Bundesgesundheitsbl – Gesundheitsforsch – Gesundheitsschutz 2007 • 50: 600-608

T. Lampert, M. Thamm

Consumption of tobacco, alcohol and drugs among adolescents in Germany. Results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) [pdf]

Abstract

Due to its long-lasting effects, the consumption of tobacco, alcohol and drugs is one of the central topics of prevention and health promotion in childhood and adolescence. The data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) show that in Germany today 20.5 % of 11–17-year-old boys and 20.3 % of girls the same age smoke. More than one quarter of adolescents who do not smoke themselves are exposed to cigarette smoke several times a week; around one fifth are even exposed to it almost every day. In the case of alcohol, 64.8 % of boys and 63.8 % of girls have drunk it before. Around one third of boys and one quarter of girls indicated that they currently consumed alcohol at least once a week. In the last 12 months before the survey 9.2 % of the boys and 6.2 % of the girls had taken hashish or marijuana. Other drugs such as Ecstasy, amphetamines or speed had been consumed by less than 1 % of the adolescents. The use of psychoactive substances rises markedly as children get older and is thus the most widespread among 16–17-year-olds. Adolescents of low social status smoke more frequently; in the case of alcohol and drug consumption, however, no significant status-specific differences are observed. There is also a raised prevalence of smoking among boys and girls who attend a secondary school and live in the states of the former GDR. The results emphasise the need for an addiction prevention programme which should include intervention to prevent children taking up substance use, as well as withdrawal treatment.

Keywords  Health survey - Children - Adolescents - Tobacco - Smoking - Alcohol - Drugs - Substance use

Bundesgesundheitsbl – Gesundheitsforsch – Gesundheitsschutz 2007 • 50: 609-623

G. B. M. Mensink, C. Kleiser, A. Richter

Food consumption of children and adolescents in Germany. Results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) [pdf]

Abstract

Since dietary behaviour has an essential impact on health, information on food consumption was obtained in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). The average food frequency and portion size "in recent weeks" was assessed with a food frequency questionnaire. Two versions of the questionnaire, identical in content, exist: one aimed at parents of 1–10-year-olds and the other directly at 11–17-year-olds. The results include data on 7,186 boys and 6,919 girls, aged 3–17. About half of the participants each consume bread, milk and fresh fruits every day. The majority (about three quarter) eat fast food only once a month or less. However, 16% of the participants eat chocolate, and almost 20% other sweets every day. More boys than girls individually consume soft drinks, milk, dairy products, meat, sausage, cereals and white bread every day. More girls consume fresh fruits and raw vegetables each day. With increasing age the proportion of daily consumers of soft drinks, cheese (and among boys also meat and sausage) increases, but the proportion of daily consumers of juices, tap water, milk, dairy products, fresh fruits, raw vegetables, cookies, chocolate, sweets (and among girls also breakfast cereals) falls. As expected the consumption of sweets and soft drinks is relatively high. Whereas more than half of the children each consume fruits and vegetables on a daily base, this consumption declines with increasing age.

Keywords  Health survey - Children - Adolescents - Nutritional epidemiology - Dietary assessment methods

Bundesgesundheitsbl – Gesundheitsforsch – Gesundheitsschutz 2007 • 50: 624-633

C. Lange, L. Schenk, R. Bergmann

Distribution, duration and temporal trend of breastfeeding in Germany. Results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) [pdf]

Abstract

Breast milk is the most natural and best type of nutrition for almost all infants. Moreover, breastfeeding is associated with health benefits for mother and child: breast milk supports the development of the infant and protects it against diseases; the health benefits for the mothers also extend beyond the period after birth. Therefore, the WHO recommends exclusive breastfeeding for at least six months. Until now, no representative data on the breastfeeding rate have been available in Germany. The KiGGS results show an increase in the breastfeeding rate from 1986 to 2005. Across all age groups studied, 76.7 % (95 % CI: 75.2 %–78.1 %) of the children were ever breastfed. The rate of ever-breastfed children was significantly lower in mothers from socially disadvantaged population groups, children of mothers who had smoked during pregnancy or in situations with problems after birth. Children with migration background were more frequently ever-breastfed than children without migration background. The average duration of breastfeeding was ¡V across all age-groups ¡V 6.9 months (95 % CI: 6.8–7.0); the duration of full breastfeeding was 4.6 months (95 % CI: 4.5-4.7) on average. 22.4 % (95 % CI: 21.4 %–23.5 %) of all children from the KiGGS study population were exclusively breastfed for a period of six months. The results emphasises the necessity to further promote breastfeeding, especially to support the socially disadvantaged, and most of all to encourage a positive attitude towards breastfeeding in the society.

