Intergenerational transmission of overweight and the role of built environment indicators

Abstract Background 15.4% of children and adolescents in Germany suffer from overweight that can be partially explained by parental weight status. As there is little national evidence, we focused on the intergenerational transmission of overweight. We expected the household's food and physical activity environment to interact with parental overweight to explain the occurrence of childhood overweight, which led us to analyze moderating effects of the neighborhood. Methods Our sample consisted of 10,073 children (data: German Child and Adolescent Health Survey), and we calculated body mass index (BMI) based on self-reported height and weight. Childhood overweight was defined according to the International Obesity Task Force definition. Parental overweight was measured if the BMI of at least one or both parents exceeded the threshold of 25 kg/m2. Food environment was defined by the number of fast food restaurants around the child's address (1-km buffer; data: OpenStreetMap). Physical activity environment was defined by the total number of playgrounds, recreational facilities and at least 5,000 m2 of green space around the child's address (1-km buffer; data: Basic-DLM). Results We estimated that 14.4% of children in our sample were overweight and 71.8% lived in a household with at least one overweight parent. Probit regression models adjusted for child and household characteristics showed an 8.6 percentage point increase in overweight among children when parents were overweight. However, we found no significant interaction effects for the two built environment indicators. Conclusions Robust intergenerational correlates of overweight indicate that unhealthy lifestyles are transmitted. Tackling the causes of weight gain in children must therefore not only begin in the early stages of life, but must also start with children and parents simultaneously. However, the influence of the built environment must be investigated further, as some results pointed in the expected direction. Key messages • Parental overweight was associated with an 8.6 percentage point increase in childhood overweight. • Indicators of the physical activity and food environment showed no moderating effects.