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This study of the dynamics of BMI in children from birth to adolescence assessed the age of susceptibility for sustained obesity and of onset of obesity. The most rapid weight gain occurred between 2 and 6 years of age; obesity at that age forecast obesity in adolescence.

Background Physical inactivity, especially in the context of the worldwide childhood obesity epidemic, is still a growing public health concern. Moreover, both physical inactivity and overweight often become ingrained and subsequently persist into adulthood. Therefore, the main purpose of this study was to investigate how weight status, sex, age, sedentary behavior, pubertal status and socioeconomic status influence physical activity levels in children and adolescents. Methods This study utilized accelerometer data (SenseWear Pro 2, Bodymedia) to explore correlations between the outcome variable physical activity levels and the predictor variables weight status, sex, age, sedentary behavior, pubertal status and socioeconomic status. We analyzed 847 observations from 397 children and adolescents between the ages of 5.9 and 17.9 years, employing linear mixed-effect regression models. Roughly 55% of participants were categorized as overweight, 45% normal- or underweight. Results A mere 18% of the cohort met the World Health Organization`s activity recommendations for 60 min of moderate to vigorous physical activity (MVPA) per day on weekdays. Specifically, children classified as overweight/obese participated less frequently in MVPA compared with their normal or lower weight peers. Children 14 years of age or younger with overweight or obesity were 30 min less active per day on weekends ( p  < 0.001). Furthermore, girls were less active than boys. This effect was most pronounced on weekends for those between the ages of 14 and 17.9, when girls engaged in 21 fewer min of MVPA ( p  = 0.013). Across all participants, every year older corresponded to a weekly decrease in MVPA of approximately 47 min ( p  < 0.001). Additionally, MVPA levels declined significantly with advancing pubertal stage, with postpubertal adolescents accumulating 4.1 h less MVPA than their prepubertal peers ( p  < 0.001). Low socioeconomic status was associated with an 18-minute reduction in MVPA ( p  = 0.016) on weekends, but only in boys. Conclusion These findings demonstrate a significant association between physical activity levels and the examined predictors, highlighting the importance of addressing multiple factors to enhance physical activity engagement. The results underscore the need for a multifaceted, targeted approach at enhancing physical activity levels and improving child health, curbing the ongoing prevalence of overweight and obesity in childhood and subsequent adulthood.

The familial social background of a child can significantly impact their behavior and health. We investigated associations between socio-economic status (SES) and health parameters and behaviors in German children and adolescents. Data were collected between 2011 and 2018 in the framework of the LIFE Child study. Participants included 2998 children aged 3–18 years. SES was represented by an index combining information on parental education, occupation, and income. Associations between SES and health outcomes were estimated using linear and logistic regression analyses. In a moderator analysis, all associations were checked for interactions between SES and age or sex. A higher SES composite score was associated with better health (lower body mass index (β = −0.26), fewer behavioral difficulties (β = −0.18), higher quality of life (β = 0.21), fewer critical life events (odds ratio (OR) = 0.93); all p < 0.05) and a healthier lifestyle (healthier nutrition (β = 0.16), less excessive television use (OR = 0.87), less nicotine consumption (OR = 0.93), and more physical activity (OR = 1.18); all p < 0.05). However, SES was not associated with alcohol consumption (OR = 1.02) or sleep problems (β = −0.04). The strengths of the associations between SES and child health did not differ depending on SES indicator (education, occupation, income). The associations between SES and parent-reported behavioral difficulties and physical activity were stronger in older vs. younger children. In contrast, none of the observed associations were moderated by sex. This study highlights the strong association between socio-economic status and child health, even in modern Western societies.

Background Since children can only control and limit their own media use to a limited extent, it is often the parents who regulate their children’s media use. However, there is insufficient research on which strategies they use and on how these strategies are related to socio-demographic and behavioral parameters. Methods The parental media regulation strategies co-use, active mediation, restrictive mediation, monitoring, and technical mediation were assessed in a sample of 563 four- to 16-year-old children and adolescents from middle to high social strata participating in the German cohort study LIFE Child. We investigated cross-sectional associations with socio-demographic characteristics (age and sex of child, age of parent, and socio-economic status (SES)) and other behavioral parameters of children (media use, ownership of media devices, engagement in extracurricular activities) and their parents (media use). Results All media regulation strategies were applied frequently, with restrictive mediation occurring most frequently. Overall, parents of younger children and of boys mediated media use more frequently, while we observed no differences depending on SES. Regarding child behavior, the ownership of a smartphone and a tablet/personal computer/laptop was associated with more frequent technical restriction, while screen time and engagement in extracurricular activities was not associated with parental media regulation. In contrast, parental screen time was related to more frequent co-use and less frequent use of restrictive and technical mediation. Conclusion Parental regulation of child media use is influenced by parental attitudes and a perceived need for mediation (e.g., in younger children or children owning internet-enabled devices) rather than child behavior.