Keywords  Health survey - Children - Adolescents - Duration of breastfeeding - Breastfeeding rate - Full breastfeeding - Social disadvantage - Promotion of breastfeeding

Bundesgesundheitsbl – Gesundheitsforsch – Gesundheitsschutz 2007 • 50: 634-642

T. Lampert, G. B. M. Mensink, N. Romahn, A. Woll

Physical activity among children and adolescents in Germany. Results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) [pdf]

Abstract

Regular physical activity has a positive effect on health and wellbeing at any age. For this reason, sports and exercise enhancing measures are inherent parts of public health in Germany. The German Health Interview and Examination Survey for Children and Adolescents (KiGGS) provides a nationally representative database which allows a comprehensive analysis of physical activity behaviour among young people. This may support the planning and implementation of health intervention measures. Primary results of KiGGS indicate that most children aged 3 to 10 years regularly go in for sports: around three quarters of girls and boys go in for sports at least once a week, and even more than one third three times a week or more. Children without sport engagement come disproportionately often from families with low socioeconomic status, with a migration background or from former East Germany. Also among adolescents sports and exercise activity is very common. Among 11–17 year olds, how ever, the current recommendation to conduct physical and or sports activities on most days of the week is only achieved by every fourth boy and every sixth girl. Especially girls with low socioeconomic status and with a migration background show a lack of physical activity. These results underline the importance of sports- and exercise-promoting measures in childhood and adolescence, designed for specific target groups.

Keywords  Health survey - Children - Adolescents - Sport - Exercise - Physical activity

Bundesgesundheitsbl – Gesundheitsforsch – Gesundheitsschutz 2007 • 50: 643-652

T. Lampert, R. Sygusch, R. Schlack

Use of electronic media in adolescence. Results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) [pdf]

Abstract

The use of electronic media is playing an ever greater role in adolescents' recreational behaviour. From the point of view of the health sciences, one question which arises is the extent to which intensive media use is detrimental to physical activity and adolescents' health development. The data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), which were evaluated with a focus on 11–17-year-olds, confirm this heavy use of electronic media. However, there are distinct group-specific differences. For example, boys spend more time than girls on computers, the internet and games consoles, whereas girls more often listen to music and use their mobile phones. Watching television and videos is equally popular among girls and boys. Adolescents of low social status or a low level of school education use electronic media far more frequently and for longer times, especially television and video, games consoles and mobile phones. The same is true of boys and girls from the former states of the GDR and for boys (but not girls) with a background of migration. A connection to physical activity has been established for adolescents who spend more than five hours a day using electronic media. Moreover, this group of heavy users is more often affected by adiposity. The results of the KiGGS study, which are in line with earlier research findings, thus demonstrate that the use of electronic media is also of relevance from the point of view of public health and should be included in investigations into the health of children and adolescents.

Keywords  Health survey - Children - Adolescents - Electronic media - Television - Computer - Internet - Video games

Bundesgesundheitsbl – Gesundheitsforsch – Gesundheitsschutz 2007 • 50: 653-658

L. Schenk, H. Knopf

Oral health behaviour of children and adolescents in Germany. First results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) [pdf]

Abstract

Despite successful prevention and the possibility to directly control oral health by individual behaviour, children are still affected by caries. Aim of this article is to determine the prevalence and the social factors influencing selected aspects of oral health behaviour based on data of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Over a period of three years, 17,641 children and adolescents aged 0 to 17 years – a representative sample for Germany – were examined in the nationwide KiGGS study. Based on a written survey and a medical interview, data on oral health behaviour were also collected. 29 % of the surveyed children and adolescents brushed their teeth only once daily or less frequently. This type of teeth brushing behaviour shows a social status gradient (low: 39%, middle: 28%, high: 22%) and is more frequently found in children with a migration background (45 %) than in those without a migration background (26 %). Differences were also found between girls and boys (girls: 25 %; boys: 33 %). In only 8 % of cases, parents stated that their children have a dental check-up less than once a year. However, this information substantially differs from the actual visits to dentists. Here again, differences regarding social status (low: 12 %; high: 6 %) and migration status (migrants: 16 %; nonmigrants: 6 %) were found. According to the parents, 43 % of the 0-to-2-year-olds and 7 % of the 3-to-6-year-olds use pharmaceutical preparations for caries prevention. Relevant differences were found between migrants (5 %) and non-migrants (8 %). These results show that there is primarily a need for social status-specific and culture-specific prevention. To identify starting points for effectively offering preventative measures, a systematic study into the factors causing these behavioural differences is needed.

