Main topic English version of “Übergewicht und Adipositas in Deutschland. Ergebnisse der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1)” Bundesgesundheitsbl 2013 · 56:786–794 DOI 10.1007/s00103-012-1656-3 © Springer-Verlag Berlin Heidelberg 2013

G.B.M. Mensink · A. Schienkiewitz · M. Haftenberger · T. Lampert ·   T. Ziese · C. Scheidt-Nave Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin

Overweight and obesity in Germany Results of the German Health Interview and Examination Survey for Adults (DEGS1)

Background and purpose Nutrition, physical activity and genetic disposition determine in close interaction with each other, to a large extent the development of overweight. Life circumstances and individual habits represent a challenge to many people to keep a good balance between energy requirements and energy intake. In the last decades, an increase in the prevalence of overweight and obesity has been observed in many countries, recently also in many threshold and developing countries [1]. Worldwide, the highest prevalence of overweight and obesity for both men and women can be observed in the USA and some islands in the Pacific. Germany belongs to the countries with high overweight and obesity prevalence [1, 2]. In the late 1990s, several European countries, such as the Benelux states, France, Switzerland, Austria and Denmark, had lower obesity prevalence than Germany. Prevalence estimates similar to Germany were reported from the UK, Ireland and Norway and higher estimates from Poland, the Czech Republic, Italy and Spain [3]. More recent data show that there have only been slight changes in prevalence since then [4]. Overweight and obesity are usually defined on the basis of the Body Mass Index (BMI). According to the classification of the WHO, overweight is defined with a BMI of 25 kg/m2 and higher. This category includes obesity, which specifies a BMI

of 30 kg/m2 and higher. The BMI range between 25 and 30 kg/m2 is referred to as pre-obesity [1]. Obesity can have consequences for a person’s social life, mobility and quality of life [5, 6, 7], but overweight and obesity are also associated with many complaints and diseases [8]. Persons with obesity have an increased risk of type 2 diabetes mellitus [9, 10], cardiovascular disease [11, 12, 13, 14, 15] and certain types of cancers including cancer of the colon, pancreas, kidneys, breast and cervix [16, 17]. As a result, the life expectancy of obese people is observed to be lower than that of people with normal weight [18, 19]. The health risks of pre-obesity are less well substantiated than those of obesity [18, 19, 20]. Against this background, we present information on the prevalence of overweight and obesity among adults in Germany on the basis of the anthropometrical examinations of the first wave of the German Health Interview and Examination Survey for Adults (DEGS1). To determine time developments and trends, key results from DEGS1 are compared with results from the German National Health Interview and Examination Survey 1998 and the Health Examination Surveys 1990/92.

Methods The German Health Interview and Examination Survey for Adults (“Studie zur Gesundheit Erwachsener in Deutschland”, DEGS) is part of the health mon-

itoring system at the Robert Koch Institute (RKI). The concept and design of DEGS are described in detail elsewhere [21, 22, 23, 24]. The first wave (DEGS1) was conducted from 2008–2011 and comprised interviews, examinations and tests [21, 24]. The target population comprises residents of Germany aged 18–79 years. DEGS1 has a mixed design which permits both cross-sectional and longitudinal analyses. For this purpose, a random sample from local population registries was drawn to complete participants of the German National Health Interview and Examination Survey 1998 (GNHIES98), who re-participated. A total of 8,152 persons participated, including 4,193 first-time participants (response rate 42%) and 3,959 revisiting participants of GNHIES98 (response rate 62%). In all, 7,238 persons attended one of the 180 examination centres, and 914 were interviewed only. A non-response analysis and a comparison of selected indicators with data from census statistics indicate a high level of representativeness of the net sample for the residential population aged 18–79 years of Germany [22]. The net sample (n=7,988, of these 7,116 participated in examination centres) permits representative cross-sectional and time trend analyses for the age range of 18– 79 years in comparison with GNHIES98 [22]. A comparison with the Health Examination Surveys 1990/92 is possible for the age range of 25–69 years [25, 26]. The following analyses consider the 18–

