Percorrer por autor "Wickramasinghe, Kremlin"
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- Childhood overweight and obesity abatement policies in EuropePublication . Wickramasinghe, Kremlin; Chatterjee, Saion; Williams, Julianne; Weber, Martin W.; Rito, Ana Isabel; Rippin, Holly; Breda, JoãoOver the past two decades, a concerted effort to combat the rising tide of childhood overweight and obesity has taken shape. The World Health Organization (WHO) Commission on Ending Childhood Obesity (ECHO) provides recommendations for six priority areas of action, including the promotion of healthy food consumption, promotion of physical activity, preconception and pregnancy care, early childhood diet and physical activity, healthy nutrition and physical activity for school-aged children, and community-based weight management. This paper provides a snapshot of policies and measures aligned to these areas of action within the WHO European Region in order to encourage other countries to make similar efforts. Examples are drawn from Portugal (sugar-sweetened beverage tax, integrated nutrition strategy), the United Kingdom (soft drink levy, active commuting programs, urban design principles), Lithuania (prohibition of energy drinks), Norway (industry and government partnerships to promote healthier foods, nutrition education curriculum for schools), Hungary (tax subsidies to promote healthy diets), the European Union (cross-border marketing regulations, preconception and pregnancy care), Slovenia (food marketing restrictions), Spain (marketing restrictions within educational settings), Poland (investing in sports infrastructure), Russia (increasing sports participation), Estonia (redevelopment of the physical education curriculum), Netherlands (preconception and pregnancy care), Croatia (conditions to support breastfeeding), Austria (perinatal and early childhood nutrition), Czechia (life-course strategy), San Marino (nutrition and physical activity for school-aged children), Ukraine (potable water for schools), Ireland and Italy (community-based weight management approaches). Our findings suggest that a large disparity exists among the type and breadth of policies adopted by Member States, with a mix of single-issue policy responses and more cohesive strategies. The role of data, implementation research, and ongoing surveillance of country-level progress related to childhood overweight and obesity policies are discussed as an essential part of the iterative process of policy development. Additional work to systematically gather context-specific information on policy development, implementation, and reach according to ECHO's six areas of action by WHO European Region countries will inform future policy paradigms within the region.
- Impact of the COVID-19 pandemic on the eating habits, physical activity and sedentary behaviours of school-aged children in 13 countries within the WHO European Region: “COSI COVID” Study, 2020-2022Publication . Rito, Ana; Buoncristiano, Marta; Mendes, Sofia; Figueira, Ines; Abdrakhmanova, Shynar; Akhmedova, Dilorom; Ciardullo, Silvia; Fijałkowska, Anna; Gualtieri, Andrea; Huidumac‐Petrescu, Constanta; Kakutia, Natia; Kujundžić, Enisa; Musić-Milanović, Sanja; Seyidov, Nabil; Tabona, Lorraine; Tichá, Ľubica; Heinen, Mirjam M.; Whiting, Steve; Williams, Julianne; Rakovac, Ivo; Wickramasinghe, KremlinIntroduction: In 2020, the world population was hit by a global pandemic caused by a new coronavirus (SARS-Cov2), with rapid human-to-human transmission. To limit the spread of the virus and minimize its impact, governments around the world implemented containment measures, leading to many changes in the lifestyle of millions of people. Although children and adolescents were, generally, at low risk of infection and less affected by mortality1, this unprecedented situation led to significant impacts in their daily routines/habits and had a profound effect on their health and well-being2-3. We aimed to understand the impact of the COVID-19 pandemic on the daily routine and behaviours of school aged children, within the WHO/COSI European study. Methods: 13 COSI countries participated in the study: Azerbaijan, Croatia, Georgia, Italy, Kazakhstan, Malta, Montenegro, Poland, Portugal, Romania, San Marino, Slovakia and Uzbekistan. Countries could decide to implement the study together with the 6th round of COSI/WHO Europe in the 2021/2021 school year. A common methodological protocol was designed for this study. Information on children’s behaviors regarding eating habits and physical activity/inactivity before and during the COVID-19 confinement periods, was collected through the “Family COSI-COVID Form” with 12 questions. This form was completed on a voluntary basis by the parents/care givers of participating children. Results: This study included 42 731 children (6-10 years old). Preliminary results suggested that sweets and savory snacks increased during the pandemic in comparison to pre-pandemic period (15.7% and 13,2%, respectively). As for children’s sedentary behaviours, 36.7% of the children increased their time spent watching TV, playing video/computer games, or using social media for non-educational purposes on weekdays and 34.4% on weekends, during the pandemic period. In addition, the time spent learning at home also increased (35.5%). Regarding physical activity, the opposite was reported, showing a decrease in the time children spent being active outside school hours, both on weekdays (26.6%) and weekends (22.0%). Conclusion: These preliminary results are important to better understand the impact of COVID-19 on children’s lifestyles behaviours. These findings may be useful for future public health interventions as countries recover from the pandemic and take measures to address childhood obesity.
