Migration background and childhood overweight in the Hannover Region in 2010–2014: a population-based secondary data analysis of school entry examinations

Yusheng Zhou, Thomas von Lengerke, Ulla Walter, Maren Dreier

Overweight and obesity constitute a global epidemic with rates that are increasing rapidly in children. The aim of the present study was to examine ethnic differences in the prevalence of overweight in pre-school children in a multicultural context. Data were collected from a compulsory school entry examination in the Hannover Region, Germany (n = 50,716) from 2010 to 2014. The prevalence of overweight (including pre-obesity and obesity status) and obesity was estimated using a German national reference. The migration status of the children was based on the parent's migration history. Multivariable logistic and hierarchical multinomial regression analyses were performed to identify factors associated with the overweight, pre-obesity, and obesity status. The prevalence of overweight was significantly higher among migrant children (12.7%) than among the non-migrant children (6.9%). After adjusting for socioeconomic and child development variables, migration background was strongly associated with weight status. The Turkish migrant children showed the highest odds of being pre-obesity (OR 2.05, 95%CI 1.7-2.56) and obesity (OR 2.09, 95%CI 1.67-2.77) compared to non-migrant children. Ethnic and social inequalities exist in childhood overweight among pre-school children in the Hannover Region. Thus, appropriate interventions targeting high-risk migrant groups are needed. What is Known: • The current trend of prevalence rates in Germany for overweight and obesity of pre-school children is becoming stable. • Prevalence of overweight and obesity is clearly higher among migrant children than among non-migrant children. What is New: • This article reveals ethnic variance among different migrant groups. • Turkish migrant children have a higher rate of prevalence even compared to other migrant groups. • Length of child day care attendance fails to exert a strong influence on overweight after adjusting for socio-economic and child development variables.