Thinness, overweight, and obesity in 6- to 9-year-old children from 36 countries: The World Health Organization European Childhood Obesity Surveillance Initiative-COSI 2015-2017

Angela Spinelli¹, Marta Buoncristiano², Paola Nardone¹, Gregor Starc³, Tatjana Hejgaard⁴, Petur Benedikt Júlíusson^{5

6}, Anne-Siri Fismen⁷, Daniel Weghuber⁸, Sanja Musić Milanović^{9

10}, Marta García-Solano¹¹, Harry Rutter¹², Ivo Rakovac², Alexandra Cucu^{13

14}, Lacramioara Aurelia Brinduse^{14

15}, Ana Isabel Rito¹⁶, Viktoria Anna Kovacs¹⁷, Mirjam M Heinen¹⁸, Eha Nurk¹⁹, Päivi Mäki²⁰, Shynar Abdrakhmanova^{21

22}, Sanavbar Rakhmatulleoeva²³, Vesselka Duleva²⁴, Victoria Farrugia Sant'Angelo²⁵, Anna Fijałkowska²⁶, Andrea Gualtieri²⁷, Elena Sacchini²⁷, Maria Hassapidou²⁸, Jolanda Hyska²⁹, Cecily C Kelleher¹⁸, Enisa Kujundžić³⁰, Marie Kunešová³¹, Eliza Markidou Ioannidou³², Sergej M Ostojic³³, Valentina Peterkova³⁴, Aušra Petrauskienė³⁵, Stevo Popović^{36

37}, Iveta Pudule³⁸, Kenisha Russell Jonsson³⁹, Maria Ángeles Dal-Re Saavedra¹¹, Benoît Salanave^{40

41}, Lela Shengelia⁴², Igor Spiroski^{43

44}, Maya Tanrygulyyeva⁴⁵, Ľubica Tichá⁴⁶, Zhamilya Usupova⁴⁷, Lütfiye Hilal Ozcebe⁴⁸, Akbota Abildina⁴⁹, Karin Schindler⁵⁰, Martin W Weber⁵¹, Aida Filipović Hadžiomeragić⁵², Marina Melkumova⁵³, Dragana Stojisavljević^{54

55}, Khadichamo Boymatova⁵⁶, Julianne Williams², João Breda²

Affiliations

¹ National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy.
² World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation.
³ Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia.
⁴ Health Promotion and Inequality, Danish Health Authority, Copenhagen, Denmark.
⁵ Department of Health Registry Research and Development, Norwegian Institute of Public Health, Bergen, Norway.
⁶ Department of Clinical Science, University of Bergen, Bergen, Norway.
⁷ Department of Health Promotion and Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Bergen, Norway.
⁸ Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria.
⁹ Croatian Institute of Public Health, Zagreb, Croatia.
¹⁰ School of Medicine, University of Zagreb, Zagreb, Croatia.
¹¹ Spanish Agency for Food Safety and Nutrition, Ministry of Consumer Affairs, Madrid, Spain.
¹² Department of Social and Policy Sciences, University of Bath, Bath, UK.
¹³ Faculty of Midwifery and Nursing, Discipline of Public health and Health Management, University of Medicine and Pharmacy Carol Davila Bucharest, Bucharest, Romania.
¹⁴ National Centre of Health Promotion and Health Evaluation, National Institute of Public Health, Bucharest, Romania.
¹⁵ Faculty of Medicine, Department of Public Health and Management, University of Medicine and Pharmacy Carol Davila Bucharest, Bucharest, Romania.
¹⁶ WHO/Europe Collaborating Center for Nutrition and Childhood Obesity - Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal.
¹⁷ Hungarian School Sport Federation, Budapest, Hungary.
¹⁸ National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.
¹⁹ Department of Nutrition Research, National Institute for Health Development, Tallinn, Estonia.
²⁰ Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland.
²¹ Department of Science and Professional Development, National Center of Public Health of the Ministry of Health of the Republic of Kazakhstan, Almaty, Kazakhstan.
²² Kazakhstan School of Public Health, Kazakhstan's Medical University, Almaty, Kazakhstan.
²³ Department of the Organization of Medical Services for Mothers, Children and Family Planning Ministry of Health and Social Protection, Dushanbe, Tajikistan.
²⁴ Department Food and Nutrition, National Center of Public Health and Analyses, Sofia, Bulgaria.
²⁵ Primary Child Health Unit, Primary Health Care, Floriana, Malta.
²⁶ Department of Cardiology, Institute of Mother and Child, Warsaw, Poland.
²⁷ Health Authority, Ministry of Health, San Marino, San Marino.
²⁸ Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece.
²⁹ Nutrition and Food Safety Sector, Institute of Public Health, Tirana, Albania.
³⁰ Center for Health Ecology, Institute of Public Health, Podgorica, Montenegro.
³¹ Obesity Management Centre, Institute of Endocrinology, Prague, Czech Republic.
³² Department of Medical and Public Health Services, Ministry of Health, Nicosia, Cyprus.
³³ Biomedical Sciences Department, Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia.
³⁴ Institute of Paediatric Endocrinology, National Medical Research Centre for Endocrinology of the Ministry of Health of the Russian Federation, Moscow, Russian Federation.
³⁵ Department of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania.
³⁶ Faculty for Sport and Physical Education, University of Montenegro, Niksic, Montenegro.
³⁷ Montenegrin Sports Academy, Podgorica, Montenegro.
³⁸ Department of Research and Health Statistics, Centre for Disease and Prevention Control, Riga, Latvia.
³⁹ Department of Living Conditions and Lifestyle, Public Health Agency of Sweden, Solna, Sweden.
⁴⁰ Departement of Non-Communicable Diseases and Traumatisms, Santé publique France, the French Public Health Agency, Saint Maurice, France.
⁴¹ Nutritional Surveillance and Epidemiology Team (ESEN), University Sorbonne Paris Nord, Bobigny, France.
⁴² Maternal, Child and Reproductive Health, National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia.
⁴³ Institute of Public Health, Skopje, North Macedonia.
⁴⁴ Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, North Macedonia.
⁴⁵ Scientific Research Institute of Maternal and Child Health, Ashgabat, Turkmenistan.
⁴⁶ Children's Hospital National Institute of Children's Diseases, Medical Faculty, Comenius University, Bratislava, Slovakia.
⁴⁷ Republican Center for Health Promotion and Mass Communication, Ministry of Health of the Kyrgyz Republic, Bishkek, Kyrgyzstan.
⁴⁸ Medical Faculty, Department of Public Health, Hacettepe University, Ankara, Turkey.
⁴⁹ National Center of Public Health, Ministry of Health of the Republic of Kazakhstan/WHO Collaborating Center for Promoting Healthy Lifestyle, Nur-Sultan, Kazakhstan.
⁵⁰ Federal Ministry Social Affairs, Health Care and Consumer Protection, Division of Mother, Child, Gender Health and Nutrition, Vienna, Austria.
⁵¹ World Health Organization (WHO) Child and Adolescent Health and Development, WHO Regional Office for Europe, Copenhagen, Denmark.
⁵² Department of Hygiene, Health Ecology Service, Institute of Public Health of Federation of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina.
⁵³ Institute of Child and Adolescent Health, Arabkir Medical Centre- Institute of Child and Adolescent Health, Yerevan, Armenia.
⁵⁴ Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina.
⁵⁵ Public Health Institute of Republic of Srpska, Banja Luka, Bosnia and Herzegovina.
⁵⁶ Division of Noncommunicable Diseases and Promoting Health through the Life-course, WHO Tajikistan Country Office, Dushanbe, Tajikistan.

