Die Adipositas stellt einen Risikofaktor für das Auftreten einer Reihe von chronischen Erkrankungen dar. Das Risiko für Diabetes, Hypertonie und Dyslipidämie steigt schon ab einem BMI von 21 kg/m2 an. In den Industrieländern verursacht ein erhöhter BMI ein Drittel aller ischämischen Herzerkrankungen und ein Viertel aller zerebrovaskulären Erkrankungen. Die Beziehung zwischen der Höhe des BMI und dem relativen Risiko für Gesamtmortalität ist j-förmig. Als unabhängiger Risikofaktor für die Gesamtmortalität belegt Adipositas weltweit den sechsten Rang; in Deutschland steht sie an vierter Stelle. Die Prävalenz der Adipositas in Deutschland hat zwischen 1985 und 2002 konstant zugenommen, bei Männern von 16,2 % auf 22,5 % und bei Frauen von 16,2 % auf 23,3 %. Die Prävalenz des Übergewichts bzw. der Adipositas bei Kindern und Jugendlichen in Deutschland wird derzeit auf 15 % bzw. 6 % geschätzt. Der sozioökonomische Status ist eine wichtige Determinante der Adipositas, wobei der Einfluss sozialer Unterschiede auf die Prävalenz der Adipositas bei Frauen größer ist als bei Männern. Konzepte zur Eindämmung der Adipositas erfordern multiple Strategien, um sowohl auf der Individualebene, als auch auf der Populationsebene eine Trendwende in der Entwicklung dieser Epidemie herbeizuführen.
Summary
Obesity is associated with an increased risk for various chronic diseases. The risk of diabetes, hypertension and dyslipidemia is increased upwards from a body mass index (BMI) of 21 kg/m2. In industrial countries a high BMI accounts for one third of cases of ischemic heart disease and one quarter of cerebrovascular diseases. The relationship between BMI and relative risk of death is 'J'-shaped. Obesity ranks sixth as an independent risk factor for overall mortality worldwide, and fourth among the leading causes of death in Germany. The prevalence of obesity in Germany increased continuously between 1985 and 2002: in men from 16.2% to 22.5% and in women form 16.2% to 23.3%. Prevalence of overweight and obesity in children and adolescents in Germany is estimated to be 15% and 6%, respectively. Socio-economic status is an important determinant of obesity and the effect of social differences on the prevalence of obesity is stronger for women than men. Concepts to curtail obesity require multiple strategies on the individual and population level if the trend of the epidemic is to be reversed.
Schlüsselwörter
Adipositas - Epidemie - Deutschland
Key words
obesity - epidemic - Germany
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