Dataset Information

WHO European Childhood Obesity Surveillance Initiative: School nutrition environment and body mass index in primary schools.

ABSTRACT:

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: 0.30-0.93). 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: 0.20-1.02), 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.

SUBMITTER: Wijnhoven TM

PROVIDER: S-EPMC4245612 | biostudies-literature | 2014 Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

WHO European Childhood Obesity Surveillance Initiative: School nutrition environment and body mass index in primary schools.

Wijnhoven Trudy M A TM van Raaij Joop M A JM Sjöberg Agneta A Eldin Nazih N Yngve Agneta A Kunešová Marie M Starc Gregor G Rito Ana I AI Duleva Vesselka V Hassapidou Maria M Martos Eva E Pudule Iveta I Petrauskiene Ausra A Sant'Angelo Victoria Farrugia VF Hovengen Ragnhild R Breda João J

International journal of environmental research and public health 20141030 11

<h4>Background</h4>Schools are important settings for the promotion of a healthy diet and sufficient physical activity and thus overweight prevention.<h4>Objective</h4>To assess differences in school nutrition environment and body mass index (BMI) in primary schools between and within 12 European countries.<h4>Methods</h4>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, respectivel ...[more]

PMID: 25361044

Similar Datasets

Project description:BackgroundIn Europe, although the prevalence of childhood obesity seems to be plateauing in some countries, progress on tackling this important public health issue remains slow and inconsistent. Breastfeeding has been described as a protective factor, and the more exclusively and the longer children are breastfed, the greater their protection from obesity. Birth weight has been shown to have a positive association with later risk for obesity.ObjectivesIt was the aim of this paper to investigate the association of early-life factors, namely breastfeeding, exclusive breastfeeding and birth weight, with obesity among children.MethodData from 22 participating countries in the WHO European COSI study (round 4: 2015/2017) were collected using cross-sectional, nationally representative samples of 6- to 9-year-olds (n = 100,583). The children's standardized weight and height measurements followed a common WHO protocol. Information on the children's birth weight and breastfeeding practice and duration was collected through a family record form. A multivariate multilevel logistic regression analysis regarding breastfeeding practice (both general and exclusive) and characteristics at birth was performed.ResultsThe highest prevalence rates of obesity were observed in Spain (17.7%), Malta (17.2%) and Italy (16.8%). A wide between-country disparity in breastfeeding prevalence was found. Tajikistan had the highest percentage of children that were breastfed for ≥6 months (94.4%) and exclusively breastfed for ≥6 months (73.3%). In France, Ireland and Malta, only around 1 in 4 children was breastfed for ≥6 months. Italy and Malta showed the highest prevalence of obesity among children who have never been breastfed (21.2%), followed by Spain (21.0%). The pooled analysis showed that, compared to children who were breastfed for at least 6 months, the odds of being obese were higher among children never breastfed or breastfed for a shorter period, both in case of general (adjusted odds ratio [adjOR] [95% CI] 1.22 [1.16-1.28] and 1.12 [1.07-1.16], respectively) and exclusive breastfeeding (adjOR [95% CI] 1.25 [1.17-1.36] and 1.05 [0.99-1.12], respectively). Higher birth weight was associated with a higher risk of being overweight, which was reported in 11 out of the 22 countries. Bulgaria, Croatia, France, Italy, Poland and Romania showed that children who were preterm at birth had higher odds of being obese, compared to children who were full-term babies.ConclusionThe present work confirms the beneficial effect of breastfeeding against obesity, which was highly increased if children had never been breastfed or had been breastfed for a shorter period. Nevertheless, adoption of exclusive breastfeeding is below global recommendations and far from the target endorsed by the WHO Member States at the World Health Assembly Global Targets for Nutrition of increasing the prevalence of exclusive breastfeeding in the first 6 months up to at least 50% by 2025.

Project description:IntroductionParents 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.MethodsWe 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.ResultsOverall, 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/conclusionOur 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.

Project description:BackgroundLoneliness has been recognized as a public health issue and has moved into a number of European countries' policy agendas. Literature examining loneliness in young people (and especially in adolescents) is scarce, but it does show that at this age feelings of loneliness have been increasing in recent decades and are detrimental for both adolescents' current and future well-being. In order to explain loneliness, current literature focuses generally on individual, rather than on broader, environmental characteristics. This study examines school associates of loneliness and compares their importance to those at the individual level because schools are the most important places in which adolescents are socially embedded. In addition, policy interventions on loneliness might be more feasible at the school than the individual level.MethodsThis study uses a single-item measure of adolescents' loneliness feelings in schools and exploits rich data from the Programme for International Student Assessment (PISA 2018) on 23 European countries covering 118,698 students (50.2% female) in 4,819 schools. This study applies multi-level models to investigate school level factors jointly with those at the individual level.ResultsDifferences between European schools can explain a 20% variation in feelings of loneliness, thereby indicating the importance of the school environment. Furthermore, adolescents' bullying experiences and a bullying climate in school more than doubles incidences of loneliness. In addition, a cooperative climate as well as teacher support can considerably decrease school loneliness. Cross-level interactions do exist: being from a lower socioeconomic background for instance, while not important generally, increases loneliness feelings if most of the school peers are from a better socioeconomic background. School factors appear to be more important for explaining young people's loneliness incidence than individual characteristics.ConclusionThis is the first study to compare school level and individual level factors relating to youth loneliness in schools throughout Europe. Results emphasizing the importance of school environment for explaining adolescents' loneliness suggest that school level initiatives may be most appropriate in tackling loneliness when compared to wider and less contextualized national policies that focus on adolescents outside of school.

Project description:BackgroundObesogenic environment is important in driving obesity epidemic. Children spend large amount of their time in schools. School neighborhood environment, as well as its interaction with socioeconomic status (SES) needs to be explored to provide evidence for children obesity prevention policies.MethodsObjective anthropometric measurement, a household structured questionnaire, and school geospatial analyses were carried out on 3670 children (aged 9-12 years) of 26 schools in northeast China. Interaction between SES inter-categorical intersectionality group and school neighborhood environment was tested for the effect on children's body mass index z scores (z-BMI) and waist-hip ratio z scores (z-WHR), following formulation of SES inter-categorical intersectionality group based on household wealth, parental education, and parental occupation.ResultsSES groups formed by household wealth, parental education and parental occupation was associated with z-BMI and z-WHR for girls. Those from moderate wealth & self-employed (M&S) families had the highest adjusted z-BMI and z-WHR among all SES groups. School neighborhood environment factors interacted with SES groups in association with WHR for girls. Number of school neighborhood supermarkets and residential sites were negatively associated with z-WHR for girls from M&S families (β= -0.45 (95%CI: -0.76, -0.15) for supermarkets; β= -0.01 (95%CI: -0.03, 0.00) for residential sites). Number of school neighborhood convenience stores and public transport stops were positively associated with z-WHR for girls from M&S families (β = 0.02 (95%CI: 0.00, 0.03) for convenience stores; β = 0.23 (95%CI: 0.15, 0.31) for public transport stops). While non-significant association was found for number of vegetable stores.ConclusionGirls from moderate wealth & self-employed families may be the group susceptible to school neighborhood environment. Local policies targeted at improving the school neighborhood environment may be one avenue for reducing socioeconomic disparities in obesity especially for girls.

Dataset Information

WHO European Childhood Obesity Surveillance Initiative: School nutrition environment and body mass index in primary schools.

Background

Objective

Methods

Results

Conclusions

Publications

WHO European Childhood Obesity Surveillance Initiative: School nutrition environment and body mass index in primary schools.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets