Hostname: page-component-745bb68f8f-s22k5 Total loading time: 0 Render date: 2025-01-22T04:12:14.781Z Has data issue: false hasContentIssue false
  • English
  • Français

Childhood obesity in Europe: a growing concern

Published online by Cambridge University Press:  01 February 2001

MBE Livingstone
MBE Livingstone*
Affiliation:
Northern Ireland Centre for Diet and Health, University of Ulster, Cromore Road, Coleraine, Co. Londonderry, Northern Ireland, BT52 1SA, UK
*
*Corresponding author: E-mail [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Estimation of the prevalence and secular trends in paediatric obesity in Europe is impeded by methodological problems in the definition of obesity and the paucity of data sets that mirror the demographic, cultural and socioeconomic composition of the European population. The available prevalence data show that paediatric obesity is increasing throughout Europe but the patterns vary with time, age, sex and geographical region. The highest rates of obesity are observed in eastern and southern European countries. Even within countries there may be marked variability in the rates of obesity. It is unclear whether these trends are a simple consequence of an overall increase in fatness in Europe or whether there may be sub-groups of children who, at certain ages, are either particularly susceptible to environmental challenges or are selectively exposed to such challenges. In addition to the general increase in adiposity in European youth, there is also evidence of an increasing degree of obesity, particularly in older children and adolescents. No definite conclusions can be made about the respective contribution of energy intake and physical activity to the increasing prevalence of obesity. Changing demographic and social circumstances are linked to childhood obesity but it is highly unlikely that these interact in similar ways in the genesis of obesity in different individuals and population groups. In conclusion, the limited understanding of the variability in susceptibility to obesity in European youth provides powerful justification for the development of preventive strategies which are population based rather than selectively targeted at high-risk children.

Keywords

ChildrenAdolescentsDefinition of obesityPrevalence of obesityTrackingEnergy intakePhysical activitySociodemographic factors
Type
Research Article
Information
Public Health Nutrition , Volume 4 , Issue 1a , February 2001 , pp. 109 - 116
Copyright
Copyright © CABI Publishing 2001

