PMID- 31030201 OWN - NLM STAT- MEDLINE DCOM- 20200210 LR - 20200309 IS - 1662-4033 (Electronic) IS - 1662-4025 (Print) IS - 1662-4025 (Linking) VI - 12 IP - 2 DP - 2019 TI - Prevalence of Severe Obesity among Primary School Children in 21 European Countries. PG - 244-258 LID - 10.1159/000500436 [doi] AB - 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. CI - (c) 2019 The Author(s) Published by S. Karger AG, Basel. FAU - Spinelli, Angela AU - Spinelli A AD - Istituto Superiore di Sanita (National Institute of Health), National Centre for Disease Prevention and Health Promotion, Rome, Italy, angela.spinelli@iss.it. FAU - Buoncristiano, Marta AU - Buoncristiano M AD - WHO European Office for the Prevention and Control of the NCDs, Moscow, Russian Federation. FAU - Kovacs, Viktoria Anna AU - Kovacs VA AD - National Institute of Pharmacy and Nutrition, DG of Food and Nutrition Science, Budapest, Hungary. FAU - Yngve, Agneta AU - Yngve A AD - Department of food studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden. FAU - Spiroski, Igor AU - Spiroski I AD - Institute of Public Health of the Republic of Macedonia, Skopje, North Macedonia. FAU - Obreja, Galina AU - Obreja G AD - State University of Medicine and Pharmacy, Chisinau, Moldova. FAU - Starc, Gregor AU - Starc G AD - Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia. FAU - Perez, Napoleon AU - Perez N AD - Spanish Observatory of Nutrition and Study of Obesity, Madrid, Spain. FAU - Rito, Ana Isabel AU - Rito AI AD - National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal. FAU - Kunesova, Marie AU - Kunesova M AD - Obesity Management Centre, Institute of Endocrinology, Prague, Czechia. FAU - Sant'Angelo, Victoria Farrugia AU - Sant'Angelo VF AD - Primary Health Care, Floriana, Malta. FAU - Meisfjord, Jorgen AU - Meisfjord J AD - Department of Health and Inequality, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway. FAU - Bergh, Ingunn Holden AU - Bergh IH AD - Department of Child Health and Development, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway. FAU - Kelleher, Cecily AU - Kelleher C AD - University College Dublin, Dublin, Ireland. FAU - Yardim, Nazan AU - Yardim N AD - Turkish Ministry of Health, Ankara, Turkey. FAU - Pudule, Iveta AU - Pudule I AD - Centre for Disease Prevention and Control, Riga, Latvia. FAU - Petrauskiene, Ausra AU - Petrauskiene A AD - Department of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania. FAU - Duleva, Vesselka AU - Duleva V AD - National Center of Public Health and Analyses, Sofia, Bulgaria. FAU - Sjoberg, Agneta AU - Sjoberg A AD - Department of Food and Nutrition and Sport Science, University of Gothenburg, Gothenburg, Sweden. FAU - Gualtieri, Andrea AU - Gualtieri A AD - Social Security Institute San Marino, San Marino, San Marino. FAU - Hassapidou, Maria AU - Hassapidou M AD - Department of Nutrition and Dietetics, Alexander Technological Educational Institute of Thessaloniki, Thessaloniki, Greece. FAU - Hyska, Jolanda AU - Hyska J AD - Institute of Public Health, Tirana, Albania. FAU - Burazeri, Genc AU - Burazeri G AD - Institute of Public Health, Tirana, Albania. FAU - Petrescu, Constanta Huidumac AU - Petrescu CH AD - National Institute of Public Health, Bucharest, Romania. FAU - Heinen, Mirjam AU - Heinen M AD - University College Dublin, Dublin, Ireland. FAU - Takacs, Hajnalka AU - Takacs H AD - Semmelweis University, Karoly Racz School of PhD Studies, Budapest, Hungary. FAU - Zamrazilova, Hana AU - Zamrazilova H AD - Obesity Management Centre, Institute of Endocrinology, Prague, Czechia. FAU - Bosi, Tulay Bagci AU - Bosi TB AD - Public Health Department, Hacettepe University, Ankara, Turkey. FAU - Sacchini, Elena AU - Sacchini E AD - Health Authority San Marino, San Marino, San Marino. FAU - Pagkalos, Ioannis AU - Pagkalos I AD - Department of Nutrition and Dietetics, Alexander Technological Educational Institute of Thessaloniki, Thessaloniki, Greece. FAU - Cucu, Alexandra AU - Cucu A AD - National Institute of Public Health, Bucharest, Romania. FAU - Nardone, Paola AU - Nardone P AD - Istituto Superiore di Sanita (National Institute of Health), National Centre for Disease Prevention and Health Promotion, Rome, Italy. FAU - Gately, Paul AU - Gately P AD - Centre for Applied Obesity Research, Leeds Beckett University, Leeds, United Kingdom. FAU - Williams, Julianne AU - Williams J AD - WHO European Office for the Prevention and Control of the NCDs, Moscow, Russian Federation. FAU - Breda, Joao AU - Breda J AD - WHO European Office for the Prevention and Control of the NCDs, Moscow, Russian Federation. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20190426 PL - Switzerland TA - Obes Facts JT - Obesity facts JID - 101469429 SB - IM MH - Adolescent MH - Child MH - Cross-Sectional Studies MH - Europe/epidemiology MH - Female MH - Humans MH - Male MH - Obesity, Morbid/*epidemiology MH - Overweight/epidemiology MH - Pediatric Obesity/*epidemiology MH - Prevalence MH - Schools/*statistics & numerical data MH - Students/statistics & numerical data MH - World Health Organization PMC - PMC6547273 OTO - NOTNLM OT - BMI OT - Childhood Obesity Surveillance Initiative OT - Europe OT - Obesity EDAT- 2019/04/29 06:00 MHDA- 2020/02/11 06:00 PMCR- 2019/04/26 CRDT- 2019/04/29 06:00 PHST- 2019/02/22 00:00 [received] PHST- 2019/04/17 00:00 [accepted] PHST- 2019/04/29 06:00 [pubmed] PHST- 2020/02/11 06:00 [medline] PHST- 2019/04/29 06:00 [entrez] PHST- 2019/04/26 00:00 [pmc-release] AID - 000500436 [pii] AID - ofa-0012-0244 [pii] AID - 10.1159/000500436 [doi] PST - ppublish SO - Obes Facts. 2019;12(2):244-258. doi: 10.1159/000500436. Epub 2019 Apr 26.