[Obesity in Bavarian adolescents: prevalence in trend, sociodemographic structural features and subjective health]

Prehypertension and Left Ventricular Diastolic Dysfunction in Middle-Aged Koreans

Background and Objectives

Left ventricular diastolic dysfunction is known to be a marker of myocardial damage, in particular myocardial fibrosis resulting from hypertension (HT). However, few studies have shown an association between the grade of diastolic dysfunction and blood pressure classification. We investigated the association between diastolic dysfunction and prehypertension (preHT) in apparently healthy adults who underwent routine health examinations.

Subjects and Methods

The study sample included 4261 Koreans, 45 to 64 years of age with no previous history of HT, diabetes mellitus, malignancy, proven coronary artery disease, or valvular heart disease based on echocardiography, who underwent routine health examinations including echocardiography. The subjects were classified into three groups based on resting blood pressure: prehypertensive, hypertensive, and normotensive.

Results

The prevalence of preHT in our study was 42.1%. After adjusting for age, gender, smoking status, alcohol consumption, fasting blood sugar, serum lipid profile, and body mass index, left ventricular diastolic dysfunction grades 1 and 2 were significantly more frequent in subjects with preHT (odds ratio [OR] 1.66 [95% confidence interval {CI} 1.40-1.96] and 1.37 [95% CI 0.95-1.97], respectively). When analyzed according to gender, the increased OR was especially notable in males.

Conclusion

Left ventricular diastolic dysfunction appears to be significantly associated with preHT in Korean middle-aged males.

Relation between overweight/obesity and self-rated health among adolescents in Germany. Do socio-economic status and type of school have an impact on that relation?

This study investigates the relation between overweight/obesity and self-rated health (SRH), and whether this relation varies by social factors. Data was taken from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS, baseline 2003‒2006). For the definition of overweight and obesity, body mass index was calculated based on standardized height and weight measurements. SRH of adolescents (n = 6813, 11‒17 years) was raised with the question: “How would you describe your health in general?” The response categories were “very good”, “good”, “fair”, “poor”, and “very poor”. We dichotomized these responses into: “very good/good” vs. “fair/poor/very poor”. Socio-economic status (SES) in the family of origin and adolescents’ school type were analyzed as modifying factors. Prevalence and age-adjusted odds ratios with 95% confidence intervals were calculated by binary logistic regression models. We found that overweight and obese boys and obese girls reported fair to very poor SRH more often than their normal weight peers, and that these differences were more apparent in early than late adolescence. In addition, the relation between obesity and SRH was similarly strong in all sub-groups, but there was seldom a relation between overweight and SRH. In summary, the results show that obesity is linked to poor SRH regardless of SES and school type, while the relation between overweight and SRH varies by social factors among adolescents.

Declining prevalence rates for overweight and obesity in German children starting school

To estimate the development of prevalence rates for overweight and obesity in children starting school in Germany, data for children's height and weight out of the compulsory school enrolment examinations (SEE), conducted annually in every German federal state, were available. A former analysis of these data showed a marked increase of prevalence of overweight and obesity until 2004. The aim of this project was to give an updated overview on the development of prevalence rates for overweight and obesity in children upon school entry by including recent data until 2008. Data on measured height and weight from the yearly conducted SEE were obtained from all 16 German federal states. Overweight and obesity were defined by BMI > 90th and BMI > 97th age- and gender-related percentiles of German reference values, respectively. In 2008, the prevalence for overweight varied from 8.4% in Saxony to 11.9% in Bremen and Thuringia. The current prevalence rates for obesity ranged from 3.3% in Brandenburg and Saxony till 5.4% in Saarland. The current data from SEE by the majority of the individual states showed that the prevalence for both overweight and obesity did not increase any more after 2004 and is even declining in some states compared to the former data inquiry. Absolute decrease of prevalence rates was up to 3% for overweight and 1.8% for obesity.

CONCLUSION

The current data from the SEE of individual German states are based on census and showed by the majority that the prevalence of overweight and obese children starting school did not increase anymore and even declined in the last 4 years, respectively. It is supposed that the measures for prevention initiated in the 1990s and implemented afterwards have contributed to this positive development in Germany.