European Journal of Nutrition

, Volume 53, Issue 3, pp 865–875 | Cite as

Pediatric adiposity stabilized in Switzerland between 1999 and 2012

  • Stefanie B. Murer
  • Siret Saarsalu
  • Michael B. Zimmermann
  • Isabelle Aeberli
Original Contribution



Several countries have recently reported stabilization and/or a decrease in the prevalence of pediatric obesity. However, systematic, repeated national monitoring studies are scarce, and it is unclear whether this trend would be sustained. The objective was to present the latest overweight and obesity prevalence in Swiss children and to investigate trends in prevalence from 1999 to 2012.


Using probability-proportionate-to-size cluster sampling, nationally representative samples of children aged 6–12 years were recruited in 1999 (n = 594), 2002 (n = 2,493), 2004 (n = 328), 2007 (n = 2,218), 2009 (n = 907), and 2012 (n = 2,963). Height and weight were measured to calculate BMI (kg/m2). BMI cutoffs proposed by the Centers for Disease Control and Prevention (CDC) and by the International Obesity Task Force were used to determine the prevalence of overweight (excluding obesity) and obesity. Waist circumference was measured in 2007 and 2012, and multiple skinfold thicknesses assessed in 2002 and 2012.


Using the CDC criteria, prevalences of overweight and obesity in 2012 were 11.9 % (95 % CI 10.7–13.1) and 7.1 % (95 % CI 6.2–8.0), respectively, and did not change between 1999 and 2012 (β = −0.144, p = 0.293 and β = −0.063, p = 0.552, respectively). Boys had significantly higher obesity prevalence than girls in 2007 (5.6 vs. 3.4 %) and 2012 (8.1 vs. 5.9 %). Percentage of children with excess waist circumference and body fat percentage did not differ between 2007 and 2012, and 2002 and 2012, respectively.


Our data indicate the prevalence of childhood adiposity in Switzerland stabilized between 1999 and 2012, but ≈1 in 5 children remain overweight or obese and further efforts are needed to control the epidemic.


Obesity Overweight Children Trends Body fat percentage Waist circumference 



Body fat percentage


BMI standard deviation scores


Centers for Disease Control and Prevention


Body density


International Obesity Task Force




Skinfold thicknesses



We would like to thank the principals of all participating schools as well as all teachers and children for their cooperation. Furthermore, we thank Regula Schüpbach, Jasmin Zimmermann, Jasmin Tajeri Foman, and Sara Stinca for their assistance in the study. Financial support for the study was provided by the Swiss Federal Office of Public Health (Bern, Switzerland). The authors’ responsibilities were as follows: SBM, MBZ, and IA designed research; SBM and SS conducted research; SBM analyzed data; SBM, MBZ, and IA wrote the paper; SBM, MBZ, and IA had primary responsibility for final content. All authors have read and approved the final manuscript.