References

1Power, C, Lake, JK, Cole, TJ. Measurement and long term health risks of child and adolescent fatness. Int. J Obes. Relat. Metab. Disord. 1997; 21: 507–26.CrossRefGoogle ScholarPubMed
2Power, C, Lake, JK, Cole, TJ. Body mass index and height from childhood to adulthood in the 1958 British birth cohort. Am. J. Clin. Nutr. 1997; 66: 1094–101.CrossRefGoogle Scholar
3Serdula, MK, Ivery, D, Coates, RJ, Freedman, DS, Williamson, DF, Byers, T. Do obese children become obese adults? A review of the literature. Prev. Med. 1993; 22: 167–77.CrossRefGoogle ScholarPubMed
4Whitaker, RC, Wright, JA, Pepe, MS, Seidel, KD, Dietz, WH. Prediciting obesity in young adulthood from childhood and parental obesity. N. Eng. J. Med. 1997; 337: 869–73.CrossRefGoogle Scholar
5Gortmaker, SL, Must, A, Perrin, JM, Sobol, AM, Dietz, WH. Social and economic consequences of overweight in adolescence and young adulthood. N. Eng. J. Med. 1993; 329: 1008–12.CrossRefGoogle ScholarPubMed
6Sargent, JD, Blanchflower, DG. Obesity and stature in adolescence and earnings in young adulthood. Arch. Pediatr. Adolesc. Med. 1994; 148: 681–7.CrossRefGoogle ScholarPubMed
7DiPietro, L, Mossberg, HO, Stunkard, AJ. A 40-year history of overweight children in Stockholm: life-time overweight, morbidity and mortality. Int. J. Obes. Relat. Metab. Disord. 1994; 18: 585–90.Google ScholarPubMed
8Must, A, Jacques, PF, Dallal, GE, Bajema, CJ, Dietz, WH. Longterm morbidity and mortality of overweight adolescents: a follow-up of the Harvard Growth Study of 1922 to 1935. N. Eng. J. Med. 1992; 327: 1350–5.CrossRefGoogle ScholarPubMed
9Nieto, FJ, Szklo, M, Comstock, GW. Childhood weight and growth rate as predictors of adult mortality. Am. J. Epidemiol. 1992; 136: 201–13.CrossRefGoogle ScholarPubMed
10Popkin, BM, Doak, CM. The obesity epidemic is a worldwide phenomenon. Nutr. Rev. 1998; 56: 106–14.CrossRefGoogle ScholarPubMed
11Guillaume, M. Defining obesity in childhood: current practice. Am. J. Clin. Nutr. 1999; 70: S126–30.CrossRefGoogle ScholarPubMed
12Zimmermann, MB, Hess, SY, Hurrell, RF. A national study of the prevalence of overweight and obesity in 6-12-y-old Swiss children: body mass index, body-weight perceptions and goals. Eur. J. Clin. Nutr. 2000; 54: 568–72.CrossRefGoogle Scholar
13Himes, JH. Reliability of anthropometric methods and replicate measurements. Am. J. Phys. Anthropol. 1989; 79: 77–80.CrossRefGoogle ScholarPubMed
14Chumlea, WC, Guo, S, Kuczmarski, RJ, Johnson, CL, Leahy, CK. Reliability for anthropometric measurements in the Hispanic Health and Nutrition Examination Survey (NHANES 1982–1984). Am. J. Clin. Nutr. 1990; 51: S902–7.CrossRefGoogle Scholar
15Poskitt, EM. Defining childhood obesity: the relative body mass index (BMI). Acta Paediatr. 1995; 84: 961–3CrossRefGoogle ScholarPubMed
16Dietz, WH, Robinson, TN. Use of the body mass index (BMI) as a measure of overweight in children and adolescents. J. Paediatr. 1998; 132: 191–3.Google ScholarPubMed
17Prentice, AM. Body mass index standards for children are useful for clinicians but not yet for epidemiologists. BMJ 1998; 317: 1401–2.CrossRefGoogle Scholar
18Pietrobelli, A, Faith, MS, Allison, DB, Gallagher, D, Chiumello, G, Heymsfield, SB. Body mass index as a measure of adiposity among children and adolescents: a validation study. J. Paediatr. 1998; 132: 204–10.CrossRefGoogle ScholarPubMed
19Daniels, SR, Khoury, PR, Morrison, JA. The utility of body mass index as a measure of body fatness in children and adolescents: differences by age and gender. Pediatrics 1997; 99: 804–7.CrossRefGoogle Scholar
20Rolland-Cachera, MF, Sempé, M, Guilloud-Bataille, M, Patois, E, Péquignot-Guggenbuhl, F, Fautrad, V. Adiposity indices in children. Am. J. Clin. Nutr. 1982; 36: 178–84.CrossRefGoogle ScholarPubMed
21Cole, TJ, Freeman, JV, Preece, MA. Body mass index reference curves for the UK, 1990. Arch. Dis. Child. 1995; 73: 25–9.CrossRefGoogle ScholarPubMed
22Must, A, Dallal, GE, Dietz, WH. Reference data for obesity: 85th and 95th percentiles of body mass index (wt/ht2) and triceps skinfold thickness. Am. J. Clin. Nutr. 1991; 53: 839–46.CrossRefGoogle ScholarPubMed
23Lindgren, G, Strandell, A, Cole, T, Healy, M, Tanner, J. Swedish population reference standards for height, weight and body mass index attained at 6 to 16 years (girls) or 19 years (boys). Acta. Paediatr. 1995; 84: 1019–28.CrossRefGoogle ScholarPubMed
24Troiano, RP, Flegal, KM. Overweight prevalence among youth in the United States: why so many different numbers? Int. J. Obes. Relat. Metab. Disord. 1999; 23: S22–7.CrossRefGoogle ScholarPubMed
25Cole, TJ, Bellizzi, MC, Flegal, KM, Dietz, WH. Establishing a standard definition for childhood overweight and obesity worldwide: international survey. BMJ 2000; 320: 1240–3.CrossRefGoogle Scholar
26Flegal, KM. Defining obesity in children and adolescents: epidemiological approaches. Crit. Rev. Food Sci. Nutr. 1993; 33: 307–12.CrossRefGoogle Scholar