Keywords  Health survey - Children - Adolescents - Teeth brushing frequency - Dental check-up - Caries prevention

Results - Development

H. Stolzenberg, H. Kahl, K. E. Bergmann

Body measurements of children and adolescents in Germany. Results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) [pdf]

Abstract

In the nationwide German Health Interview and Examination Survey for Children and Adolescents (KiGGS), a number of anthropometric parameters were assessed in a standardised way in 17,641 boys and girls. To this end, body weight and height, head circumference and upper arm length, as well as two skinfold thicknesses (triceps, subscapular) were measured for the entire age range (0–12 years); starting from 6 years of age, elbow breadth and from 11 years of age waist and hip circumference were measured in addition. For all parameters, means with confidence intervals are reported per age (in years) and gender. Median graphs depict the changes with increasing age according to gender for each body measurement. The complex agerelated anthropometric developments along with significant gender specificity show the full range of the dynamic physical development in boys and girls. Based on skinfold measurement data, the body fat percentage was estimated. Thickness and location of the skinfolds, as well as the calculated waist-to-hip ratio is used as an indicator for gender-specific fat distribution. Using the frame index, it is attempted to estimate skeletal robustness. For the anthropometric parameters studied, hardly any regional differences were found. However, head circumference, frame index and all parameters strongly associated with body fat show a significant social status gradient. Children and adolescents with migration background have on average a lower height, larger waist circumference and higher percentage of body fat.

Keywords  Health survey - Children - Adolescents - Anthropometry - Body measurements

Bundesgesundheitsbl – Gesundheitsforsch – Gesundheitsschutz 2007 • 50: 670-676

K. E. Bergmann, R. L. Bergmann, U. Ellert, J. W. Dudenhausen

Perinatal risk factors for long-term health. Results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) [pdf]

Abstract

KiGGS is a health survey on 17,641 children and adolescents in 167 communities representative for Germany, conducted between May 2003 and May 2006. Of the perinatal indicators, only a small proportion of data important for long-term outcomes was available for statistical analysis, and is presented here. In the past 20 years the mean weight gain during pregnancy has increased significantly by 2 kg, the mean birth weight has increased significantly by an average of 50 g, there has been no significant time trend for smoking and alcohol consumption in pregnancy. Birth weight and pregnancy weight gain of the mother correlate significantly. Pregnancy weight gain explains 5% of the birth weight in first-born infants. 17–18% of the mothers smoked during pregnancy, 4 times as many in the lower than the upper social class. 14% of the mothers consumed alcohol in pregnancy, but only 1% regularly. Only 5% of the migrants, but 3 times as many of the non-migrants consumed alcohol in pregnancy, and 2 1/2 times as many of the upper class compared to the lower class. With respect to smoking and alcohol consumption during pregnancy there seems to be an urgent need for political action.

Keywords  Health Survey - Children - Adolescents - Pregnancy - Birth weight - Smoking - Alcohol - Weight gain

Bundesgesundheitsbl – Gesundheitsforsch – Gesundheitsschutz 2007 • 50: 677-685

H. Kahl, A. Schaffrath Rosario, M. Schlaud

Sexual maturation of children and adolescents in Germany. Results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) [pdf]

Abstract

Following the standstill in maturity acceleration in the eighties of the twentieth century, now a further shift in maturity development towards younger ages is the issue of an international and also German discussion. The collection of sexual maturity data in boys and girls as part of the nationwide German Health Interview and Examination Survey for Children and Adolescents (KiGGS) is intended to pro vide population-representative information on sexual maturation and to evaluate associations between maturity status and selected health and social data. Girls were interviewed regarding their first menstrual period (menarche) and boys regarding voice change (status-quo method). Pubic hair was self-assessed by children and adolescents from 10 to 17 years of age, based on drawings of Tanner's defined developmental stages. The median age for menarche, for voice change and pubic hair stages were calculated using a logit model. At an age of 10 years, 42.4 % of girls and 35.7 % of boys report the development of pubic hair. At 17 years of age, the majority of girls and boys have reached the stages PH5 (girls 57.5 %, boys 47.8 %) and PH6 (girls 23.6 %, boys 46.5 %) according to Tanner. The average age for each pubic hair stage is lower in girls (PH2 10.8; PH3 11.7; PH4 12.3; PH5 13.4 years) than in boys (PH2 10.9; PH3 12.6; PH4 13.4; PH5 14.1). The median age at menarche is 12.8 years, the median for voice change (voice low) 15.1 years. Significant differences in age at menarche are found in girls depending on socioeconomic status (12.7/12.9/13.0 years for low/middle/high status) and between girls with and without migration background (12.5/12.9 years). No differences in age at menarche can be seen between East and West Germany or cities and rural areas. The association between maturity status and BMI is more pronounced in girls than in boys. Overall, the onset of maturity development in German children and adolescents is not significantly earlier than in other European studies.

Keywords  Health survey - Children - Adolescents - Sexual maturity - Menarche - Mutation - Pubic hair

Last updated: June 2007