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Wang Y, Lobstein T (2006) Worldwide trends in childhood overweight and obesity. Int J Pediatr Obes 1:11–25CrossRefGoogle Scholar
  2. 2.
    Wang YF, Lim HJ (2012) The global childhood obesity epidemic and the association between socio-economic status and childhood obesity. Int Rev of Psychiatry 24:176–188. doi: 10(3109/09540261),2012,688195 CrossRefGoogle Scholar
  3. 3.
    Lobstein T, Baur L, Uauy R (2004) Obesity in children and young people: a crisis in public health. Obes Rev 5(Suppl 1):4–104. doi: 10.1111/j.1467-789X.2004.00133.x CrossRefGoogle Scholar
  4. 4.
    Singh AS, Mulder C, Twisk JW, van Mechelen W, Chinapaw MJ (2008) Tracking of childhood overweight into adulthood: a systematic review of the literature. Obes Rev 9:474–488. doi: 10.1111/j.1467-789X.2008.00475.x CrossRefGoogle Scholar
  5. 5.
    de Onis M, Blossner M, Borghi E (2010) Global prevalence and trends of overweight and obesity among preschool children. Am J Clin Nutr 92:1257–1264. doi: 10.3945/ajcn.2010.29786 CrossRefGoogle Scholar
  6. 6.
    Rokholm B, Baker JL, Sorensen TI (2010) The levelling off of the obesity epidemic since the year 1999–a review of evidence and perspectives. Obes Rev 11:835–846. doi: 10.1111/j.1467-789X.2010.00810.x CrossRefGoogle Scholar
  7. 7.
    Olds T, Maher C, Zumin S, Peneau S, Lioret S, Castetbon K, Bellisle J, de Wilde J, Hohepa M, Maddison R, Lissner L, Sjoberg A, Zimmermann M, Aeberli I, Ogden C, Flegal K, Summerbell C (2011) Evidence that the prevalence of childhood overweight is plateauing: data from nine countries. Int J Pediatr Obes 6:342–360. doi: 10(3109/17477166),2011,605895 CrossRefGoogle Scholar
  8. 8.
    Zimmermann MB, Gubeli C, Puntener C, Molinari L (2004) Overweight and obesity in 6-12 year old children in Switzerland. Swiss Med Wkly 134:523–528Google Scholar
  9. 9.
    Prader A, Largo RH, Molinari L, Issler C (1989) Physical growth of Swiss children from birth to 20 years of age. First Zurich longitudinal study of growth and development. Helv Paediatr Acta Suppl 52:1–125Google Scholar
  10. 10.
    Aeberli I, Ammann RS, Knabenhans M, Molinari L, Zimmermann MB (2009) Decrease in the prevalence of paediatric adiposity in Switzerland from 2002 to 2007. Public Health Nutr 1–6. doi  10.1017/S1368980009991558
  11. 11.
    Freedman DS, Wang J, Maynard LM, Thornton JC, Mei Z, Pierson RN, Dietz WH, Horlick M (2005) Relation of BMI to fat and fat-free mass among children and adolescents. Int J Obes (Lond) 29:1–8. doi: 10.1038/sj.ijo.0802735 CrossRefGoogle Scholar
  12. 12.
    McCarthy HD (2006) Body fat measurements in children as predictors for the metabolic syndrome: focus on waist circumference. Proc Nutr Soc 65:385–392Google Scholar
  13. 13.
    Sarria A, Garcia-Llop LA, Moreno LA, Fleta J, Morellon MP, Bueno M (1998) Skinfold thickness measurements are better predictors of body fat percentage than body mass index in male Spanish children and adolescents. Eur J Clin Nutr 52:573–576CrossRefGoogle Scholar
  14. 14.
    Liem ET, De Lucia Rolfe E, L’Abee C, Sauer PJ, Ong KK, Stolk RP (2009) Measuring abdominal adiposity in 6 to 7-year-old children. Eur J Clin Nutr 63:835–841. doi: 10.1038/ejcn.2008.57 CrossRefGoogle Scholar
  15. 15.
    Freedman DS, Wang J, Ogden CL, Thornton JC, Mei Z, Pierson RN, Dietz WH, Horlick M (2007) The prediction of body fatness by BMI and skinfold thicknesses among children and adolescents. Ann Hum Biol 34:183–194. doi: 10.1080/03014460601116860 CrossRefGoogle Scholar
  16. 16.
    Pouliot MC, Despres JP, Lemieux S, Moorjani S, Bouchard C, Tremblay A, Nadeau A, Lupien PJ (1994) Waist circumference and abdominal sagittal diameter: best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women. Am J Cardiol 73:460–468CrossRefGoogle Scholar
  17. 17.
    Browning LM, Hsieh SD, Ashwell M (2010) A systematic review of waist-to-height ratio as a screening tool for the prediction of cardiovascular disease and diabetes: 0.5 could be a suitable global boundary value. Nutr Res Rev 23:247–269. doi: 10.1017/S0954422410000144 CrossRefGoogle Scholar
  18. 18.
    Cowin I, Emmett P (2000) Cholesterol and triglyceride concentrations, birthweight and central obesity in pre-school children. ALSPAC Study Team. Avon Longitudinal Study of Pregnancy and Childhood. Int J Obes Relat Metab Disord 24:330–339CrossRefGoogle Scholar
  19. 19.
    Flodmark CE, Sveger T, Nilsson-Ehle P (1994) Waist measurement correlates to a potentially atherogenic lipoprotein profile in obese 12-14-year-old children. Acta Paediatr 83:941–945CrossRefGoogle Scholar