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 5/6 · 2013 

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Main topic Tab. 1  Means (95% confidence interval) and medians (5th and 95th percentile) of anthropometric measurements in the adult German

population (DEGS1), stratified by sex and age group (n=7,116) Age group Women Means (95% CI) Body height (cm)

18–29 years

165.8 (165.1–166.4) Body weight (kg) 65.2 (64.0–66.4) 2 BMI (kg/m ) 23.7 (23.3–24.1) Medians (5-95th percentile) Body height (cm) 165.8 (155.5–176.3) Body weight (kg) 61.8 (49.7–90.5) BMI (kg/m2) 22.4 (18.6–33.2) Men Means (95% CI) Body height (cm) 179.8 (179.1–180.6) Body weight (kg) 79.6 (78.1–81.0) 2 BMI (kg/m ) 24.5 (24.1–24.9) Medians (5-95th percentile) Body height (cm) 179.4 (168.0–192.3) Body weight (kg) 76.7 (57.9–106.4) 2 BMI (kg/m ) 23.9 (19.0–31.9)

30–39 years

40–49 years

50–59 years

60–69 years

70–79 years

Total

165.0 (164.1–165.9) 68.7 (66.9–70.4) 25.2 (24.6–25.8)

165.9 (165.3–166.6) 70.8 (69.6–72.0) 25.8 (25.3–26.2)

163.1 (162.5–163.6) 73.0 (71.6–74.4) 27.4 (26.9–28.0)

161.1 (160.5–161.7) 74.0 (72.7–75.4) 28.5 (28.0–29.0)

158.5 (157.8–159.1) 73.5 (72.2–74.8) 29.3 (28.8–29.9)

163.5 (163.2–163.9) 70.7 (70.1–71.3) 26.5 (26.3–26.7)

165.1 (153.3–176.0) 64.7 (48.5–98.2) 23.5 (18.8–35.8)

166.1 (154.9–175.5) 67.9 (52.2–98.4) 24.4 (19.5–35.9)

162.6 (153.3–173.4) 70.0 (53.6–104.9) 26.3 (20.4–38.8)

161.1 (151.5–170.9) 71.9 (54.8–102.6) 27.9 (21.4–37.8)

158.2 (147.3–169.2) 73.0 (53.6–95.9) 28.9 (21.8–39.3)

163.4 (152.3–174.5) 68.0 (51.6–98.2) 25.4 (19.6–37.0)

179.1 (178.1–180.1) 86.0 (84.1–87.8) 26.8 (26.3–27.3)

177.8 (177.0–178.5) 87.0 (85.5–88.5) 27.6 (27.0–28.1)

176.7 (176.0–177.3) 87.4 (85.9–88.8) 27.9 (27.5–28.3)

174.1 (173.3–174.8) 87.3 (85.9–88.7) 28.8 (28.4–29.2)

172.0 (171.2–172.7) 84.3 (83.0–85.7) 28.5 (28.1–28.9)

177.0 (176.6–177.3) 85.2 (84.5–85.9) 27.2 (27.0–27.4)

179.2 (166.5–191.0) 84.9 (63.7–112.8) 26.1 (20.9–34.9)

178.0 (166.0–190.1) 85.3 (67.4–115.3) 27.0 (21.5–35.9)

176.7 (165.0–187.5) 85.9 (64.3–112.3) 27.5 (21.6–34.7)

174.2 (162.1–184.7) 85.1 (66.5–112.6) 28.1 (22.9–36.2)

171.6 (160.7–183.3) 83.5 (64.8–105.8) 27.8 (23.1–35.2)

176.9 (164.5–189.8) 83.8 (75.1–93.3) 26.7 (24.1–29.8)

79 year olds who participated in the examination part (n=7,116). The anthropometric examinations were conducted by trained staff according to standardised procedures. During the measurements the participants were dressed only in underwear without shoes. Body height was measured with a portable stadiometer (Holtain Ltd., UK) with a precision of 0.1 cm, and body weight on a calibrated electronic scale (SECA, column scale 930) with a precision of 0.1 kg. Overweight (BMI≥25 kg/m2), pre-obesity (BMI≥25 to