Browsing by Author "Ahrens, Wolfgang"
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- Association between Characteristics at Birth, Breastfeeding and Obesity in 22 Countries: The WHO European Childhood Obesity Surveillance Initiative – COSI 2015/2017Publication . Rito, Ana Isabel; Buoncristiano, Marta; Spinelli, Angela; Salanave, Benoit; Kunešová, Marie; Hejgaard, Tatjana; García Solano, Marta; Fijałkowska, Anna; Sturua, Lela; Hyska, Jolanda; Kelleher, Cecily; Duleva, Vesselka; Musić Milanović, Sanja; Farrugia Sant’Angelo, Victoria; Abdrakhmanova, Shynar; Kujundzic, Enisa; Peterkova, Valentina; Gualtieri, Andrea; Pudule, Iveta; Petrauskienė, Aušra; Tanrygulyyeva, Maya; Sherali, Rakhmatulloev; Huidumac-Petrescu, Constanta; Williams, Julianne; Ahrens, Wolfgang; Breda, JoãoBackground: In Europe, although the prevalence of childhood obesity seems to be plateauing in some countries, progress on tackling this important public health issue remains slow and inconsistent. Breastfeeding has been described as a protective factor, and the more exclusively and the longer children are breastfed, the greater their protection from obesity. Birth weight has been shown to have a positive association with later risk for obesity. Objectives: It was the aim of this paper to investigate the association of early-life factors, namely breastfeeding, exclusive breastfeeding and birth weight, with obesity among children. Method: Data from 22 participating countries in the WHO European COSI study (round 4: 2015/2017) were collected using cross-sectional, nationally representative samples of 6- to 9-year-olds (n = 100,583). The children’s standardized weight and height measurements followed a common WHO protocol. Information on the children’s birth weight and breastfeeding practice and duration was collected through a family record form. A multivariate multilevel logistic regression analysis regarding breastfeeding practice (both general and exclusive) and characteristics at birth was performed. Results: The highest prevalence rates of obesity were observed in Spain (17.7%), Malta (17.2%) and Italy (16.8%). A wide between-country disparity in breastfeeding prevalence was found. Tajikistan had the highest percentage of children that were breastfed for ≥6 months (94.4%) and exclusively breastfed for ≥6 months (73.3%). In France, Ireland and Malta, only around 1 in 4 children was breastfed for ≥6 months. Italy and Malta showed the highest prevalence of obesity among children who have never been breastfed (21.2%), followed by Spain (21.0%). The pooled analysis showed that, compared to children who were breastfed for at least 6 months, the odds of being obese were higher among children never breastfed or breastfed for a shorter period, both in case of general (adjusted odds ratio [adjOR] [95% CI] 1.22 [1.16–1.28] and 1.12 [1.07–1.16], respectively) and exclusive breastfeeding (adjOR [95% CI] 1.25 [1.17–1.36] and 1.05 [0.99–1.12], respectively). Higher birth weight was associated with a higher risk of being overweight, which was reported in 11 out of the 22 countries. Bulgaria, Croatia, France, Italy, Poland and Romania showed that children who were preterm at birth had higher odds of being obese, compared to children who were full-term babies. Conclusion: The present work confirms the beneficial effect of breastfeeding against obesity, which was highly increased if children had never been breastfed or had been breastfed for a shorter period. Nevertheless, adoption of exclusive breastfeeding is below global recommendations and far from the target endorsed by the WHO Member States at the World Health Assembly Global Targets for Nutrition of increasing the prevalence of exclusive breastfeeding in the first 6 months up to at least 50% by 2025.
- Methodology and implementation of the WHO European Childhood Obesity Surveillance Initiative (COSI)Publication . Breda, João; McColl, Karen; Buoncristiano, Marta; Williams, Julianne; Abdrakhmanova, Shynar; Abdurrahmonova, Zulfiya; Ahrens, Wolfgang; Akhmedova, Dilorom; Bakacs, Márta; Boer, Jolanda M.A.; Boymatova, Khadichamo; Brinduse, Lacramioara Aurelia; Cucu, Alexandra; Duleva, Vesselka; Endevelt, Ronit; Sant'Angelo, Victoria Farrugia; Fijałkowska, Anna; Hadžiomeragić, Aida Filipović; García‐Solano, Marta; Grøholt, Else Karin; Gualtieri, Andrea; Hassapidou, Maria; Hejgaard, Tatjana; Hyska, Jolanda; Kelleher, Cecily C.; Kujundžić, Enisa; Mäki, Päivi; Markidou Ioannidou, Eliza; Melkumova, Marina; Moyersoen, Isabelle; Milanović, Sanja Musić; Nurk, Eha; Ostojic, Sergej M.; Peterkova, Valentina; Petrauskienė, Aušra; Pudule, Iveta; Rito, Ana Isabel; Russell Jonsson, Kenisha; Rutter, Harry; Salanave, Benoît; Seyidov, Nabil; Shengelia, Lela; Silitrari, Natalia; Spinelli, Angela; Spiroski, Igor; Starc, Gregor; Stojisavljević, Dragana; Tanrygulyyeva, Maya; Tichá, Ľubica; Usupova, Zhamilya; Weghuber, Daniel; Yardim, Nazan; Zamrazilová, Hana; Zbanatskyi, Vladyslav; Branca, Francesco; Weber, Martin; Rakovac, IvoEstablishment of the WHO European Childhood Obesity Surveillance Initiative (COSI)has resulted in a surveillance system which provides regular, reliable, timely, andaccurate data on children's weight status—through standardized measurement ofbodyweight and height—in the WHO European Region. Additional data on dietaryintake, physical activity, sedentary behavior, family background, and schoolenvironments are collected in several countries. In total, 45 countries in the EuropeanRegion have participated in COSI. The first five data collection rounds, between 2007and 2021, yielded measured anthropometric data on over 1.3 million children. In COSI,data are collected according to a common protocol, using standardized instrumentsand procedures. The systematic collection and analysis of these data enables inter-country comparisons and reveals differences in the prevalence of childhood thinness,overweight, normal weight, and obesity between and within populations. Furthermore,it facilitates investigation of the relationship between overweight, obesity, and poten-tial risk or protective factors and improves the understanding of the development ofoverweight and obesity in European primary-school children in order to supportappropriate and effective policy responses.
