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Prevalence of Severe Obesity among Primary School Children in 21 European Countries

Journal article
Authors Angela Spinelli
Marta Buoncristiano
Viktoria Anna Kovacs
Agneta Yngve
Igor Spiroski
Galina Obreja
Gregor Starc
Napoleón Pérez
Ana Isabel Rito
Marie Kunešová
Victoria Farrugia Sant'Angelo
Jørgen Meisfjord
Ingunn Holden Bergh
Cecily Kelleher
Nazan Yardim
Iveta Pudule
Ausra Petrauskiene
Vesselka Duleva
Agneta Sjöberg
Genc Burazeri
Jolanda Hyska
Constanta Huidumac Petrescu
Mirjam Heinen
Hajnalka Takacs
Hana Zamrazilová
Tulay Bagci Bosi
Elena Sacchini
Ioannis Pagkalos
Alexandra Cucu
Paola Nardone
Paul Gately
Julianne Williams
João Breda
Published in Obesity facts
Volume 12
Issue 2
Pages 244-258
ISSN 1662-4033
Publication year 2019
Published at Department of Food and Nutrition, and Sport Science
Pages 244-258
Language en
Links dx.doi.org/10.1159/000500436
www.ncbi.nlm.nih.gov/entrez/query.f...
Keywords Body mass index
Subject categories Epidemiology, Pediatrics

Abstract

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

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