- Nutrition remains a top priority in Ukraine despite the ongoing war: the fight against trans fatsPublication . Gonzales, Gerard Bryan; Fino Alberto da Motta, Carla Alexandra; Farrand, Clare; Habicht, Jarno; Kuriata, Olena; Phyo, Pyi Pyi; Skipalskyi, Andrii; Wickramasinghe, KremlinDespite the ongoing war, nutrition remains a top priority in Ukraine. In collaboration with the WHO, Ukraine remains steadfast in its mission to eliminate trans fats in the food supply as a measure to reduce non-communicable diseases in the country. Ukraine has passed legislation on the monitoring and regulation of trans fats in foods, and WHO has been supporting the country in building laboratory capacity to achieve this goal.
- Nutritional Composition of Ultra-Processed Plant-Based Foods in the Out-of-Home Setting: A Case-Study with Vegan BurgersPublication . Vellinga, Reina E.; Temme, Elisabeth H.M.; Rippin, Holly; Motta, Carla; Gonzales, Gerard Bryan; Farrand, Clare; Wickramasinghe, KremlinUltra-processed plant-based foods, such as plant-based burgers, have gained popularity and are perceived by consumers as a healthier and more environmentally sustainable alternative to animal-based foods. However, evidence regarding their nutritional profile and environmental sustainability is still evolving. To contribute to the understanding of the nutrient profile of ultra-processed plant-based foods in the out-of-home environment. Cities in four WHO European Member States were selected for study in a convenience sample across the regions of Amsterdam, Copenhagen, Lisbon, and London. Plant-based burgers available at selected out-of-home sites were randomly sampled. In total 41 plant-based burgers were lab-analyzed for their energy, macronutrients, amino-acids and minerals content per 100 g and per serving size. Descriptive data were used to summarize the nutritional composition per 100 g and serving size. The content per serving was compared to the appropriate reference values. The median energy content was 234 kcal/100 g (IQR = 50). Median macronutrient composition was 20.8 g/100 g (IQR = 5.7) carbohydrates and 3.5 g/100 g (IQR = 1.8) dietary fibre. Protein content was 8.9 g/100 g (IQR = 3.7) with low protein quality. The median total fat content was 12.0 g/100 g (IQR = 4.2), including 0.08 g (IQR = 0.05) TFA and 2.2 g (IQR = 2.3) SFA. The median sodium content was 389 mg/100 g (IQR = 113), equivalent to 2.7 g salt. When compared with reference values, the median serving of plant-based burgers (280 g) provided 31% of energy intake and contributed 17–28% of carbohydrates, 42% of dietary fibre, 40% of protein, and 48% of total fat including 26% of SFA. The burgers had low-quality protein. One serving provided 15–20% of the reference values for calcium, potassium, and magnesium, while higher contributions were found for zinc (30%), manganese (38%), phosphorus (51%), and iron (67%). Ultra-processed plant-based foods, such as plant-based burgers, provide protein, dietary fibre, and essential minerals. They also contain high levels of energy, sodium, and fatty acids. Despite their potential as a source of protein, the quality of protein in plant-based burgers is low. The multifaceted nutritional profile of plant-based burgers highlights the need for manufacturers to implement improvements to better support healthy dietary habits. These improvements should include reducing salt and fatty acids while also enhancing protein quality.