PMID: 34235850
DOI: 10.1111/obr.13214

Thinness, overweight, and obesity in 6- to 9-year-old children from 36 countries: The World Health Organization European Childhood Obesity Surveillance Initiative-COSI 2015-2017

Angela Spinelli et al. Obes Rev. 2021 Nov.

. 2021 Nov:22 Suppl 6:e13214.

doi: 10.1111/obr.13214. Epub 2021 Jul 7.

Authors

Affiliations

¹ National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy.
² World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation.
³ Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia.
⁴ Health Promotion and Inequality, Danish Health Authority, Copenhagen, Denmark.
⁵ Department of Health Registry Research and Development, Norwegian Institute of Public Health, Bergen, Norway.
⁶ Department of Clinical Science, University of Bergen, Bergen, Norway.
⁷ Department of Health Promotion and Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Bergen, Norway.
⁸ Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria.
⁹ Croatian Institute of Public Health, Zagreb, Croatia.
¹⁰ School of Medicine, University of Zagreb, Zagreb, Croatia.
¹¹ Spanish Agency for Food Safety and Nutrition, Ministry of Consumer Affairs, Madrid, Spain.
¹² Department of Social and Policy Sciences, University of Bath, Bath, UK.
¹³ Faculty of Midwifery and Nursing, Discipline of Public health and Health Management, University of Medicine and Pharmacy Carol Davila Bucharest, Bucharest, Romania.
¹⁴ National Centre of Health Promotion and Health Evaluation, National Institute of Public Health, Bucharest, Romania.
¹⁵ Faculty of Medicine, Department of Public Health and Management, University of Medicine and Pharmacy Carol Davila Bucharest, Bucharest, Romania.
¹⁶ WHO/Europe Collaborating Center for Nutrition and Childhood Obesity - Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal.
¹⁷ Hungarian School Sport Federation, Budapest, Hungary.
¹⁸ National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.
¹⁹ Department of Nutrition Research, National Institute for Health Development, Tallinn, Estonia.
²⁰ Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland.
²¹ Department of Science and Professional Development, National Center of Public Health of the Ministry of Health of the Republic of Kazakhstan, Almaty, Kazakhstan.
²² Kazakhstan School of Public Health, Kazakhstan's Medical University, Almaty, Kazakhstan.
²³ Department of the Organization of Medical Services for Mothers, Children and Family Planning Ministry of Health and Social Protection, Dushanbe, Tajikistan.
²⁴ Department Food and Nutrition, National Center of Public Health and Analyses, Sofia, Bulgaria.
²⁵ Primary Child Health Unit, Primary Health Care, Floriana, Malta.
²⁶ Department of Cardiology, Institute of Mother and Child, Warsaw, Poland.
²⁷ Health Authority, Ministry of Health, San Marino, San Marino.
²⁸ Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece.
²⁹ Nutrition and Food Safety Sector, Institute of Public Health, Tirana, Albania.
³⁰ Center for Health Ecology, Institute of Public Health, Podgorica, Montenegro.
³¹ Obesity Management Centre, Institute of Endocrinology, Prague, Czech Republic.
³² Department of Medical and Public Health Services, Ministry of Health, Nicosia, Cyprus.
³³ Biomedical Sciences Department, Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia.
³⁴ Institute of Paediatric Endocrinology, National Medical Research Centre for Endocrinology of the Ministry of Health of the Russian Federation, Moscow, Russian Federation.
³⁵ Department of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania.
³⁶ Faculty for Sport and Physical Education, University of Montenegro, Niksic, Montenegro.
³⁷ Montenegrin Sports Academy, Podgorica, Montenegro.
³⁸ Department of Research and Health Statistics, Centre for Disease and Prevention Control, Riga, Latvia.
³⁹ Department of Living Conditions and Lifestyle, Public Health Agency of Sweden, Solna, Sweden.
⁴⁰ Departement of Non-Communicable Diseases and Traumatisms, Santé publique France, the French Public Health Agency, Saint Maurice, France.
⁴¹ Nutritional Surveillance and Epidemiology Team (ESEN), University Sorbonne Paris Nord, Bobigny, France.
⁴² Maternal, Child and Reproductive Health, National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia.
⁴³ Institute of Public Health, Skopje, North Macedonia.
⁴⁴ Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, North Macedonia.
⁴⁵ Scientific Research Institute of Maternal and Child Health, Ashgabat, Turkmenistan.
⁴⁶ Children's Hospital National Institute of Children's Diseases, Medical Faculty, Comenius University, Bratislava, Slovakia.
⁴⁷ Republican Center for Health Promotion and Mass Communication, Ministry of Health of the Kyrgyz Republic, Bishkek, Kyrgyzstan.
⁴⁸ Medical Faculty, Department of Public Health, Hacettepe University, Ankara, Turkey.
⁴⁹ National Center of Public Health, Ministry of Health of the Republic of Kazakhstan/WHO Collaborating Center for Promoting Healthy Lifestyle, Nur-Sultan, Kazakhstan.
⁵⁰ Federal Ministry Social Affairs, Health Care and Consumer Protection, Division of Mother, Child, Gender Health and Nutrition, Vienna, Austria.
⁵¹ World Health Organization (WHO) Child and Adolescent Health and Development, WHO Regional Office for Europe, Copenhagen, Denmark.
⁵² Department of Hygiene, Health Ecology Service, Institute of Public Health of Federation of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina.
⁵³ Institute of Child and Adolescent Health, Arabkir Medical Centre- Institute of Child and Adolescent Health, Yerevan, Armenia.
⁵⁴ Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina.
⁵⁵ Public Health Institute of Republic of Srpska, Banja Luka, Bosnia and Herzegovina.
⁵⁶ Division of Noncommunicable Diseases and Promoting Health through the Life-course, WHO Tajikistan Country Office, Dushanbe, Tajikistan.

PMID: 34235850
DOI: 10.1111/obr.13214

Abstract

In 2015-2017, the fourth round of the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative (COSI) was conducted in 36 countries. National representative samples of children aged 6-9 (203,323) were measured by trained staff, with similar equipment and using a standardized protocol. This paper assesses the children's body weight status and compares the burden of childhood overweight, obesity, and thinness in Northern, Eastern, and Southern Europe and Central Asia. The results show great geographic variability in height, weight, and body mass index. On average, the children of Northern Europe were the tallest, those of Southern Europe the heaviest, and the children living in Central Asia the lightest and the shortest. Overall, 28.7% of boys and 26.5% of girls were overweight (including obesity) and 2.5% and 1.9%, respectively, were thin according to the WHO definitions. The prevalence of obesity varied from 1.8% of boys and 1.1% of girls in Tajikistan to 21.5% and 19.2%, respectively, in Cyprus, and tended to be higher for boys than for girls. Levels of thinness, stunting, and underweight were relatively low, except in Eastern Europe (for thinness) and in Central Asia. Despite the efforts to halt it, unhealthy weight status is still an important problem in the WHO European Region.

Keywords: malnutrition; obesity; prevention; thinness.

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Thinness, overweight, and obesity in 6- to 9-year-old children from 36 countries: The World Health Organization European Childhood Obesity Surveillance Initiative-COSI 2015-2017

Affiliations

Thinness, overweight, and obesity in 6- to 9-year-old children from 36 countries: The World Health Organization European Childhood Obesity Surveillance Initiative-COSI 2015-2017

Authors

Affiliations

Abstract

References

REFERENCES

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources