Although childhood overweight and obesity are increasing worldwide, some countries report trends for stabilization. However, the trend for the potentially atherogenic components of the metabolic syndrome (MetS) in children and adolescents is not well understood. Therefore, the purpose of this study was to analyze the trend of the five components of over 10 years in 2228 first graders aged 6 years. Waist circumference (WC) remained mainly unchanged between 1994 and 2003 whereas the other four components continuously decreased. In boys and girls mean values of triglycerides (？25.9% and ？28.6%, resp.), HDL cholesterol (？19.8% and ？23.4%, resp.), fasting glucose (？7.3% and ？9%, resp.), systolic (？3.8% and ？4.1%, resp.), and diastolic (？10.2% and ？9.7%, resp.) blood pressure significantly decreased. Whereas the prevalence of abdominal adiposity was stable at baseline and after 10 years (？1% in boys and +2% in girls), the prevalence of hypertension, hypertriglyceridemia, low HDL-C, and glucose was very low without any trend. 1. Introduction Overweight, obesity, and the metabolic syndrome (MetS) are an emerging health problem in industrialized and developing countries [1, 2]. Ethnic disparities are reported regarding the prevalence of MetS, which was four times higher in Iranian than in German adolescents as well as regarding single components in terms of considerably higher prevalence of dyslipidemia in Brazilian and Iranian compared with German youths [3, 4]. Secular trends of childhood overweight and obesity in terms of increased body mass index (BMI) are heterogeneous in different countries with a large variation across countries [5–7]. However, BMI is not a component of the metabolic syndrome (MetS) according to the International Diabetes Federation (IDF) defining central obesity for children and adolescents as waist circumference (WC) at or above the 90th percentile . Increasing prevalence of central adiposity indicates increasing cardiovascular risk [9, 10]. Furthermore, early elementary school years are a critical period for increases in obesity prevalence sharply increasing from 10.4% to 19.6% below and above age six years . Therefore, the purpose of this study was to assess the trend of the five single components over 10 years in a large sample of six-year-old first graders. 2. Material and Methods We investigated 2228 German first graders (1116 boys and 1112 girls, median age 6.0 years) who participated in yearly cross-sectional surveys between 1994 and 2003. Continuously trained research assistants measured waist circumference (WC), systolic
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