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- 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.
- Thinness, overweight, and obesity in 6‐ to 9‐year‐old children from 36 countries: The World Health Organization European Childhood Obesity Surveillance Initiative - COSI 2015-2017Publication . Spinelli, Angela; Buoncristiano, Marta; Nardone, Paola; Starc, Gregor; Hejgaard, Tatjana; Júlíusson, Petur Benedikt; Fismen, Anne‐Siri; Weghuber, Daniel; Musić Milanović, Sanja; García‐Solano, Marta; Rutter, Harry; Rakovac, Ivo; Cucu, Alexandra; Brinduse, Lacramioara Aurelia; Rito, Ana Isabel; Kovacs, Viktoria Anna; Heinen, Mirjam M.; Nurk, Eha; Mäki, Päivi; Abdrakhmanova, Shynar; Rakhmatulleoeva, Sanavbar; Duleva, Vesselka; Farrugia Sant'Angelo, Victoria; Fijałkowska, Anna; Gualtieri, Andrea; Sacchini, Elena; Hassapidou, Maria; Hyska, Jolanda; Kelleher, Cecily C.; Kujundžić, Enisa; Kunešová, Marie; Markidou Ioannidou, Eliza; Ostojic, Sergej M.; Peterkova, Valentina; Petrauskienė, Aušra; Popović, Stevo; Pudule, Iveta; Russell Jonsson, Kenisha; Dal‐Re Saavedra, Maria Ángeles; Salanave, Benoît; Shengelia, Lela; Spiroski, Igor; Tanrygulyyeva, Maya; Tichá, Ľubica; Usupova, Zhamilya; Ozcebe, Lütfiye Hilal; Abildina, Akbota; Schindler, Karin; Weber, Martin W.; Filipović Hadžiomeragić, Aida; Melkumova, Marina; Stojisavljević, Dragana; Boymatova, Khadichamo; Williams, Julianne; Breda, JoãoIn 2015-2017, the fourth round of the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative (COSI) was conducted in 36 countries. National representative samples of children aged 6–9 (203,323) were measured by trained staff, with similar equipment and using a standardized protocol. This paper assesses the children's body weight status and compares the burden of childhood overweight, obesity, and thinness in Northern, Eastern, and Southern Europe and Central Asia. The results show great geographic variability in height, weight, and body mass index. On average, the children of Northern Europe were the tallest, those of Southern Europe the heaviest, and the children living in Central Asia the lightest and the shortest. Overall, 28.7% of boys and 26.5% of girls were overweight (including obesity) and 2.5% and 1.9%, respectively, were thin according to the WHO definitions. The prevalence of obesity varied from 1.8% of boys and 1.1% of girls in Tajikistan to 21.5% and 19.2%, respectively, in Cyprus, and tended to be higher for boys than for girls. Levels of thinness, stunting, and underweight were relatively low, except in Eastern Europe (for thinness) and in Central Asia. Despite the efforts to halt it, unhealthy weight status is still an important problem in the WHO European Region.
- Urban and rural differences in frequency of fruit, vegetable, and soft drink consumption among 6–9‐year‐old children from 19 countries from the WHO European regionPublication . Heinen, Mirjam M.; Bel‐Serrat, Silvia; Kelleher, Cecily C.; Buoncristiano, Marta; Spinelli, Angela; Nardone, Paola; Milanović, Sanja Musić; Rito, Ana Isabel; Bosi, A. Tülay Bağci; Gutiérrrez‐González, Enrique; Pudule, Iveta; Abdrakhmanova, Shynar; Abdurrahmonova, Zulfiya; Brinduse, Lacramioara Aurelia; Cucu, Alexandra; Duleva, Vesselka; Fijałkowska, Anna; Gualtieri, Andrea; Hejgaard, Tatjana; Hyska, Jolanda; Kujundžić, Enisa; Petrauskiene, Ausra; Sacchini, Elena; Shengelia, Lela; Tanrygulyyeva, Maya; Usupova, Zhamilya; Bergh, Ingunn Holden; Weghuber, Daniel; Taxová Braunerová, Radka; Kunešová, Marie; Sant'Angelo, Victoria Farrugia; Nurk, Eha; Ostojic, Sergej M.; Spiroski, Igor; Tichá, Ľubica; Rutter, Harry; Williams, Julianne; Boymatova, Khadichamo; Rakovac, Ivo; Weber, Martin W.; Breda, JoãoIn order to address the paucity of evidence on the association between childhood eating habits and urbanization, this cross-sectional study describes urban–rural differences in frequency of fruit, vegetable, and soft drink consumption in 123,100 children aged 6–9 years from 19 countries participating in the fourth round (2015-2017) of the WHO European Childhood Obesity Surveillance Initiative (COSI). Children's parents/caregivers completed food-frequency questionnaires. A multivariate multilevel logistic regression analysis was performed and revealed wide variability among countries and within macroregions for all indicators. The percentage of children attending rural schools ranged from 3% in Turkey to 70% in Turkmenistan. The prevalence of less healthy eating habits was high, with between 30–80% and 30–90% children not eating fruit or vegetables daily, respectively, and up to 45% consuming soft drinks on >3 days a week. For less than one third of the countries, children attending rural schools had higher odds (OR-range: 1.1–2.1) for not eating fruit or vegetables daily or consuming soft drinks >3 days a week compared to children attending urban schools. For the remainder of the countries no significant associations were observed. Both population-based interventions and policy strategies are necessary to improve access to healthy foods and increase healthy eating behaviors among children.