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      WHO European Childhood Obesity Surveillance Initiative: body mass index and level of overweight among 6–9-year-old children from school year 2007/2008 to school year 2009/2010

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          Abstract

          Background

          The World Health Organization (WHO) Regional Office for Europe has established the Childhood Obesity Surveillance Initiative (COSI) to monitor changes in overweight in primary-school children. The aims of this paper are to present the anthropometric results of COSI Round 2 (2009/2010) and to explore changes in body mass index (BMI) and overweight among children within and across nine countries from school years 2007/2008 to 2009/2010.

          Methods

          Using cross-sectional nationally representative samples of 6−9-year-olds, BMI, anthropometric Z-scores and overweight prevalence were derived from measured weight and height. Significant changes between rounds were assessed using variance and t-tests analyses.

          Results

          At Round 2, the prevalence of overweight (including obesity; WHO definitions) ranged from 18% to 57% among boys and from 18% to 50% among girls; 6 − 31% of boys and 5 − 21% of girls were obese. Southern European countries had the highest overweight prevalence. Between rounds, the absolute change in mean BMI (range: from −0.4 to +0.3) and BMI-for-age Z-scores (range: from −0.21 to +0.14) varied statistically significantly across countries. The highest significant decrease in BMI-for-age Z-scores was found in countries with higher absolute BMI values and the highest significant increase in countries with lower BMI values. The highest significant decrease in overweight prevalence was observed in Italy, Portugal and Slovenia and the highest significant increase in Latvia and Norway.

          Conclusions

          Changes in BMI and prevalence of overweight over a two-year period varied significantly among European countries. It may be that countries with higher prevalence of overweight in COSI Round 1 have implemented interventions to try to remedy this situation.

          Electronic supplementary material

          The online version of this article (doi:10.1186/1471-2458-14-806) contains supplementary material, which is available to authorized users.

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          Most cited references39

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          International ethical guidelines for biomedical research involving human subjects.

          (2002)
          The CIOMS guidelines have been developed and revised with the problems of conducting medical research in less developed countries particularly in mind. The proposed guidelines were first published in 1982, revised in 1993, and have now been published in a third version after a revision process lasting three years. Last month the Bulletin published just one guideline and accompanying commentary. There now follow all the guidelines, without commentary, but with an appendix detailing what should be in a protocol.
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            Prevalence of overweight among children in Europe.

            Estimates of the prevalence of childhood overweight and obesity have been made in several European countries during the last decade. The methods used and the assessment criteria differ from survey to survey. The present paper reports the prevalence data from 21 surveys in Europe using a single, internationally accepted definition of overweight in childhood, allowing direct comparisons to be made. A tendency for a higher prevalence of overweight among children in western and especially southern Europe is shown and some possible reasons for this are discussed.
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              Differences in Weight Status and Energy-Balance Related Behaviors among Schoolchildren across Europe: The ENERGY-Project

              Background Current data on the prevalence of overweight and energy-balance behaviors among European children is necessary to inform overweight prevention interventions. Methodology/Principal Findings A school-based survey among 10–12 year old children was conducted in seven European countries using a standardized protocol. Weight, height, and waist circumference were measured; Engagement in physical activity, sedentary and dietary behaviors, and sleep duration were self-reported. Descriptive analyses were conducted, looking at differences according to country, gender, and parental education. 7234 children (52%girls; 11.6±0.7 years) participated. 25.8% and 5.4% of boys, and 21.8% and 4.1% of girls were overweight (including obese) and obese (according to International Obesity Task Force criteria), respectively. Higher prevalence of overweight/obesity was observed in Greece, Hungary, Slovenia and Spain than in Belgium, Netherlands and Norway. Large differences between countries were found in intakes of sugar-sweetened beverages, breakfast, active transport, TV and computer time. More favorable overweight status and behavior patterns were found in girls than boys and in children of higher educated parents than in children of lower educated parents. Conclusions/Significance High levels and striking differences in overweight status and potential risk behaviors were found among schoolchildren across Europe.
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                Author and article information

