Browsing by Author "Heinen, Mirjam"
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- Clustering of Multiple Energy Balance-Related Behaviors in School Children and its Association with Overweight and Obesity-WHO European Childhood Obesity Surveillance Initiative (COSI 2015⁻2017)Publication . Bel-Serrat, Silvia; Ojeda-Rodríguez, Ana; Heinen, Mirjam; Buoncristiano, Marta; Abdrakhmanova, Shynar; Duleva, Vesselka; Sant’Angelo, Victoria; Fijałkowska, Anna; Hejgaard, Tatjana; Huidumac, Constanta; Hyska, Jolanda; Kujundzic, Enisa; Milanović, Sanja; Ovezmyradova, Guljemal; Pérez-Farinós, Napoleón; Petrauskiene, Ausra; Rito, Ana; Shengelia, Lela; Braunerová, Radka; Rutter, Harry; Murrin, Celine; Kelleher, Cecily; Breda, JoãoIt is unclear how dietary, physical activity and sedentary behaviors co-occur in school-aged children. We investigated the clustering of energy balance-related behaviors and whether the identified clusters were associated with weight status. Participants were 6- to 9-year-old children (n = 63,215, 49.9% girls) from 19 countries participating in the fourth round (2015/2017) of the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative. Energy balance-related behaviors were parentally reported. Weight and height were objectively measured. We performed cluster analysis separately per group of countries (North Europe, East Europe, South Europe/Mediterranean countries and West-Central Asia). Seven clusters were identified in each group. Healthier clusters were common across groups. The pattern of distribution of healthy and unhealthy behaviors within each cluster was group specific. Associations between the clustering of energy balance-related behaviors and weight status varied per group. In South Europe/Mediterranean countries and East Europe, all or most of the cluster solutions were associated with higher risk of overweight/obesity when compared with the cluster 'Physically active and healthy diet'. Few or no associations were observed in North Europe and West-Central Asia, respectively. These findings support the hypothesis that unfavorable weight status is associated with a particular combination of energy balance-related behavior patterns, but only in some groups of countries.
- Prevalence of Severe Obesity among Primary School Children in 21 European CountriesPublication . Spinelli, Angela; Buoncristiano, Marta; Kovacs, Viktoria Anna; Yngve, Agneta; Spiroski, Igor; Obreja, Galina; Starc, Gregor; Pérez, Napoleón; Rito, Ana Isabel; Kunešová, Marie; Sant'Angelo, Victoria Farrugia; Meisfjord, Jørgen; Bergh, Ingunn Holden; Kelleher, Cecily; Yardim, Nazan; Pudule, Iveta; Petrauskiene, Ausra; Duleva, Vesselka; Sjöberg, Agneta; Gualtieri, Andrea; Hassapidou, Maria; Hyska, Jolanda; Burazeri, Genc; Petrescu, Constanta Huidumac; Heinen, Mirjam; Takacs, Hajnalka; Zamrazilová, Hana; Bosi, Tulay Bagci; Sacchini, Elena; Pagkalos, Ioannis; Cucu, Alexandra; Nardone, Paola; Gately, Paul; Williams, Julianne; Breda, JoãoThe 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.
- A Snapshot of European Children’s Eating Habits: Results from the Fourth Round of the WHO European Childhood Obesity Surveillance Initiative (COSI)Publication . Williams, Julianne; Buoncristiano, Marta; Nardone, Paola; Rito, Ana Isabel; Spinelli, Angela; Hejgaard, Tatjana; Kierkegaard, Lene; Nurk, Eha; Kunešová, Marie; Musić Milanović, Sanja; García-Solano, Marta; Gutiérrez-González, Enrique; Brinduse, Lacramioara Aurelia; Cucu, Alexandra; Fijałkowska, Anna; Farrugia Sant’Angelo, Victoria; Abdrakhmanova, Shynar; Pudule, Iveta; Duleva, Vesselka; Yardim, Nazan; Gualtieri, Andrea; Heinen, Mirjam; Bel-Serrat, Silvia; Usupova, Zhamyla; Peterkova, Valentina; Shengelia, Lela; Hyska, Jolanda; Tanrygulyyeva, Maya; Petrauskiene, Ausra; Rakhmatullaeva, Sanavbar; Kujundzic, Enisa; Ostojic, Sergej M.; Weghuber, Daniel; Melkumova, Marina; Spiroski, Igor; Starc, Gregor; Rutter, Harry; Rathmes, Giulia; Bunge, Anne Charlotte; Rakovac, Ivo; Boymatova, Khadichamo; Weber, Martin; Breda, JoãoConsuming a healthy diet in childhood helps to protect against malnutrition and noncommunicable diseases (NCDs). This cross-sectional study described the diets of 132,489 children aged six to nine years from 23 countries participating in round four (2015-2017) of the WHO European Childhood Obesity Surveillance Initiative (COSI). Children's parents or caregivers were asked to complete a questionnaire that contained indicators of energy-balance-related behaviors (including diet). For each country, we calculated the percentage of children who consumed breakfast, fruit, vegetables, sweet snacks or soft drinks "every day", "most days (four to six days per week)", "some days (one to three days per week)", or "never or less than once a week". We reported these results stratified by country, sex, and region. On a daily basis, most children (78.5%) consumed breakfast, fewer than half (42.5%) consumed fruit, fewer than a quarter (22.6%) consumed fresh vegetables, and around one in ten consumed sweet snacks or soft drinks (10.3% and 9.4%, respectively); however, there were large between-country differences. This paper highlights an urgent need to create healthier food and drink environments, reinforce health systems to promote healthy diets, and continue to support child nutrition and obesity surveillance.
- WHO European Childhood Obesity Surveillance Initiative: Impact of Type of Clothing Worn during Anthropometric Measurements and Timing of the Survey on Weight and Body Mass Index Outcome Measures in 6–9-Year-Old ChildrenPublication . Wijnhoven, Trudy M.A.; van Raaij, Joop M.A.; Spinelli, Angela; Yngve, Agneta; Lissner, Lauren; Spiroski, Igor; Farrugia Sant'Angelo, Victoria; Pérez-Farinós, Napoleón; Martos, Éva; Heinen, Mirjam; Kunešová, Marie; Rito, Ana I.; Hovengen, Ragnhild; Starc, Gregor; Duleva, Vesselka; Pudule, Iveta; Petrauskiene, Ausra; Braeckevelt, Lien; Hassapidou, Maria; Breda, João; van 't Veer, PieterBackground. The World Health Organization European Childhood Obesity Surveillance Initiative (COSI) conducted examinations in 6–9-year-old children from 16 countries in the first two rounds of data collection. Allowing participating countries to adhere to their local legal requirements or adapt to other circumstances required developing a flexible protocol for anthropometric procedures. Objectives. (1) Review intercountry variation in types of clothing worn by children during weight and height measurements, clothes weight adjustments applied, timing of the survey, and duration of data collection; (2) assess the impact of the observed variation in these practices on the children’s weight or body mass index (BMI) outcome measures. Results. The relative difference between countries’ unadjusted and clothes-adjusted prevalence estimates for overweight was 0.3–11.5%; this figure was 1.4–33.3% for BMI-for-age Z-score values. Monthly fluctuations in mean BMI-for-age Z-score values did not show a systematic seasonal effect. The majority of the monthly BMI-for-age Z-score values did not differ statistically within a country; only 1–3 monthly values were statistically different within some countries. Conclusions. The findings of the present study suggest that the built-in flexibility in the COSI protocol concerning the data collection practices addressed in the paper can be kept and thus do not necessitate a revision of the COSI protocol.