The present study aimed to investigate and compare parent-child agreement in different domains of child health and behavior. Data were collected between 2011 and 2019 within the framework of the LIFE Child study (Germany). Different subgroups of 10- to 12-year-old children and their parents (n (max) = 692) completed questionnaires on several health behaviors (diet, media use, physical activity, sleep), parameters of health (behavioral strengths and difficulties, psychosomatic complaints), and school grades. Agreement between child and parent reports was evaluated using weighted kappa coefficients. Furthermore, the frequencies of different types of (dis)agreement (parent report > child report, same response, child report > parent report) were assessed and checked for associations with child or parent gender. Agreement between child and parent reports varied from low to almost perfect, with the greatest levels of agreement for school grades and organized physical activity, and the lowest for dizziness, sleep duration, and the consumption of potatoes. Child gender had no significant effect on parent-child agreement. In contrast, the findings suggest that parent gender had some effect on agreement levels, with higher agreement for certain psychosomatic complaints when parent reports were completed by the mother, and higher agreement for white bread consumption if they were completed by the father. For some of the questionnaire items (especially those relating to behavioral difficulties and psychosomatic complaints, but also to the consumption of individual food products and mobile phone use), the type of (dis)agreement differed depending on child or parent gender. The findings suggest that the perceptions and reporting strategies of children and their parents can diverge considerably, in particular for behavior that is not easily observable or measurable.

Background Overweight and obesity represent huge concerns for children's physical and mental well-being. This study examined the relationship between body mass index (BMI) and health-related quality of life (HRQoL), somatoform complaints, and behavioral problems in children and adolescents. Additionally, the influence of sex, age, and socioeconomic status (SES) on these associations was considered. Methods In total, we studied 2350 participants between the ages of 4 and 18 years (1213 4- to 10-years-old (child sample) and 1137 11-to 18-year-olds (adolescent sample)). To assess HRQoL, somatoform complaints, and behavioral difficulties, we applied the KIDSCREEN-27, a short form of the Giessen Complaints Questionnaire, and the Strengths and Difficulties Questionnaire (SDQ). The BMI was transformed to BMI standard deviation scores (BMI-SDS), according to German gender- and age-specific reference data. Associations were investigated using linear regression analyses. Each association was checked for interaction with sex, age, and SES. Results Regarding HRQoL, we found worsening scores in physical well-being and psychological well-being with increasing BMI-SDS. Somatoform complaints were not significantly associated with BMI-SDS. Conduct problems, peer relationship problems, and emotional problems (the latter only in the adolescent sample) were positively associated with BMI-SDS. While we did not observe any significant interactions with sex, we found some significant interactions with age and/or SES. Conclusion Our findings highlight the importance of mental difficulties in children and adolescents with higher BMI and, consequently, underline the relevance of including psychological interventions in the treatment of overweight or obesity.

In spring 2020, the first Covid-19-related lockdown included the closing of kindergartens and schools. Home schooling, the lack of social contacts with peers and the care of the children at home posed an enormous challenge for many families. The present study investigated the leisure behavior of 285 one- to 10-year-old German children at two time points (t1 and t2) during the Covid-19-related lockdown in spring 2020. In the subsample of primary school children (n = 102), we also explored children's attitudes towards schoolwork at home. Analyses focused on the change of behavior from t1 to t2, on differences in these changes depending on socio-economic status (SES), and on associations of behavior with SES, the number of children at home, and the frequency of receiving learning materials from school. While the frequency of playing outside increased significantly from t1 to t2, the frequency of handicrafts, playing board games, indoor sports, and motivation to do schoolwork decreased. The observed changes between t1 and t2 did not differ depending on SES. However, a lower SES was associated with higher media use, less outdoor activity, and (though only marginally significant) a reduced time doing schoolwork and a reduced ability to concentrate on schoolwork at t1. In households with more children, children played outside more often, but were read to less frequently and (though only marginally significant) watched movies and series less frequently. Children receiving learning materials from school on a regular basis spent significantly more time doing schoolwork at home than children receiving materials only irregularly. A continuing loss of childcare in day-care facilities and schools entails the danger of declining education in the form of (inter)active indoor activities and schoolwork.

