Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Oct 1;173(10):e192430.
doi: 10.1001/jamapediatrics.2019.2430. Epub 2019 Oct 7.

Prevalence and Trends of Overweight and Obesity in European Children From 1999 to 2016: A Systematic Review and Meta-analysis

Miriam Garrido-Miguel  1 , Iván Cavero-Redondo  1 , Celia Álvarez-Bueno  1 , Fernando Rodríguez-Artalejo  2   3 , Luis A Moreno  4   5   6   7 , Jonatan R Ruiz  8 , Wolfgang Ahrens  9 , Vicente Martínez-Vizcaíno  1   10
Affiliations

Prevalence and Trends of Overweight and Obesity in European Children From 1999 to 2016: A Systematic Review and Meta-analysis

Miriam Garrido-Miguel et al. JAMA Pediatr. .

Abstract

Importance: Studies of trends in excess weight among European children throughout the last few decades have rendered mixed results. Additionally, some studies were outdated, were based on self-reported weight and height, or included only a few European countries.

Objective: To assess prevalence trends in measured overweight and obesity among children across Europe from 1999 to 2016 using a systematic methodology.

Data sources: MEDLINE, Embase, CINAHL, and Web of Science were searched from their inception until May 2018. Moreover, searches were conducted on health institutions' websites to identify studies not published in scientific journals.

Study selection: The inclusion criteria were: (1) studies reporting the population-based prevalence of excess weight (overweight plus obesity) or obesity according to body mass index cutoffs proposed by the International Obesity Task Force; (2) cross-sectional or follow-up studies; and (3) studies including populations aged 2 to 13 years.

Data extraction and synthesis: Literature review and data extraction followed established guidelines. The Mantel-Haenszel method was used to compute the pooled prevalence estimates and their 95% CI whenever there was no evidence of heterogeneity (I2 < 50%); otherwise, the DerSimonian and Laird random-effects method was used. Subgroup analyses by study year, country, or European region (Atlantic, Iberian, Central, and Mediterranean) were conducted. Prevalence estimates were calculated as an aggregate mean, weighted by the sample size and the number of individuals in each study.

Results: A total of 103 studies (477 620 children aged 2 to 13 years) with data from 28 countries were included. The combined prevalence of overweight and obesity in the Iberian region tended to decrease from 30.3% (95% CI, 28.3%-32.3%) to 25.6% (95% CI, 19.7%-31.4%) but tended to increase in the Mediterranean region from 22.9% (95% CI, 17.9%-27.9%) to 25.0% (95% CI, 14.5%-35.5%). No substantial changes were observed in Atlantic Europe or Central Europe, where the overweight and obesity prevalence changed from 18.3% (95% CI, 14.0%-23.9%) to 19.3% (95% CI, 17.7%-20.9%) and from 15.8% (95% CI, 13.4%-18.5%) to 15.3% (95% CI, 11.6%-20.3%), respectively.

Conclusions and relevance: The prevalence of childhood overweight and obesity is very high, but trends have stabilized in most European countries. There are substantial between-country differences in the current levels and trends of overweight and obesity. The rising prevalence in some Mediterranean countries is worrisome.

Trial registration: PROSPERO identifier: CRD42017056924.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Disclosures: Dr Garrido-Miguel reported receiving grants from the Ministerio de Educación and Cultura y Deporte during the conduct of this study. Dr Cavero-Redondo reported receiving a grant from the Universidad de Castilla-La Mancha during the conduct of the study. Dr Ruiz reported receiving support from the University of Granada Plan Propio de Investigación Unit of Excellence on Exercise and Health and Plan Propio de Investigación 2018, Programa Contratos-Puente, and the Junta de Andalucía, Consejería de Conocimiento, Investigación y Universidades. No other disclosures were reported.

Figures

Figure 1.
Figure 1.. PRISMA Flow Diagram
IOTF indicates International Obesity Task Force.
Figure 2.
Figure 2.. Pooled Estimate for the Prevalence of Overweight and Obesity in Children Aged 2-13 Years Across European Regions According to International Obesity Task Force Definition Criteria
Pooled estimate and trends are presented for the combined prevalence of overweight and obesity in children aged 2 to 6 years (A) and prevalence of obesity in children aged 2 to 6 years (B). Pooled estimate and trends are presented for the prevalence of overweight and obesity combined in children aged 7 to 13 years (C) and prevalence of obesity in children aged 7 to 13 years (D). NA indicates not available.
Figure 3.
Figure 3.. Meta-regression Plot of Prevalence
Plot shows the prevalence of the combined overweight and obesity of different countries in Europe during 2011 to 2016 according to their gross national income (GNI) per capita based on purchasing power parity (PPP). Dotted lines indicate the confidence interval and solid lines, regression.
Figure 4.
Figure 4.. Meta-regression Plot of Trends
Plot shows the trends of combined overweight and obesity in different countries of Europe during 1999 to 2016 according to their gross national income (GNI) per capita based on purchasing power parity (PPP). Dotted lines indicate the confidence interval and solid lines, regression.
See this image and copyright information in PMC

Comment in

References

    1. Ng M, Fleming T, Robinson M, et al. . Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384(9945):-. doi:10.1016/S0140-6736(14)60460-8 - DOI - PMC - PubMed
    1. Wang Y, Lobstein T. Worldwide trends in childhood overweight and obesity. Int J Pediatr Obes. 2006;1(1):11-25. doi:10.1080/17477160600586747 - DOI - PubMed
    1. Abarca-Gómez L, Abdeen ZA, Hamid ZA, et al. ; NCD Risk Factor Collaboration (NCD-RisC) . Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet. 2017;390(10113):2627-2642. doi:10.1016/S0140-6736(17)32129-3 - DOI - PMC - PubMed
    1. Wijnhoven TM, van Raaij JM, Spinelli A, et al. . WHO European Childhood Obesity Surveillance Initiative 2008: weight, height and body mass index in 6-9-year-old children. Pediatr Obes. 2013;8(2):79-97. doi:10.1111/j.2047-6310.2012.00090.x - DOI - PubMed
    1. Prentice AM. The emerging epidemic of obesity in developing countries. Int J Epidemiol. 2006;35(1):93-99. doi:10.1093/ije/dyi272 - DOI - PubMed