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Prevalence of Severe Obesity among Primary School Children in 21 European Countries
Istituto Superiore di Sanita, National Centre for Disease Prevention and Health Promotion, Rome, Italy.
WHO European Office for the Prevention and Control of the NCDs, Moscow, Russian Federation.
National Institute of Pharmacy and Nutrition, DG of Food and Nutrition Science, Budapest, Hungary.
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics. (Agneta Yngve)ORCID iD: 0000-0002-7165-279x
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2019 (English)In: Obesity Facts, ISSN 1662-4025, E-ISSN 1662-4033, Vol. 12, no 2, p. 244-258Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The World Health Organization (WHO) European Childhood Obesity Surveillance Initiative (COSI) was established more than 10 years ago to estimate prevalence and monitor changes in overweight and obesity in children aged 6-9 years. Since then, there have been five rounds of data collection in more than 40 countries involving more than half a million children. To date, no comparative studies with data on severe childhood obesity from European countries have been published.

OBJECTIVES: The aim of this work was to present the prevalence of severe obesity in school-aged children from 21 countries participating in COSI.

METHOD: The data are from cross-sectional studies in 21 European WHO member states that took part in the first three COSI rounds of data collection (2007/2008, 2009/2010, 2012/2013). School-aged children were measured using standardized instruments and methodology. Children were classified as severely obese using the definitions provided by WHO and the International Obesity Task Force (IOTF). Analyses overtime, by child's age and mother's educational level, were performed in a select group of countries.

RESULTS: A total of 636,933 children were included in the analysis (323,648 boys and 313,285 girls). The prevalence of severe obesity varied greatly among countries, with higher values in Southern Europe. According to the WHO definition, severe obesity ranged from 1.0% in Swedish and Moldovan children (95% CI 0.7-1.3 and 0.7-1.5, respectively) to 5.5% (95% CI 4.9-6.1) in Maltese children. The prevalence was generally higher among boys compared to girls. The IOTF cut-offs lead to lower estimates, but confirm the differences among countries, and were more similar for both boys and girls. In many countries 1 in 4 obese children were severely obese. Applying the estimates of prevalence based on the WHO definition to the whole population of children aged 6-9 years in each country, around 398,000 children would be expected to be severely obese in the 21 European countries. The trend between 2007 and 2013 and the analysis by child's age did not show a clear pattern. Severe obesity was more common among children whose mother's educational level was lower.

CONCLUSIONS: Severe obesity is a serious public health issue which affects a large number of children in Europe. Because of the impact on educational, health, social care, and economic systems, obesity needs to be addressed via a range of approaches from early prevention of overweight and obesity to treatment of those who need it.

Place, publisher, year, edition, pages
S. Karger, 2019. Vol. 12, no 2, p. 244-258
Keywords [en]
BMI, Childhood Obesity Surveillance Initiative, Europe, Obesity
National Category
Public Health, Global Health, Social Medicine and Epidemiology Pediatrics Nutrition and Dietetics
Research subject
Nutrition
Identifiers
URN: urn:nbn:se:uu:diva-382708DOI: 10.1159/000500436ISI: 000468937100011PubMedID: 31030201OAI: oai:DiVA.org:uu-382708DiVA, id: diva2:1307869
Funder
Swedish Research CouncilForte, Swedish Research Council for Health, Working Life and WelfareAvailable from: 2019-04-29 Created: 2019-04-29 Last updated: 2019-06-24Bibliographically approved

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