                Contributors
                twi@euro.who.int
                joop.van.raaij@rivm.nl
                angela.spinelli@iss.it
                gregor.starc@guest.arnes.si
                mnhas@nutr.teithe.gr
                i.spiroski@iph.mk
                harry.rutter@lshtm.ac.uk
                martos.eva@oeti.antsz.hu
                ana.i.rito@gmail.com
                Ragnhild.Hovengen@fhi.no
                nperezf@msssi.es
                ausrapet@vector.kmu.lt
                Nazih.Eldin@hse.ie
                lien.braeckevelt@wvg.vlaanderen.be
                Iveta.Pudule@spkc.gov.lv
                mkunesova@endo.cz
                jbr@euro.who.int
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                7 August 2014
                2014
                : 14
                : 1
                : 806
                Affiliations
                [ ]Division of Noncommunicable Diseases and Life-course, World Health Organization Regional Office for Europe, UN City, Marmorvej 51, DK-2100 Copenhagen Ø, Denmark
                [ ]Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, PO Box 1, 3720 BA Bilthoven, The Netherlands
                [ ]Division of Human Nutrition, Wageningen University, PO Box 8129, 6700 EV Wageningen, The Netherlands
                [ ]National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health, Viale Regina Elena 299, I-00161 Rome, Italy
                [ ]Faculty of Sport, University of Ljubljana, Gortanova 22, 1000 Ljubljana, Slovenia
                [ ]Department of Nutrition and Dietetics, Alexander Technological Educational Institute of Thessaloniki, PO Box 14561, 54101 Thessaloniki, Greece
                [ ]Department of Physiology and Monitoring of Nutrition, Institute for Public Health of the Republic of Macedonia, 50 Divizija 6, 1000 Skopje, the former Yugoslav Republic of Macedonia
                [ ]Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH United Kingdom
                [ ]National Institute for Food and Nutrition Science, Gyali ut 3/a., 1097 Budapest, Hungary
                [ ]National Institute of Health Doutor Ricardo Jorge IP, Av. Padre Cruz, 1649-016 Lisbon, Portugal
                [ ]Department of Health Statistics, Norwegian Institute of Public Health, PO Box 4404, Nydalen, N-0403 Oslo, Norway
                [ ]Spanish Agency for Consumer Affairs, Food Safety and Nutrition, Alcala 56, 28071 Madrid, Spain
                [ ]Department of Preventive Medicine, Lithuanian University of Health Sciences, Eiveniu str. 4, 50009 Kaunas, Lithuania
                [ ]Health Promotion Department, Health Service Executive, Railway St, Navan, County Meath, Ireland
                [ ]National Nutrition Surveillance Centre, School of Public Health, Physiotherapy & Population Science, University College Dublin, Belfield, Dublin, 4, Ireland
                [ ]Flemish Agency for Care and Health, Flemish Ministry of Welfare, Public Health and Family, Koning Albert II-Laan 35, PO Box 33, 1030 Brussels, Belgium
                [ ]Centre for Disease Prevention and Control, 22 Duntes Street, LV-1005 Riga, Latvia
                [ ]Obesity Management Centre, Institute of Endocrinology, Narodni 8, 116 94 Prague 1, Czech Republic
                Article
                6942
                10.1186/1471-2458-14-806
                4289284
                25099430
                580144a9-4b63-4ea0-81fc-d5d7d0c52fed
                © World Health Organization; licensee BioMed Central Ltd. 2014

                This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution IGO License ( http://creativecommons.org/licenses/by/3.0/igo/legalcode), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In any reproduction of this article there should not be any suggestion that WHO or this article endorse any specific organization or products. The use of the WHO logo is not permitted. This notice should be preserved along with the article's original URL.

                History
                : 16 January 2014
                : 29 July 2014
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                © The Author(s) 2014

                Public health
                Public health

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