WHO European Childhood Obesity Surveillance Initiative: health-risk behaviours on nutrition and physical activity in 6–9-year-old schoolchildren

Abstract

Objective: To assess to what extent eight behavioural health risks related to breakfast and food consumption and five behavioural health risks related to physical activity, screen time and sleep duration are present among schoolchildren, and to examine whether health-risk behaviours are associated with obesity. Design: Cross-sectional design as part of the WHO European Childhood Obesity Surveillance Initiative (school year 2007/2008). Children's behavioural data were reported by their parents and children's weight and height measured by trained fieldworkers. Descriptive statistics and logistic regression analyses were performed. Setting: Primary schools in Bulgaria, Lithuania, Portugal and Sweden; paediatric clinics in the Czech Republic. Subjects: Nationally representative samples of 6-9-year-olds (n 15 643). Results: All thirteen risk behaviours differed statistically significantly across countries. Highest prevalence estimates of risk behaviours were observed in Bulgaria and lowest in Sweden. Not having breakfast daily and spending screen time ≥2 h/d were clearly positively associated with obesity. The same was true for eating 'foods like pizza, French fries, hamburgers, sausages or meat pies' >3 d/week and playing outside <1 h/d. Surprisingly, other individual unhealthy eating or less favourable physical activity behaviours showed either no or significant negative associations with obesity. A combination of multiple less favourable physical activity behaviours showed positive associations with obesity, whereas multiple unhealthy eating behaviours combined did not lead to higher odds of obesity. Conclusions: Despite a categorization based on international health recommendations, individual associations of the thirteen health-risk behaviours with obesity were not consistent, whereas presence of multiple physical activity-related risk behaviours was clearly associated with higher odds of obesity.

Proportion of children meeting recommendations for 24-hour movement guidelines and associations with adiposity in a 12-country study

“…Other studies have evaluated the influence of energy-related behaviors (including data on diet or some food group’s intake or breakfast consumption, physical activity, sedentary time and sleep duration) and obesity in children and adolescents [15–17, 34, 35]. The studies by Duncan et al [34] and Danielzik et al [35] were the first ones that examined the cumulative effects of multiple risk factors on adiposity in children.…”

“…The studies by Duncan et al [34] and Danielzik et al [35] were the first ones that examined the cumulative effects of multiple risk factors on adiposity in children. Except for the study by Duncan et al that was conducted in New Zealand [34], all of them were conducted in European countries, either analyzing selected samples [35], national samples [15] or multi-country data [16, 17]. Pérez-Rodrigo et al [15] identified a combination of high physical activity level, low sedentary time and longer sleep time to be associated with a lower prevalence of obesity in a representative sample of Spanish children.…”

“…They identified a short sleeper inactive cluster that was most prevalent in Greece and contained the highest proportion of overweight and obese boys and girls. Finally, the study by Wijnhoven et al [17] contained data from the European Childhood Obesity Surveillance Initiative (COSI) and evaluated the relationship between some health risk behaviors related to diet and physical activity and overweight and obesity in children from Bulgaria, Czech Republic, Lithuania, Portugal and Sweden. They found that children with an unhealthier physical activity-risk behavior score (defined as the combination of the use of inactive transportation going to and from school, going to a sports or dancing club less than 2 days/week, playing outside less than 1 h/day, engaging in screen time 2 or more hours/day, and a sleep duration lower than 9 h/day) were more likely to be obese than children with a better score.…”

Surveillance Systems to Track and Evaluate Obesity Prevention Efforts

“…This report identified indicators that assess not only outcomes such as obesity, diet, and physical activity, but also a variety of environmental and policy measures, including political will, cultural climate, dietary and activity norms, and legislative efforts. Environmental measures are being incorporated into existing surveillance systems, such as the COSI protocol, which includes detailed school environmental measures as an option (112,113).…”

Actividad física, ejercicio y deporte en la lucha contra la obesidad infantil y juvenil

“…Esta tendencia deberá confirmarse con posteriores recogidas de información en años venideros. Estos datos pueden compararse con los datos a nivel europeo, de estudios similares al estudio Aladino (29,30).…”