Browsing by Author "Rito, A.I."
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- Obesity prevention within the framework of WHO Healthy CitiesPublication . Rito, A.I.; Bollars, C.
- Overweight and obesity in infants and pre-school children in the European Union: a review of existing dataPublication . Cattaneo, A.; Monasta, L.; Stamatakis, E.; Lioret, S.; Castetbon, K.; Frenken, F.; Manios, Y.; Moschonis, G.; Savva, S.; Zaborskis, A.; Rito, A.I.; Nanu, M.; Vignerová, J.; Caroli, M.; Ludvigsson, J.; Koch, F.S.; Serra-Majem, L.; Szponar, L.; van Lenthe, F.; Brug, J.The objective of this study was to synthesize available information on prevalence and time trends of overweight and obesity in pre-school children in the European Union. Retrieval and analysis or re-analysis of existing data were carried out. Data sources include WHO databases, Medline and Google, contact with authors of published and unpublished documents. Data were analysed using the International Obesity Task Force reference and cut-offs, and the WHO standard. Data were available from 18/27 countries. Comparisons were problematic because of different definitions and methods of data collection and analysis. The reported prevalence of overweight plus obesity at 4 years ranges from 11.8% in Romania (2004) to 32.3% in Spain (1998-2000). Countries in the Mediterranean region and the British islands report higher rates than those in middle, northern and eastern Europe. Rates are generally higher in girls than in boys. With the possible exception of England, there was no obvious trend towards increasing prevalence in the past 20-30 years in the five countries with data. The use of the WHO standard with cut-offs at 1, 2 and 3 standard deviations yields lower rates and removes gender differences. Data on overweight and obesity in pre-school children are scarce; their interpretation is difficult. Standard methods of surveillance, and research and policies on prevention and treatment, are urgently needed.
- Program Obesity Zero (POZ) – a community based intervention to address overweight primary school children from five Portuguese municipalitiesPublication . Rito, A.I.; Carvalho, M.A.; Ramos, C.; Breda, J.OBJECTIVE: Results of the WHO European Childhood Obesity Surveillance Initiative indicated that on average one out of four primary-school children is overweight or obese. Portugal presented one of the highest prevalences of obesity. Childhood obesity prevention and treatment should be a top priority. The aim of the present study was to evaluate the effectiveness of Program Obesity Zero (POZ), a multi-component, community-, family- and school-based childhood obesity intervention. DESIGN: Parents and children attended four individual nutrition and physical activity counselling sessions, a one-day healthy cooking workshop and two school extracurricular sessions of nutrition education. Waist circumference, BMI, physical activity level, sedentary behaviours, and nutrition and physical activity knowledge, attitudes and behaviour were assessed at baseline and after 6 months. Diet was assessed using two 24 h recalls, at baseline and at 6 months. SETTING: Five Portuguese municipalities and local communities. SUBJECTS: Two hundred and sixty-six overweight children (BMI ≥ 85th percentile) aged 6-10 years, from low-income families in five Portuguese municipalities, were assigned to the intervention. RESULTS: Children showed reductions in waist circumference (-2.0 cm; P < 0.0001), mean BMI (-0.7 kg/m2; P < 0.0001) and BMI-for-age percentile (-1.7; P < 0.0001) at 6 months. Overall, children's intake of fruit and vegetables was <400 g/d throughout the intervention. After 6 months, higher fibre consumption and an apparent decrease in sugary soft drinks intake to a quarter of that observed at baseline (mean intake: 198 ml/d at baseline), with improvements in physical activity levels and screen time <2 h/d, were also observed. CONCLUSIONS: The findings suggested that POZ is a promising intervention programme, at municipality level, to tackle childhood overweight and obesity.
- Socioeconomic inequalities in childhood overweight: heterogeneity across five countries in the WHO European childhood obesity surveillance initiative (COSI-2008)Publication . Lissner, L.; Wijnhoven, T.M.A.; Mehlig, K.; Sjöberg, A.; Kunesova, M.; Yngve, A.; Petrauskiene, A.; Duleva, V.; Rito, A.I.; Breda, J.BACKGROUND: Excess risk of childhood overweight and obesity occurring in socioeconomically disadvantaged families has been demonstrated in numerous studies from high-income regions, including Europe. It is well known that socioeconomic characteristics such as parental education, income and occupation are etiologically relevant to childhood obesity. However, in the pan-European setting, there is reason to believe that inequalities in childhood weight status may vary among countries as a function of differing degrees of socioeconomic development and equity. SUBJECTS AND METHODS: In this cross-sectional study, we have examined socioeconomic differences in childhood obesity in different parts of the European region using nationally representative data from Bulgaria, the Czech Republic, Lithuania, Portugal and Sweden that were collected in 2008 during the first round of the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative. RESULTS: Heterogeneity in the association between parental socioeconomic indicators and childhood overweight or obesity was clearly observed across the five countries studied. Positive as well as negative associations were observed between parental socioeconomic indicators and childhood overweight, with statistically significant interactions between country and parental indicators. CONCLUSIONS: These findings have public health implications for the WHO European Region and underscore the necessity to continue documenting socioeconomic inequalities in obesity in all countries through international surveillance efforts in countries with diverse geographic, social and economic environments. This is a prerequisite for universal as well as targeted preventive actions.
- WHO European Childhood Obesity Surveillance Initiative 2008: weight, height and body mass index in 6–9-year-old childrenPublication . Wijnhoven, T.M.A.; van Raaij, J.M.A.; Spinelli, A; Rito, A.I.; Hovengen, R.; Kunesova, M.; Starc, G.; Rutter, H; Sjoberg, A; Petrauskiene, A.; O'Dwyer, U.; Petrova, S.; Farrugia Sant'Angelo, V.; Wauters, M; Yngve, A.; Rubana, I.M.; Breda, JBackground: Nutritional surveillance in school-age children, using measured weight and height, is not common in the European Region of the World Health Organization (WHO). The WHO Regional Office for Europe has therefore initiated the WHO European Childhood Obesity Surveillance Initiative. Objective: To present the anthropometric results of data collected in 2007/2008 and to investigate whether there exist differences across countries and between the sexes. Methods: Weight and height were measured in 6–9-year-old children in 12 countries. Prevalence of overweight, obesity, stunting, thinness and underweight as well as mean Z-scores of anthropometric indices of height, weight and body mass index were calculated. Results: A total of 168 832 children were included in the analyses and a school participation rate of more than 95% was obtained in 8 out of 12 countries. Stunting, underweight and thinness were rarely prevalent. However, 19.3-49.0% of boys and 18.4-42.5% of girls were overweight (including obesity and based on the 2007 WHO growth reference).The prevalence of obesity ranged from 6.0 to 26.6% among boys and from 4.6 to 17.3% among girls. Multi-country comparisons suggest the presence of a north–south gradient with the highest level of overweight found in southern European countries. Conclusions: Overweight among 6–9-year-old children is a serious public health concern and its variation across the European Region highly depends on the country. Comparable monitoring of child growth is possible across Europe and should be emphasized in national policies and implemented as part of action plans.
- 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.