSP60 knockout (Hsp60+/−) mice were fed a high-fat diet (HFD, 60% calories from fat) for 16 weeks and subjected to extensive metabolic phenotyping. To understand the effect of HSP60 on white adipose tissue, microarray analysis of gonadal WAT was performed, ex vivo experiments were performed, and a lentiviral knockdown of HSP60 in 3T3-L1 cells was conducted to gain detailed insights into the effect of reduced HSP60 levels on adipocyte homeostasis. Results Male Hsp60+/− mice exhibited lower body weight with lower fat mass. These mice exhibited improved insulin sensitivity compared to control, as assessed by Matsuda Index and HOMA-IR. Accordingly, insulin levels were significantly reduced in Hsp60+/− mice in a glucose tolerance test. However, Hsp60+/− mice exhibited an altered adipose tissue metabolism with elevated insulin-independent glucose uptake, adipocyte hyperplasia in the presence of mitochondrial dysfunction, altered autophagy, and local insulin resistance. Conclusions We discovered that the reduction of HSP60 in mice predominantly affects adipose tissue homeostasis, leading to beneficial alterations in body weight, body composition, and adipocyte morphology, albeit exhibiting local insulin resistance. KW - Mitochondria KW - Stress response KW - Obesity KW - Glucose homeostasis KW - Insulin resistance KW - Adipose tissue Y1 - 2021 U6 - https://doi.org/10.1016/j.molmet.2021.101276 SN - 2212-8778 VL - 53 SP - 1 EP - 14 PB - Elsevier CY - Amsterdam, Niederlande ER - TY - JOUR A1 - Caliendo, Marco A1 - Lee, Wang-Sheng T1 - Fat chance! - Obesity and the transition from unemployment to employment JF - Economics and human biology N2 - This paper focuses on estimating the magnitude of any potential weight discrimination by examining whether obese job applicants in Germany get treated or behave differently from non-obese applicants. Based on two waves of rich survey data from the IZA Evaluation dataset, which includes measures that control for education, demographic characteristics, labor market history, psychological factors and health, we estimate differences in job search behavior and labor market outcomes between obese/overweight and normal weight individuals. Unlike other observational studies which are generally based on obese and non-obese individuals who might already be at different points in the job ladder (e.g., household surveys), in our data, individuals are newly unemployed and all start from the same point. The only subgroup we find in our data experiencing any possible form of negative labor market outcomes is obese women. Despite making more job applications and engaging more in job training programs, we find some indications that they experienced worse (or at best similar) employment outcomes than normal weight women. Obese women who found a job also had significantly lower wages than normal weight women. KW - Obesity KW - Discrimination KW - Employment KW - Labor demand Y1 - 2013 U6 - https://doi.org/10.1016/j.ehb.2012.02.002 SN - 1570-677X VL - 11 IS - 2 SP - 121 EP - 133 PB - Elsevier CY - Amsterdam ER - TY - JOUR A1 - Warschburger, Petra A1 - Kröller, Katja A1 - Haerting, Johannes A1 - Unverzagt, Susanne A1 - van Egmond-Fröhlich, Andreas T1 - Empowering Parents of Obese Children (EPOC): A randomized controlled trial on additional long-term weight effects of parent training JF - Appetite : multidisciplinary research on eating and drinking N2 - Although inpatient lifestyle treatment for obese children and adolescents can be highly effective in the short term, long-term results are unconvincing. One possible explanation might be that the treatment takes place far from parents' homes, limiting the possibility to incorporate the parents, who play a major role in establishing and maintaining a healthy lifestyle in childhood and adolescence. The main goal was to develop a brief behaviorally oriented parent training program that enhances ‘obesity-specific’ parenting skills in order to prevent relapse. We hypothesized that the inclusion of additional parent training would lead to an improved long-term weight course of obese children. Parents of obese children (n = 686; 7–13 years old) either participated in complementary cognitive-behavioral group sessions (n = 336) or received written information only (n = 350) during the inpatient stay. Children of both groups attended multidisciplinary inpatient rehabilitation. BMI-SDS as a primary