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Abstract Background For practical and financial reasons, self-reported instead of measured height and weight are often used. The aim of this study is to evaluate the validity of self-reports and to identify potential predictors of the validity of body mass index (BMI) derived from self-reported height and weight. Findings Self-reported and measured data were collected from a sub-sample (3,468 adolescents aged 11-17) from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). BMI was calculated from both reported and measured values, and these were compared in descriptive analyses. Linear regression models with BMI difference (self-reported minus measured) and logistic regression models with weight status misclassifications as dependent variables were calculated. Height was overestimated by 14- to 17-year-olds. Overall, boys and girls under-reported their weight. On average, BMI values calculated from self-reports were lower than those calculated from measured values. This underestimation of BMI led to a bias in the prevalence rates of under- and overweight which was stronger in girls than in boys. Based on self-reports, the prevalence was 9.7% for underweight and 15.1% for overweight. However, according to measured data the corresponding rates were 7.5% and 17.7%, respectively. Linear regression for BMI difference showed significant differences according to measured weight status: BMI was overestimated by underweight adolescents and underestimated by overweight adolescents. When weight status was excluded from the model, body perception was statistically significant: Adolescents who regarded themselves as 'too fat' underestimated their BMI to a greater extent. Symptoms of a potential eating disorder, sexual maturation, socio-economic status (SES), school type, migration background and parental overweight showed no association with the BMI difference, but parental overweight was a consistent predictor of the misclassification of weight status defined by self-reports. Conclusions The present findings demonstrate that the observed discrepancy between self-reported and measured height and weight leads to inaccurate estimates of the prevalence of under- and overweight when based on self-reports. The collection of body perception data and parents' height and weight is therefore recommended in addition to self-reports. Use of a correction formula seems reasonable in order to correct for differences between self-reported and measured data.

Background: The nationwide "German Health Interview and Examination Survey for Children and Adolescents" (KiGGS), conducted in 2003-2006, showed an increase in the prevalence rates of overweight and obesity compared to the early 1990s, indicating the need for regularly monitoring. Recently, a follow-up-KiGGS Wave 1 (2009-2012)-was carried out as a telephone-based survey, providing self-reported height and weight. Since self-reports lead to a bias in prevalence rates of weight status, a correction is needed. The aim of the present study is to obtain updated prevalence rates for overweight and obesity for 11- to 17-year olds living in Germany after correction for bias in self-reports.Methods: In KiGGS Wave 1, self-reported height and weight were collected from 4948 adolescents during a telephone interview. Participants were also asked about their body perception. From a subsample of KiGGS Wave 1 participants, measurements for height and weight were collected in a physical examination. In order to correct prevalence rates derived from self-reports, weight status categories based on self-reported and measured height and weight were used to estimate a correction formula according to an established procedure under consideration of body perception. The correction procedure was applied and corrected rates were estimated.Results: The corrected prevalence of overweight, including obesity, derived from KiGGS Wave 1, showed that the rate has not further increased compared to the KiGGS baseline survey (18.9 % vs. 18.8 % based on the German reference).Conclusion: The rates of overweight still remain at a high level. The results of KiGGS Wave 1 emphasise the significance of this health issue and the need for prevention of overweight and obesity in children and adolescents. [ABSTRACT FROM AUTHOR]

Consuming high amounts of fast food can lead to an excessive intake of energy and subsequently promote obesity. Obesity increases a person's risk for diabetes and cardiovascular diseases. The second wave of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 2, 2014-2017) included the Eating study as a KiGGS Module (EsKiMo II, 2015-2017) which assessed the self-reported dietary habits of children and adolescents in Germany. The analysis of the data permits an overview of the fast food consumption of 12- to 17-year-olds (n=1,353). Girls consume 57.5 grams and boys 86.3 grams of fast food per day on average (around 400 grams and 600 grams per week, respectively). Pizza is the most consumed fast food product, followed by filled pita and sausage/meat products such as curry sausage. Adolescent girls on average get 6.5% and boys 7.8% of total daily energy intake from fast food. 23% of 12- to 17-year-olds get at least 10% of their daily energy intake from fast food (high consumers). Significant differences between the proportion of high consumers exist regarding sex, age, socioeconomic status, community size, type of school and media consumption. Compared to EsKiMo I (2006), girls' daily energy intake from fast food has remained nearly constant, whereas that of boys has dropped substantially. From a nutrition physiology perspective, the aim should be to further reduce fast food consumption., Competing Interests: Conflict of interest The authors declared no conflicts of interest., (© Robert Koch Institute. All rights reserved unless explicitly granted.)

Data from the second Eating study as a KiGGS module (EsKiMo II, 2015-2017), are used to determine the contribution of food produced by organic farming (organic food) to the diet of children aged between six and eleven years (n=1,190) in Germany. Dietary intake was assessed by food records during a total of four days. Information on the proportion of organic food intake relative to daily food intake was used to differentiate between three groups: children who did not consume organic food; children whose diet contains 8.0% or less of organic food; and children whose diet comprises more than 8.0% of organic food. The 8.0% threshold represents the mean proportion of organic food eaten by children whose diet includes any amount of organic produce. In total, 63.2% of children eat organic food. The diet of 43.0% of children contains 8.0% or less of organic food, with the diet of 20.2% comprising more than 8.0% of organic food. Vegetables and fruit are among the most commonly consumed organic products. While consumption frequency of organic food does not differ by sex or age, consumption frequency increases with higher socioeconomic status. The large proportion of children (63.2%) who eat organic food suggests that health, environmental and ethical motives play a role in the food choices made by families with children., Competing Interests: Conflict of interest The authors declared no conflicts of interest., (© Robert Koch Institute. All rights reserved unless explicitly granted.)

