Browsing by Author "Pudule, I."
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- Improving data on overweight, obesity and undernutrition among children under the age of 5 years in the WHO European RegionPublication . Wickramasinghe, K.; Heinen, M.; Buoncristiano, M.; Pudule, I.; Rito, Ana; Spinelli, A.; Ahrens, W.; Borghi, E.; Flores-Urrutia, K.; McColl, K.; Sassi, F.; Williams, J.; Rakovac, I.Introduction: It is important for countries to be able to examine their progress toward the Sustainable Development Goals on malnutrition. Unfortunately, in the WHO European Region, there is limited and sparse crosssectional anthropometric measured data at national level from children under five years of age. The WHO European Office for the Prevention and Control of Noncommunicable Diseases in collaboration with WHO Headquarters and as part of its participation in the European Union funded project “Science Technology Obesity Policy” (STOP), is exploring to address these data gaps. Therefore, in October 2022, the WHO Regional Office for Europe convened an expert meeting to discuss the current overview of data availability, data collection, and next steps to move forward. Methods: Key stakeholders working in the areas related to childhood obesity surveillance were invited to this meeting to discuss and explore the availability of data, the feasibility, generalisability and practicality of anthropometric data collection in children under five and suggest next steps to move forward. Results: Addressing the challenge of childhood obesity in Europe was discussed, as well as the importance of anthropometric data on children under five years of age. Results of a survey from 31 European countries on the availability of anthropometric data in this age group were presented, focusing on data available from “routine health checks”. Future work is needed to identify the feasibility of accessing this data for surveillance and research purposes. Three Member States, namely Italy, Portugal and Latvia, presented their experience in data collection and perspectives on how to improve data on children under five. Discussions took place on the feasibility, generalisability and practicality of anthropometric data collection, and expected challenges and solutions. It was discussed that further explorations need to be done to harmonize joint data collection efforts coming from different sources within national health information systems. Conclusion: We concluded that it is important to move on from the idea of a perfect, ideal data source. All data sources — and the possibility of combining data from different sources — should be explored. Latvia has demonstrated the feasibility of a kindergarten-based survey and several countries have indicated willingness to participate in similar surveys. Other data sources should be further explored — it is important to gather enough information from routine data sources to be able to use and interpret these data (and combine them with other data). This is particularly important because kindergarten-based data will reach the older children in the under-five age group, while there tends to be higher coverage of younger children through routine data from paediatric systems.
- WHO European Childhood Obesity Surveillance Initiative: School nutrition environment and body mass index in primary schoolsPublication . Wijnhoven, T.A.; van Raaij, J; Sjöberg, A.; Eldin, N.; Yngve, A.; Kunešová, M.; Starc, G.; Rito, A.I.; Duleva, V.; Hassapidou, M.; Martos, E.; Pudule, I.; Petrauskiene, A.; Sant’Angelo, V.F.; Hovengen, R.; Breda, J.Background: Schools are important settings for the promotion of a healthy diet and sufficient physical activity and thus overweight prevention. Objective: To assess differences in school nutrition environment and body mass index (BMI) in primary schools between and within 12 European countries. Methods: Data from the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative (COSI) were used (1831 and 2045 schools in 2007/2008 and 2009/2010, respectively). School personnel provided information on 18 school environmental characteristics on nutrition and physical activity. A school nutrition environment score was calculated using five nutrition-related characteristics whereby higher scores correspond to higher support for a healthy school nutrition environment. Trained field workers measured children’s weight and height; BMI-for-age (BMI/A) Z-scores were computed using the 2007 WHO growth reference and, for each school, the mean of the children’s BMI/A Z-scores was calculated. Results: Large between-country differences were found in the availability of food items on the premises (e.g., fresh fruit could be obtained in 12%95% of schools) and school nutrition environment scores (range: 0.300.93). Low-score countries (Bulgaria, Czech Republic, Greece, Hungary, Latvia and Lithuania) graded less than three characteristics as supportive. High-score (≥0.70) countries were Ireland, Malta, Norway, Portugal, Slovenia and Sweden. The combined absence of cold drinks containing sugar, sweet snacks and salted snacks were more observed in high-score countries than in low-score countries. Largest within-country school nutrition environment scores were found in Bulgaria, Czech Republic, Greece, Hungary, Latvia and Lithuania. All country-level BMI/A Z-scores were positive (range: 0.201.02), indicating higher BMI values than the 2007 WHO growth reference. With the exception of Norway and Sweden, a country-specific association between the school nutrition environment score and the school BMI/A Z-score was not observed. Conclusions: Some European countries have implemented more school policies that are supportive to a healthy nutrition environment than others. However, most countries with low school nutrition environment scores also host schools with supportive school environment policies, suggesting that a uniform school policy to tackle the “unhealthy” school nutrition environment has not been implemented at the same level throughout a country and may underline the need for harmonized school policies.