Prevention of obesity - more than an intention. Concept and first results of the Kiel Obesity Prevention Study (KOPS)

OBJECTIVE:Obesity prevention is necessary to address the steady rise in the prevalence of obesity. Although all experts agree that obesity prevention has high priority there is almost no research in this area. The effectivene ss of different intervention strategies is not well documented. There is al so no structured framework for obesity prevention. DESIGN: Based on (i) our current and limited knowledge and (ii) the idea th at prevention of childhood obesity is an effective treatment of adult obesi ty, the Kiel Obesity Prevention Study (KOPS) was started in 1996. Concept, intervention strategies and first results of KOPS are reported in this pape r. KOPS is an ongoing 8 y follow-up study. We first enrolled a large scale cohort of 5 to 7-y-old children, providing sufficient baseline data. KOPS a llows further analyses of the role of individual risk factors as well as of long-term effectiveness of different intervention strategies. RESULTS: From 1996 to 1999 a representative group of 2440 5 to 7-y-old chil dren was recruited tie 30.2% of the total population of 5 to 7-y-old childr en examined by the school physicians) and a full data set was obtained from 1640 children. Of the children, 340 (20.7%) were considered as overweight and obese, 1108 children (67.6%) were normal weight, and underweight was fo und in 192 children (11.7%). Of the normal-weight children, 31% or 346 (21. 1% of the total population) were considered to have a risk of becoming obes e. Cross-sectional data provided evidence that (i) there is an inverse soci al gradient in childhood overweight as well as health-related behaviours an d (ii) parental fatness had a strong influence on childhood overweight. We observed considerable changes in health-related behaviours within 1 y after combined 'school-' and 'family-based' interventions. Interventions aimed t o improve health-related behaviours had significant effects on the age-depe ndent increases in median triceps skinfolds of the whole group (from 10.9 t o 11.3 mm in 'intervention schools' vs from 10.7 to 13.0 mm in 'control sch ools', P < 0.01) as well as in percentage fat mass of overweight children ( increase by 3.6 vs 0.4% per year without and with intervention, respectivel y; P < 0.05). CONCLUSION: First results of KOPS are promising. Besides health promotion, a better school education and social support seem to be promising strategie s for future interventions.