For some time, there have been indications that the prevalence of overweight and obesity among children and adolescents in Germany has stabilised at a high level. The second wave of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 2, 2014-2017) once again provides nationwide measurements on height and weight of children and adolescents aged 3 to 17 years. The results are confirming this trend. The prevalence of overweight is 15.4% and 5.9% for obesity. There are no differences between girls and boys. Overweight and obesity prevalence increases with age. Children and adolescents with low socioeconomic status (SES) are more likely to be overweight and obese than those with high SES. Compared to the KiGGS baseline study (2003-2006), there was no further increase in overweight and obesity prevalence overall and in all age groups., Competing Interests: Conflicts of interest The authors declared no conflicts of interest., (© Robert Koch Institute. All rights reserved unless explicitly granted.)

Nutrition plays an important role for health, in particular of children and adolescents. In addition to the baseline German Health Interview and Examination Survey for Children and Adolescents (KiGGS, 2003-2006), the nutrition survey EsKiMo (Eating study as a KiGGS Module) assessed the dietary habits of children and adolescents aged 6 to 17 in detail. In KiGGS Wave 2 (2014-2017) the corresponding module is EsKiMo II. Between June 2015 and September 2017, specially trained nutritionists will visit EsKiMo II participants at their homes. The parents of 6-to 11-year-olds are instructed on how to complete food records on four randomly chosen days - three consecutive days, followed later by an additional day. Participants aged 12 to 17 are interviewed personally on their food intake during the past four weeks with the dietary interview programme DISHES. Further information, for example, regarding dietary supplements is also recorded. EsKiMo II will provide an up-to-date and representative overview of the current nutrition status of 6-to 17-year-olds living in Germany, and it allows analysing changes in dietary behaviour over time. EsKiMo II can identify shortcomings in the nutrition of children and adolescents and thus may contribute with important information to nutrition and health policy., Competing Interests: Conflicts of interest The authors declared no conflicts of interest., (© Robert Koch Institute. All rights reserved unless explicitly granted.)

A continuous breastfeeding monitoring is essential as it enables reports on changes in breastfeeding behaviour. The German Health Interview and Examination Survey for Children and Adolescents (KiGGS), which is conducted by the Robert Koch Institute, periodically collects data about the health of children and young people living in Germany, including data on breastfeeding. Moreover, KiGGS is mentioned within the approach developed by the National Breastfeeding Committee as a possible source of data for breastfeeding monitoring. The data from KiGGS can be used to develop retrospective indicators on breastfeeding for particular birth cohorts. The data demonstrate that the prevalence of children who were ever breastfed tended to rise between the 2001/2002 and 2007/2008 cohorts; however, no significant changes were identified for the 2001-2008 cohorts with respect to breastfeeding duration. Breastfeeding monitoring relies on reports about current trends in the field; due to the periodicity with which the KiGGS study waves are conducted, data on current birth cohorts cannot be provided. Therefore, data on breastfeeding needs to be collected throughout Germany in relation to direct environmental and other factors. This data should be collected during health screenings and regular check-ups so that it can be used as a further measure in breastfeeding monitoring., Competing Interests: Conflicts of interest The authors declared no conflicts of interest., (© Robert Koch Institute. All rights reserved unless explicitly granted.)

People adopt a vegetarian diet for various reasons. A largely plant-based diet not only has advantages for health, it also has positive social and environmental aspects. The aim of this analysis is to provide a description of the people in Germany who follow a predominantly vegetarian diet and to compare their food consumption with those of non-vegetarians. As part of DEGS1 (2008-2011), a validated questionnaire was used within a representative sample of 6,933 persons aged 18 to 79 to study how often and how much of 53 different food groups was consumed during a four-week period. The questionnaire also included a question about a vegetarian diet. The data were analysed descriptively and with a binary-logistical regression model. In Germany, 4.3% of the population (6.1% of women and 2.5% of men) aged 18 to 79 usually follows a vegetarian diet. The highest proportion of vegetarians is found among 18- to 29-year-olds (women 9.2% and men 5.0%) and among women aged 60 to 69 (7.3%). People with a higher level of education are more likely to usually follow a vegetarian diet. The same applies to people who live in large cities and those who conduct more than four hours of sports per week. In addition, women and men who usually follow a vegetarian diet not only consume significantly less meat compared with non-vegetarians, they also drink less energy-reduced drinks, and less beer and wine; they also drink more tea and eat more fruit and vegetables. A vegetarian lifestyle is often associated with positive socio-political impacts. It can, among others, contribute to a reduction in factory farming, which means it can help preserve the environment. A reduction in meat consumption in Germany would also be beneficial from a public health perspective, since meat consumption is currently considerably higher than the amounts recommended by the German Nutrition Society. The benefits linked to a vegetarian diet would be further strengthened, if, in addition to the relatively small group of people who completely refrain from eating meat, a larger section of the population would reduce their meat consumption., Competing Interests: Conflicts of interest The authors declared no conflicts of interest., (© Robert Koch Institute. All rights reserved unless explicitly granted.)