outcome was evaluated at baseline, post-intervention and at 6- and 12-month follow-up. Intention-to-treat (ITT) as well as per-protocol analyses (PPA) were performed. A significant within-group decrease of 0.24 (95% CI 0.18 to 0.30) BMI-SDS points from the beginning of the inpatient stay through the first year was found, but no group difference at the one-year follow-up (mean difference 0.02; 95% CI -0.04 to 0.07). We also observed an increase in quality of life scores, intake of healthy food and exercise for both groups, without differences between groups (ITT and PPA). Thus, while the inpatient treatment proved highly effective, additional parent training did not lead to better results in long-term weight maintenance or to better psychosocial well-being compared to written psycho-educational material. Further research should focus on subgroups to answer the question of differential treatment effects. KW - Obesity KW - Children KW - Randomized controlled trial KW - Weight KW - Parent training KW - Quality of life Y1 - 2016 U6 - https://doi.org/10.1016/j.appet.2016.04.007 SN - 0195-6663 SN - 1095-8304 VL - 103 SP - 148 EP - 156 PB - Elsevier CY - London ER - TY - JOUR A1 - Laeger, Thomas A1 - Castano-Martinez, Teresa A1 - Werno, Martin W. A1 - Japtok, Lukasz A1 - Baumeier, Christian A1 - Jonas, Wenke A1 - Kleuser, Burkhard A1 - Schürmann, Annette T1 - Dietary carbohydrates impair the protective effect of protein restriction against diabetes in NZO mice used as a model of type 2 diabetes JF - Diabetologia : journal of the European Association for the Study of Diabetes (EASD) N2 - Aims/hypothesis Low-protein diets are well known to improve glucose tolerance and increase energy expenditure. Increases in circulating fibroblast growth factor 21 (FGF21) have been implicated as a potential underlying mechanism. Methods We aimed to test whether low-protein diets in the context of a high-carbohydrate or high-fat regimen would also protect against type 2 diabetes in New Zealand Obese (NZO) mice used as a model of polygenetic obesity and type 2 diabetes. Mice were placed on high-fat diets that provided protein at control (16 kJ%; CON) or low (4 kJ%; low-protein/high-carbohydrate [LP/HC] or low-protein/high-fat [LP/HF]) levels. Results Protein restriction prevented the onset of hyperglycaemia and beta cell loss despite increased food intake and fat mass. The effect was seen only under conditions of a lower carbohydrate/fat ratio (LP/HF). When the carbohydrate/fat ratio was high (LP/HC), mice developed type 2 diabetes despite the robustly elevated hepatic FGF21 secretion and increased energy expenditure. Conclusion/interpretation Prevention of type 2 diabetes through protein restriction, without lowering food intake and body fat mass, is compromised by high dietary carbohydrates. Increased FGF21 levels and elevated energy expenditure do not protect against hyperglycaemia and type 2 diabetes per se. KW - Energy expenditure KW - FGF21 KW - Hyperglycaemia KW - Insulin resistance KW - NZO KW - Obesity KW - Protein restriction Y1 - 2018 U6 - https://doi.org/10.1007/s00125-018-4595-1 SN - 0012-186X SN - 1432-0428 VL - 61 IS - 6 SP - 1459 EP - 1469 PB - Springer CY - New York ER - TY - JOUR A1 - Mumm, Rebekka A1 - Scheffler, Christiane A1 - Hermanussen, Michael T1 - Developing differential height, weight and body mass index references for girls that reflect the impact of the menarche JF - Acta paediatrica : nurturing the child N2 - Aim Growth is both a matter of amplitude and tempo. We aimed to develop references for body height, body weight and body mass index (BMI) with respect to tempo of maturity. Methods Data obtained from the German KiGGS study (2003-2006) on body height, body weight and presence or absence of the menarche were re-analysed in 3776 girls, aged 10-17years. We developed smoothed centiles for BMI-, body-height- and body-weight-for-age using the LMS method for premenarcheal and postmenarcheal girls. Results Body height, body weight and BMI differed significantly between premenarcheal and postmenarcheal girls. On average, postmenarcheal girls aged 11-17years were 5.3cm taller and 9.7kg heavier, and their BMI was 2.9kg/m2 higher than in premenarcheal girls of the same calendar age. Conclusion Adolescent BMI rises with calendar age and biological age. New reference charts for adolescent girls aged 10-18years were generated to be inserted into