  20. 20.
    Freedman DS, Serdula MK, Srinivasan SR, Berenson GS (1999) Relation of circumferences and skinfold thicknesses to lipid and insulin concentrations in children and adolescents: the Bogalusa Heart Study. Am J Clin Nutr 69:308–317Google Scholar
  21. 21.
    Hess SY, Zimmermann MB, Torresani T, Burgi H, Hurrell RF (2001) Monitoring the adequacy of salt iodization in Switzerland: a national study of school children and pregnant women. Eur J Clin Nutr 55:162–166CrossRefGoogle Scholar
  22. 22.
    Zimmermann MB, Aeberli I, Torresani T, Burgi H (2005) Increasing the iodine concentration in the Swiss iodized salt program markedly improved iodine status in pregnant women and children: a 5-y prospective national study. Am J Clin Nutr 82:388–392Google Scholar
  23. 23.
    Andersson M, Aeberli I, Wust N, Piacenza AM, Bucher T, Henschen I, Haldimann M, Zimmermann MB (2010) The Swiss iodized salt program provides adequate iodine for school children and pregnant women, but weaning infants not receiving iodine-containing complementary foods as well as their mothers are iodine deficient. J Clin Endocrinol Metab 95:5217–5224. doi: 10.1210/jc.2010-0975 CrossRefGoogle Scholar
  24. 24.
    Zimmermann MB, Hess SY, Hurrell RF (2000) A national study of the prevalence of overweight and obesity in 6-12 y-old Swiss children: body mass index, body-weight perceptions and goals. Eur J Clin Nutr 54:568–572CrossRefGoogle Scholar
  25. 25.
    Aeberli I, Henschen I, Molinari L, Zimmermann MB (2010) Stabilization of the prevalence of childhood obesity in Switzerland. Swiss Med Wkly 140:w13046. doi: 10.4414/smw.2010.13046 Google Scholar
  26. 26.
    World Health Organization (1995) Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ Tech Rep Ser 854:1–452Google Scholar
  27. 27.
    Gibson R (1993) Nutritional assessment: a laboratory manual. Oxford University Press, OxfordGoogle Scholar
  28. 28.
    Aeberli I, Gut-Knabenhans I, Kusche-Ammann RS, Molinari L, Zimmermann MB (2011) Waist circumference and waist-to-height ratio percentiles in a nationally representative sample of 6-13 year old children in Switzerland. Swiss Med Wkly 141:w13227. doi: 10.4414/smw.2011.13227 Google Scholar
  29. 29.
    Ogden CL, Kuczmarski RJ, Flegal KM, Mei Z, Guo S, Wei R, Grummer-Strawn LM, Curtin LR, Roche AF, Johnson CL (2002) Centers for Disease Control and Prevention 2000 growth charts for the United States: improvements to the 1977 National Center for Health Statistics version. Pediatrics 109:45–60CrossRefGoogle Scholar
  30. 30.
    Cole TJ, Bellizzi MC, Flegal KM, Dietz WH (2000) Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 320:1240–1243CrossRefGoogle Scholar
  31. 31.
    Zimmermann MB, Gubeli C, Puntener C, Molinari L (2004) Detection of overweight and obesity in a national sample of 6-12-y-old Swiss children: accuracy and validity of reference values for body mass index from the US Centers for Disease Control and Prevention and the International Obesity Task Force. Am J Clin Nutr 79:838–843Google Scholar
  32. 32.
    Rolland-Cachera MF (2011) Childhood obesity: current definitions and recommendations for their use. Int J Pediatr Obes 6:325–331. doi: 10(3109/17477166),2011,607458 CrossRefGoogle Scholar
  33. 33.
    Deurenberg P, Pieters JJ, Hautvast JG (1990) The assessment of the body fat percentage by skinfold thickness measurements in childhood and young adolescence. Br J Nutr 63:293–303CrossRefGoogle Scholar
  34. 34.
    Salanave B, Peneau S, Rolland-Cachera MF, Hercberg S, Castetbon K (2009) Stabilization of overweight prevalence in French children between 2000 and 2007. Int J Pediatr Obes 4:66–72. doi: 10.1080/17477160902811207 CrossRefGoogle Scholar
  35. 35.
    Peneau S, Salanave B, Maillard-Teyssier L, Rolland-Cachera MF, Vergnaud AC, Mejean C, Czernichow S, Vol S, Tichet J, Castetbon K, Hercberg S (2009) Prevalence of overweight in 6- to 15-year-old children in central/western France from 1996 to 2006: trends toward stabilization. Int J Obes (Lond) 33:401–407. doi: 10.1038/ijo.2009.31 CrossRefGoogle Scholar
  36. 36.
    Kunesova M, Vignerova J, Parizkova J, Prochazka B, Braunerova R, Riedlova J, Zamrazilova H, Hill M, Blaha P, Steflova A (2011) Long-term changes in prevalence of overweight and obesity in Czech 7-year-old children: evaluation of different cut-off criteria of childhood obesity. Obes Rev 12:483–491. doi: 10.1111/j.1467-789X.2011.00870.x CrossRefGoogle Scholar