Objective This study aimed to (1) characterise sleep disturbances and emotional/behavioural difficulties among healthy German children and adolescents aged 3 to 13 years, (2) examine the association between parent-reported sleep problems and emotional/behavioural difficulties, (3) point out possible relations between specific kinds of sleep disturbances and different behavioural difficulties. Methods Data were collected between 2011 and 2015 within the LIFE Child study in Germany. The sample included 1101 3- to 13-year-old children and adolescents. Information on sleep disturbances—assessed via the Children’s Sleep Habits Questionnaire (CSHQ), emotional/behavioural difficulties—assessed via the Strengths and Difficulties Questionnaire (SDQ), and socioeconomic status was provided by participants’ parents. Multiple regressions were applied to analyse the associations between general and specific sleep disturbances (independent variables) and emotional/behavioural difficulties (dependent variables). Results The total CSHQ score was positively associated with the total SDQ score and all SDQ subscales (emotional problems, conduct problems, hyperactivity/inattention, peer relationship problems). Most of the CSHQ subscales were related to SDQ subscale scores, except for a few non-significant relations with hyperactivity/inattention and conduct problems. The CSHQ total score, daytime sleepiness, sleep duration and parasomnias showed the strongest associations with the SDQ total score. Conclusion This study confirms an association between children’s and adolescents’ sleep habits and psychological health. We were able to demonstrate the association between sleep problems and emotional/behavioural difficulties in a large sample of healthy participants. In particular, we observed a significant relation between parasomnias and hyperactive/inattentive behaviour as well as a significant association between emotional problems and sleep problems, especially daytime sleepiness, sleep anxiety and parasomnias.

Background Behavioural and emotional difficulties might play an important role in the development of body image disturbances, which represent serious risk factors for eating disorders or depression. The present study provides a detailed overview on body image disturbances and several behavioural and emotional difficulties (differences between gender, age, and weight status) and their inter-relations in German children and adolescents. Methods Data on body image disturbances, assessed through a Figure Rating Scale, and on behavioural and emotional difficulties, assessed through Goodman’s Strengths and Difficulties Questionnaire (SDQ), were available for 5255 observations of 1982 German children and adolescents aged 8 to 18 years from the LIFE Child study, based in Leipzig, Germany. Associations were investigated using multiple logistic regression. Each association was checked for interaction with gender, age, and weight status. Results Boys reported more behavioural difficulties than girls, while girls reported more emotional difficulties. Gender, age and weight status were related to behavioural and emotional difficulties as well as body image disturbances. Individuals with fewer difficulties were more satisfied with their own body. Children and adolescents who desired to be larger showed more prosocial behaviour problems, conduct and emotional problems and more signs of hyperactivity. Those, who desired to be thinner showed more problems in all SDQ-subscales. A more accurate body size perception was associated with fewer behavioural and emotional difficulties. Children and adolescents who overestimated their body size showed more prosocial behaviour and emotional problems. Underestimation one’s body size was associated with more signs of hyperactivity. Conclusion The current findings highlight the importance of raising the awareness about the association between behavioural and emotional difficulties and body image disturbances in children and adolescents to prevent negative outcomes.

Background To investigate environmental and social risk factors for myopia in children and adolescents in Germany. Methods 1437 children aged between 3 and 18 inclusive were examined as part of the LIFE Child study based in Leipzig, Germany. Information about leisure time activities and social status was ascertained by parents and children in a questionnaire. Refractive status was attained by measuring noncycloplegic autorefraction. Myopia was defined as spherical equivalent (SE) ≤ − 0.75 D. Risk factors were identified using multiple logistic regression analysis. Results In multiple logistic regression analysis, myopia was significantly associated with less frequent outdoor activity (“once a week” vs. “twice a week or more”: odds ratio (OR) 4.35, 95% confidence interval (CI) 1.89–9.98, p<0.01) and longer near work sessions (1–2 h vs. < 1 h: OR 1.83, CI 1.10–3.04, p=0.02; > 3 h vs. < 1 h: OR 3.71, CI 1.43–9.61, p<0.01) after adjustment for age, sex and socioeconomic status (SES). Duration of outdoor activity, near work frequency and SES showed no significant association with myopia (p > 0.05). Children with a lower SES were involved in longer periods of outdoor and near work activities but on fewer occasions over the course of the week, although this connection was not significant. Conclusion Myopia is associated with environmental factors. The present findings suggest that daily exposure to sunlight and a restriction of long-duration near work activities might protect against pathological eye growth. Prevention strategies should be implemented for children at all ages.