- Physical Activity, Screen Time, and Sleep Duration of Children Aged 6-9 Years in 25 Countries: An Analysis within the WHO European Childhood Obesity Surveillance Initiative (COSI) 2015–2017Publication . Whiting, Stephen; Buoncristiano, Marta; Gelius, Peter; Abu-Omar, Karim; Pattison, Mary; Hyska, Jolanda; Duleva, Vesselka; Musić Milanović, Sanja; Zamrazilová, Hana; Hejgaard, Tatjana; Rasmussen, Mette; Nurk, Eha; Shengelia, Lela; Kelleher, Cecily C.; Heinen, Mirjam M.; Spinelli, Angela; Nardone, Paola; Abildina, Akbota; Abdrakhmanova, Shynar; Aitmurzaeva, Gulmira; Usuopva, Zhamyila; Pudule, Iveta; Petrauskiene, Aušra; Sant’Angelo, Victoria Farrugia; Kujundzic, Enisa; Popovic, Stevo; Fismen, Anne-Siri; Bergh, Ingunn Holden; Fijalkowska, Anna; Rito, Ana Isabel; Cucu, Alexandra; Brinduse, Lacramioara Aurelia; Peterkova, Valentina; Gualtieri, Andrea; García-Solano, Marta; Gutiérrez-González, Enrique; Abdurrahmonova, Zulfinissio; Boymatova, Khadichamo; Yardim, Nazan; Tanrygulyyeva, Maya; Weghuber, Daniel; Schindler, Karin; Stojisavljević, Dragana; Filipović Hadžiomeragić, Aida; Markidou Ionnaidu, Eliza; Ahrens, Wolfgang; Hassapidou, Maria; Kovacs, Viktoria Anna; Ostojic, Sergej M.; Ticha, Lubica; Starc, Gregor; Russell Jonsson, Kenisha; Spiroski, Igor; Rutter, Harry; Mendes, Romeu; Williams, Julianne; Rakovac, Ivo; Breda, JoãoBackground: Children are becoming less physically active as opportunities for safe active play, recreational activities, and active transport decrease. At the same time, sedentary screen-based activities both during school and leisure time are increasing. Objectives: This study aimed to evaluate physical activity (PA), screen time, and sleep duration of girls and boys aged 6-9 years in Europe using data from the WHO European Childhood Obesity Surveillance Initiative (COSI). Method: The fourth COSI data collection round was conducted in 2015-2017, using a standardized protocol that included a family form completed by parents with specific questions about their children's PA, screen time, and sleep duration. Results: Nationally representative data from 25 countries was included and information on the PA behaviour, screen time, and sleep duration of 150,651 children was analysed. Pooled analysis showed that: 79.4% were actively playing for >1 h each day, 53.9% were not members of a sport or dancing club, 50.0% walked or cycled to school each day, 60.2% engaged in screen time for <2 h/day, and 84.9% slept for 9-11 h/night. Country-specific analyses of these behaviours showed pronounced differences, with national prevalences in the range of 61.7-98.3% actively playing for >1 h/day, 8.2-85.6% were not members of a sport or dancing club, 17.7-94.0% walked or cycled to school each day, 32.3-80.0% engaged in screen time for <2 h/day, and 50.0-95.8% slept for 9-11 h/night. Conclusions: The prevalence of engagement in PA and the achievement of healthy screen time and sleep duration are heterogenous across the region. Policymakers and other stakeholders, including school administrators and parents, should increase opportunities for young people to participate in daily PA as well as explore solutions to address excessive screen time and short sleep duration to improve the overall physical and mental health and well-being of children.