  37. 37.
    Bluher S, Meigen C, Gausche R, Keller E, Pfaffle R, Sabin M, Werther G, Odeh R, Kiess W (2011) Age-specific stabilization in obesity prevalence in German children: a cross-sectional study from 1999 to 2008. Int J Pediatr Obes 6:e199–e206. doi: 10(3109/17477166),2010,526305 CrossRefGoogle Scholar
  38. 38.
    Stamatakis E, Zaninotto P, Falaschetti E, Mindell J, Head J (2010) Time trends in childhood and adolescent obesity in England from 1995 to 2007 and projections of prevalence to 2015. J Epidemiol Community Health 64:167–174. doi: 10.1136/jech.2009.098723 CrossRefGoogle Scholar
  39. 39.
    Huang JS, Becerra K, Oda T, Walker E, Xu R, Donohue M, Chen I, Curbelo V, Breslow A (2007) Parental ability to discriminate the weight status of children: results of a survey. Pediatrics 120:e112–e119. doi: 10.1542/peds.2006-2143 CrossRefGoogle Scholar
  40. 40.
    Crosbie A, Eichner J, Moore W (2008) Body mass index screening and volunteer bias. Ann Epidemiol 18:602–604. doi: 10.1016/j.annepidem.2008.04.008 CrossRefGoogle Scholar
  41. 41.
    Rito A, Wijnhoven TM, Rutter H, Carvalho MA, Paixao E, Ramos C, Claudio D, Espanca R, Sancho T, Cerqueira Z, Carvalho R, Faria C, Feliciano E, Breda J (2012) Prevalence of obesity among Portuguese children (6-8 years old) using three definition criteria: COSI Portugal, 2008. Pediatr Obes. doi: 10.1111/j.2047-6310.2012.00068.x Google Scholar
  42. 42.
    Binkin N, Fontana G, Lamberti A, Cattaneo C, Baglio G, Perra A, Spinelli A (2010) A national survey of the prevalence of childhood overweight and obesity in Italy. Obes Rev 11:2–10. doi: 10.1111/j.1467-789X.2009.00650.x CrossRefGoogle Scholar
  43. 43.
    Meigen C, Keller A, Gausche R, Kromeyer-Hauschild K, Bluher S, Kiess W, Keller E (2008) Secular trends in body mass index in German children and adolescents: a cross-sectional data analysis via CrescNet between 1999 and 2006. Metabolism 57:934–939. doi: 10.1016/j.metabol.2008.02.008 CrossRefGoogle Scholar
  44. 44.
    Ogden CL, Carroll MD, Kit BK, Flegal KM (2012) Prevalence of obesity and trends in body mass index among US children and adolescents, 1999-2010. JAMA 307:483–490. doi: 10.1001/jama.2012.40 CrossRefGoogle Scholar
  45. 45.
    Sjoberg A, Lissner L, Albertsson-Wikland K, Marild S (2008) Recent anthropometric trends among Swedish school children: evidence for decreasing prevalence of overweight in girls. Acta Paediatr 97:118–123. doi: 10.1111/j.1651-2227.2007.00613.x CrossRefGoogle Scholar
  46. 46.
    de Wilde JA, van Dommelen P, Middelkoop BJ, Verkerk PH (2009) Trends in overweight and obesity prevalence in Dutch, Turkish, Moroccan and Surinamese South Asian children in the Netherlands. Arch Dis Child 94:795–800. doi: 10.1136/adc.2009.163709 CrossRefGoogle Scholar
  47. 47.
    Sjoberg A, Moraeus L, Yngve A, Poortvliet E, Al-Ansari U, Lissner L (2011) Overweight and obesity in a representative sample of schoolchildren - exploring the urban-rural gradient in Sweden. Obes Rev 12:305–314. doi: 10.1111/j.1467-789X.2010.00838.x CrossRefGoogle Scholar
  48. 48.
    Ulijaszek SJ, Kerr DA (1999) Anthropometric measurement error and the assessment of nutritional status. Br J Nutr 82:165–177CrossRefGoogle Scholar
  49. 49.
    Marks GC, Habicht JP, Mueller WH (1989) Reliability, dependability, and precision of anthropometric measurements. The Second National Health and Nutrition Examination Survey 1976-1980. Am J Epidemiol 130:578–587Google Scholar
  50. 50.
    Deurenberg P, Deurenberg-Yap M, Foo LF, Schmidt G, Wang J (2003) Differences in body composition between Singapore Chinese, Beijing Chinese and Dutch children. Eur J Clin Nutr 57:405–409. doi: 10.1038/sj.ejcn.1601569 CrossRefGoogle Scholar
  51. 51.
    Ellis KJ (1997) Body composition of a young, multiethnic, male population. Am J Clin Nutr 66:1323–1331Google Scholar
  52. 52.
    Ellis KJ, Abrams SA, Wong WW (1997) Body composition of a young, multiethnic female population. Am J Clin Nutr 65:724–731Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Stefanie B. Murer
    • 1
    • 3
  • Siret Saarsalu
    • 1
  • Michael B. Zimmermann
    • 1
  • Isabelle Aeberli
    • 1
    • 2
  1. 1.Human Nutrition Laboratory, Institute of Food, Nutrition and HealthSwiss Federal Institute of Technology (ETH) ZurichZurichSwitzerland
  2. 2.Division of Endocrinology, Diabetes, and Clinical NutritionUniversity Hospital ZurichZurichSwitzerland
  3. 3.ZurichSwitzerland

Personalised recommendations