the currently used references to avoid misclassifying underweight and overweight pubertal girls. KW - Body mass index KW - Body mass index reference values KW - Menarche KW - Obesity KW - Overweight Y1 - 2014 U6 - https://doi.org/10.1111/apa.12625 SN - 0803-5253 SN - 1651-2227 VL - 103 IS - 7 SP - e312 EP - e316 PB - Wiley-Blackwell CY - Hoboken ER - TY - JOUR A1 - Warschburger, Petra A1 - Gmeiner, Michaela Silvia A1 - Morawietz, Marisa A1 - Rinck, Mike T1 - Battle of plates BT - a pilot study of an approach-avoidance training for overweight children and adolescents JF - Public health nutrition : PHN / The Nutrition Society N2 - Objective: Approach-avoidance training (AAT) is a promising approach in obesity treatment. The present study examines whether an AAT is feasible and able to influence approach tendencies in children and adolescents, comparing implicit and explicit training approaches. Design/Setting/Subjects: Fifty-nine overweight children and adolescents (aged 8-16 years; twenty-six boys) participated in an AAT for food cues, learning to reject snack items and approach vegetable items. Reaction times in the AAT and an implicit association rest (IAT) were assessed pre- and post-intervention. Results: A significant increase in the AAT compatibility scores with a large effect (eta(2) = 0.18) was found. No differences between the implicit and explicit training approaches and no change in the IAT scores were observed. Conclusions: Automatic tendencies in children can be trained, too. The implementation of AAT in the treatment of obesity might support the modification of an unhealthy nutrition behaviour pattern. Further data from randomized controlled clinical trials are needed. KW - Approach-avoidance KW - Intervention KW - Child KW - Obesity KW - Feasibility study Y1 - 2017 U6 - https://doi.org/10.1017/S1368980017002701 SN - 1368-9800 SN - 1475-2727 VL - 21 IS - 2 SP - 426 EP - 434 PB - Cambridge Univ. Press CY - Cambridge ER - TY - JOUR A1 - Warschburger, Petra A1 - Kröller, Katja T1 - "Childhood overweight and obesity maternal perceptions of the time for engaging in child weight management" JF - BMC public health N2 - Background: There is an increasing awareness of the impact of parental risk perception on the weight course of the child and the parent's readiness to engage in preventive efforts, but only less is known about factors related to the parental perception of the right time for the implementation of preventive activities. The aim of this study was to examine parental perceptions of the appropriate time to engage in child weight management strategies, and the factors associated with different weight points at which mothers recognize the need for preventive actions. Methods: 352 mothers with children aged 2-10 years took part in the study. We assessed mothers' perceptions of the actual and preferred weight status of their child, their ability to identify overweight and knowledge of its associated health risks, as well as perceptions of the right time for action to prevent overweight in their child. A regression analysis was conducted to examine whether demographic and weight related factors as well as the maternal general risk perception were associated with recognizing the need to implement prevention strategies. Results: Although most of the parents considered a BMI in the 75th to 90th percentile a valid reason to engage in the prevention of overweight, 19% of the mothers were not willing to engage in prevention until their child reached the 97th percentile. Whereas the child's sex and the identification of an elevated BMI were significant predictors for parents' recognition of the 75th percentile as right point to engage in prevention efforts, an inability to recognize physical health risks associated with overweight silhouettes emerged as a significant factor predicting which parents would delay prevention efforts until a child's BMI reached the 97th percentile. Conclusion: Parental misperceptions of overweight and associated health risks constitute unfavorable conditions for preventive actions. Feedback on the health risks associated with overweight could help increase maternal readiness for change. KW - Maternal perception KW - Need for action KW - Prevention KW - Obesity KW - Overweight KW - Children Y1 - 2012 U6 - https://doi.org/10.1186/1471-2458-12-295 SN - 1471-2458 VL - 12 IS - 12 PB - BioMed Central CY - London ER -