- Socioeconomic disparities in physical activity, sedentary behavior and sleep patterns among 6- to 9-year-old children from 24 countries in the WHO European regionPublication . Musić Milanović, Sanja; Buoncristiano, Marta; Križan, Helena; Rathmes, Giulia; Williams, Julianne; Hyska, Jolanda; Duleva, Vesselka; Zamrazilová, Hana; Hejgaard, Tatjana; Jørgensen, Maja Bæksgaard; Salanave, Benoît; Shengelia, Lela; Kelleher, Cecily C.; Spinelli, Angela; Nardone, Paola; Abdrakhmanova, Shynar; Usupova, Zhamilya; Pudule, Iveta; Petrauskiene, Ausra; Farrugia Sant'Angelo, Victoria; Kujundžić, Enisa; Fijałkowska, Anna; Rito, Ana Isabel; Cucu, Alexandra; Brinduse, Lacramioara Aurelia; Peterkova, Valentina; Gualtieri, Andrea; García‐Solano, Marta; Gutiérrez‐González, Enrique; Boymatova, Khadichamo; Yardim, Mahmut S.; Tanrygulyyeva, Maya; Melkumova, Marina; Weghuber, Daniel; Nurk, Eha; Mäki, Päivi; Bergh, Ingunn Holden; Ostojic, Sergej M.; Russell Jonsson, Kenisha; Spiroski, Igor; Rutter, Harry; Ahrens, Wolfgang; Rakovac, Ivo; Whiting, Stephen; Breda, JoãoPhysical activity, sedentary behavior, and sleep are important predictors of children's health. This paper aimed to investigate socioeconomic disparities in physical activity, sedentary behavior, and sleep across the WHO European region. This cross-sectional study used data on 124,700 children aged 6 to 9 years from 24 countries participating in the WHO European Childhood Obesity Surveillance Initiative between 2015 and 2017. Socioeconomic status (SES) was measured through parental education, parental employment status, and family perceived wealth. Overall, results showed different patterns in socioeconomic disparities in children's movement behaviors across countries. In general, high SES children were more likely to use motorized transportation. Low SES children were less likely to participate in sports clubs and more likely to have more than 2 h/day of screen time. Children with low parental education had a 2.24 [95% CI 1.94-2.58] times higher risk of practising sports for less than 2 h/week. In the pooled analysis, SES was not significantly related to active play. The relationship between SES and sleep varied by the SES indicator used. Importantly, results showed that low SES is not always associated with a higher prevalence of "less healthy" behaviors. There is a great diversity in SES patterns across countries which supports the need for country-specific, targeted public health interventions.
- Socioeconomic inequalities in overweight and obesity among 6‐ to 9‐year‐old children in 24 countries from the World Health Organization European regionPublication . Buoncristiano, Marta; Williams, Julianne; Simmonds, Philippa; Nurk, Eha; Ahrens, Wolfgang; Nardone, Paola; Rito, Ana Isabel; Rutter, Harry; Bergh, Ingunn Holden; Starc, Gregor; Jonsson, Kenisha Russell; Spinelli, Angela; Vandevijvere, Stefanie; Mäki, Päivi; Milanović, Sanja Musić; Salanave, Benoît; Yardim, Mahmut S.; Hejgaard, Tatjana; Fijałkowska, Anna; Abdrakhmanova, Shynar; Abdurrahmonova, Zulfiya; Duleva, Vesselka; Farrugia Sant'Angelo, Victoria; García‐Solano, Marta; Gualtieri, Andrea; Gutiérrez‐González, Enrique; Huidumac‐Petrescu, Constanta; Hyska, Jolanda; Kelleher, Cecily C.; Kujundžić, Enisa; Peterkova, Valentina; Petrauskiene, Ausra; Pudule, Iveta; Sacchini, Elena; Shengelia, Lela; Tanrygulyyeva, Maya; Taxová Braunerová, Radka; Usupova, Zhamilya; Maruszczak, Katharina; Ostojic, Sergej M.; Spiroski, Igor; Stojisavljević, Dragana; Wickramasinghe, Kremlin; Breda, JoãoChildhood overweight and obesity have significant short- and long-term negative impacts on children's health and well-being. These challenges are unequally distributed according to socioeconomic status (SES); however, previous studies have often lacked standardized and objectively measured data across national contexts to assess these differences. This study provides a cross-sectional picture of the association between SES and childhood overweight and obesity, based on data from 123,487 children aged 6–9 years in 24 countries in the World Health Organization (WHO) European region. Overall, associations were found between overweight/obesity and the three SES indicators used (parental education, parental employment status, and family-perceived wealth). Our results showed an inverse relationship between the prevalence of childhood overweight/obesity and parental education in high-income countries, whereas the opposite relationship was observed in most of the middle-income countries. The same applied to family-perceived wealth, although parental employment status appeared to be less associated with overweight and obesity or not associated at all. This paper highlights the need for close attention to context when designing interventions, as the association between SES and childhood overweight and obesity varies by country economic development. Population-based interventions have an important role to play, but policies that target specific SES groups are also needed to address inequalities.