- Parental Perceptions of Children’s Weight Status in 22 Countries: The WHO European Childhood Obesity Surveillance Initiative: COSI 2015/2017Publication . Ramos Salas, Ximena; Buoncristiano, Marta; Williams, Julianne; Kebbe, Maryam; Spinelli, Angela; Nardone, Paola; Rito, Ana; Duleva, Vesselka; Musić Milanović, Sanja; Kunesova, Marie; Braunerová, Radka Taxová; Hejgaard, Tatjana; Rasmussen, Mette; Shengelia, Lela; Abdrakhmanova, Shynar; Abildina, Akbota; Usuopva, Zhamyila; Hyska, Jolanda; Burazeri, Genc; Petrauskiene, Aušra; Pudule, Iveta; Sant’Angelo, Victoria Farrugia; Kujundzic, Enisa; Fijałkowska, Anna; Cucu, Alexandra; Brinduse, Lacramioara Aurelia; Peterkova, Valentina; Bogova, Elena; Gualtieri, Andrea; Solano, Marta García; Gutiérrez-González, Enrique; Rakhmatullaeva, Sanavbar; Tanrygulyyeva, Maya; Yardim, Nazan; Weghuber, Daniel; Mäki, Päivi; Russell Jonsson, Kenisha; Starc, Gregor; Juliusson, Petur Benedikt; Heinen, Mirjam M.; Kelleher, Cecily; Ostojic, Sergej; Popovic, Stevo; Kovacs, Viktoria Anna; Akhmedova, Dilorom; Farpour-Lambert, Nathalie J.; Rutter, Harry; Li, Bai; Boymatova, Khadichamo; Rakovac, Ivo; Wickramasinghe, Kremlin; Breda, JoãoIntroduction: Parents can act as important agents of change and support for healthy childhood growth and development. Studies have found that parents may not be able to accurately perceive their child’s weight status. The purpose of this study was to measure parental perceptions of their child’s weight status and to identify predictors of potential parental misperceptions. Methods: We used data from the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative and 22 countries. Parents were asked to identify their perceptions of their children’s weight status as “underweight,” “normal weight,” “a little overweight,” or “extremely overweight.” We categorized children’s (6–9 years; n = 124,296) body mass index (BMI) as BMI-for-age Z-scores based on the 2007 WHO-recommended growth references. For each country included in the analysis and pooled estimates (country level), we calculated the distribution of children according to the WHO weight status classification, distribution by parental perception of child’s weight status, percentages of accurate, overestimating, or underestimating perceptions, misclassification levels, and predictors of parental misperceptions using a multilevel logistic regression analysis that included only children with overweight (including obesity). Statistical analyses were performed using Stata version 15 1. Results: Overall, 64.1% of parents categorized their child’s weight status accurately relative to the WHO growth charts. However, parents were more likely to underestimate their child’s weight if the child had overweight (82.3%) or obesity (93.8%). Parents were more likely to underestimate their child’s weight if the child was male (adjusted OR [adjOR]: 1.41; 95% confidence intervals [CI]: 1.28–1.55); the parent had a lower educational level (adjOR: 1.41; 95% CI: 1.26–1.57); the father was asked rather than the mother (adjOR: 1.14; 95% CI: 0.98–1.33); and the family lived in a rural area (adjOR: 1.10; 95% CI: 0.99–1.24). Overall, parents’ BMI was not strongly associated with the underestimation of children’s weight status, but there was a stronger association in some countries. Discussion/Conclusion: Our study supplements the current literature on factors that influence parental perceptions of their child’s weight status. Public health interventions aimed at promoting healthy childhood growth and development should consider parents’ knowledge and perceptions, as well as the sociocultural contexts in which children and families live.
- Projected impact of the Portuguese sugar-sweetened beverage tax on obesity incidence across different age groups: A modelling studyPublication . Goiana-da-Silva, Francisco; Severo, Milton; Cruz e Silva, David; Gregório, Maria João; Allen, Luke N.; Muc, Magdalena; Morais Nunes, Alexandre; Torres, Duarte; Miraldo, Marisa; Ashrafian, Hutan; Rito, Ana; Wickramasinghe, Kremlin; Breda, João; Darzi, Ara; Araújo, Fernando; Lopes, CarlaBackground: Excessive consumption of sugar has a well-established link with obesity. Preliminary results show that a tax levied on sugar-sweetened beverages (SSBs) by the Portuguese government in 2017 led to a drop in sales and reformulation of these products. This study models the impact the market changes triggered by the tax levied on SSBs had on obesity incidence across various age groups in Portugal. Methods and findings: We performed a national market analysis and population-wide modelling study using market data for the years 2014-2018 from the Portuguese Association of Non-Alcoholic Drinks (GlobalData and Nielsen Consumer Panel), dietary data from a national survey (IAN-AF 2015-2016), and obesity incidence data from several cohort studies. Dietary energy density from SSBs was calculated by dividing the energy content (kcal/gram) of all SSBs by the total food consumption (in grams). We used the potential impact fraction (PIF) equation to model the projected impact of the tax-triggered change in sugar consumption on obesity incidence, through both volume reduction and reformulation. Results showed a reduction of 6.6 million litres of SSBs sold per year. Product reformulation led to a decrease in the average energy density of SSBs by 3.1 kcal/100 ml. This is estimated to have prevented around 40-78 cases of obesity per year between 2016 and 2018, with the biggest projected impact observed in adolescents 10 to <18 years old. The model shows that the implementation of this tax allowed for a 4 to 8 times larger projected impact against obesity than would be achieved though reformulation alone. The main limitation of this study is that the model we used includes data from various sources, which can result in biases-despite our efforts to mitigate them-related to the methodological differences between these sources. Conclusions: The tax triggered both a reduction in demand and product reformulation. These, together, can reduce obesity levels among frequent consumers of SSBs. Such taxation is an effective population-wide intervention. Reformulation alone, without the decrease in sales, would have had a far smaller effect on obesity incidence in the Portuguese population.
- 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.