27Stark, O, Atkins, E, Wolff, OH, Douglas, JWB. Longitudinal study of obesity in the National Survey of Health and Development. BMJ 1981; 283: 13–7.CrossRefGoogle ScholarPubMed
28Peckham, CS, Stark, O, Simonite, V, Wolff, OH. Prevalence of obesity in British children born in 1946 and 1958. BMJ 1983; 286: 1237–42.CrossRefGoogle ScholarPubMed
29Hughes, JM, Li, L, Chinn, S, Rona, RJ. Trends in growth in England and Scotland 1972 to 1994. Arch. Dis. Child 1997; 76: 182–9.CrossRefGoogle ScholarPubMed
30Seidell, JC. Obesity in Europe: scaling an epidemic. Int. J. Obes. Relat. Metab. Disord. 1995; 19: S1–4.Google ScholarPubMed
31Livingstone, MBE. Epidemiology of childhood obesity in Europe. Eur. J. Pediatr. 2000; 159: S14–34.CrossRefGoogle ScholarPubMed
32Blokstra, A, Kromhout, D. Trends in obesity in young adults in the Netherlands from 1974 to 1986. Int. J. Obes. Relat. Metab. Disord. 1991; 15: 513–21.Google ScholarPubMed
33Wekke, JS-vd, Meulmeester, JF, Radder, JJ, Hirasing, RA, Verloove-Vanhorick, SP. PGO-peiling 1992/1993. TNO Preventie en Gezondheid, Leiden, 1994.Google Scholar
34Seidell, JC, Verschuren, WMM, Kromhout, D. Levels and trends in obesity in the Netherlands. Int. J. Obes. Relat. Metab. Disord. 1995; 19: 924–7.Google ScholarPubMed
35Woringer, V, Schutz, Y. What is the evolution of the body mass index (BMI) in Swiss children from five to sixteen years, measured one decade apart? Int. J. Obes. Relat. Metab. Disord. 1998; 22: S209.Google Scholar
36Rolland-Cachera, MF, Spyckrelle, Y, Deschamps, JP. Evolution of pediatric obesity in France. Int. J. Obes. Relat. Metab. Disord. 1992; 16: S5.Google Scholar
37Reilly, JJ, Dorosty, AR, Emmett, PM. Prevlence of overweight and obesity in British children: cohort study. BMJ 1999; 319: 1039.CrossRefGoogle Scholar
38Maffeis, C, Schutz, Y, Piccoli, R, Gonfiantini, E, Pinelli, L. Prevalence of obesity in children in north-east Italy. Int. J. Obes. Relat. Metab. Disord. 1993; 17: 287–94.Google ScholarPubMed
39Nuutinen, EM, Turtinen, J, Pokka, T, Kuusela, V, Dahlström, S, Viikari, J, Uhari, M, Dahl, M, Kaprio, EA, Pesonen, E, Pietikäinen, M, Salo, MK, Åkerblom, HK. Obesity in children, adolescents and young adults. Ann. Med. 1991; 23: 41–6.CrossRefGoogle ScholarPubMed
40Elmadfa, I, Godina-Zarfl, B, König, J, Dichtl, M, Faist, V. Prevalence of overweight and plasma lipids in 7–18 year old Austrian children and adolescents. Int. J. Obes. Relat. Met. Disord. 1993; 17: S35.Google Scholar
41Maffeis, C, Talamini, G, Tatò, L. Influence of diet, physical activity and parents' obesity on children's adiposity: a four-year longitudinal study. Int. J. Obes. Relat. Metab. Disord. 1998; 22: 1–7.CrossRefGoogle ScholarPubMed
42Moreno, LA, Sarria, A, Fleta, J, Rodriguez, M, Bueno, M. Trends in obesity among children in Aragon (Spain) 1985–1995. Int. J. Obes. Relat. Metab. Disord. 1998; 19: S7.Google Scholar
43Dóber, I. The frequency of obesity among schoolchildren of Pécs. (In Hungarian). Népegészségügy. 1987; 68: 90–3.Google Scholar
44Kromeyer-Hauschild, K, Jaeger, U, Hoyer, H. Prevalence of overweight and obesity among school children in Jena (Germany). Int. J. Obes. Relat. Metab. Disord. 1999; 23 1143–50.CrossRefGoogle ScholarPubMed
45Amorim Cruz, JA. Dietary habits and nutritional status in adolescents over Europe – Southern Europe. Eur. J. Clin. Nutr. 2000; 54: S29–35.CrossRefGoogle Scholar
46Rolland-Cachera, MF, Bellisle, F, Deheeger, M. Nutritional status and food intake in adolescents living in Western Europe. Eur. J. Clin. Nutr. 2000; 54: S41–6.CrossRefGoogle ScholarPubMed
47Samuelson, G. Dietary habits and nutritional status in adolescents over Europe. An overview of current studies in the Nordic countries. Eur. J. Clin. Nutr. 2000; 54: S21–8.CrossRefGoogle ScholarPubMed
48Eposito-Del Puente, A, Contaldo, F, DeFilippo, E, Scalfi, L, DiMaio, S, Franzese, A, Valerio, G, Rubino, A. High prevalence of overweight in a children population living in Naples (Italy). Int. J. Obes. Relat. Metab. Disord. 1996; 20: 283–6.Google Scholar
49Flegal, KM. The obesity epidemic in children and adults: current evidence and research issues. Med. Sci. Sports Exerc. 1999; 31: S509–S14.CrossRefGoogle ScholarPubMed
50Barth, N, Ziegler, A, Himmelmann, GW, Coners, H, Wabitsch, M, Hennighausen, K, Mayer, H, Remschmidt, H, Schäfer, H, Hebebrand, J. Significant weight gains in a clinical sample of obese children and adolescents between 1985 and 1995. Int. J. Obes. Relat. Metab. Disord. 1997; 21: 122–6.CrossRefGoogle Scholar
51Sørensen, TIA, Thomsen, BL, Ekstrøm, C. Distributional analysis of trends in prevalence of obesity and body mass index among 161, 314 Danish boys born 1930 through 1975. Int. J. Obes. Relat. Metab. Disord. 1998; 22: S4.Google Scholar
52Poskitt, EM, Cole, TJ. Do fat babies stay fat?. BMJ 1977; 1: 7–9.CrossRefGoogle ScholarPubMed
53Guo, SS, Chumlea, WC. Tracking of body mass index in children in relation to overweight in adulthood. Am. J. Clin. Nutr. 1999; 70: S145–8.CrossRefGoogle ScholarPubMed
54Braddon, FEM, Rodgers, B, Wadsworth, MEJ, Davies, JMC. Onset of obesity in a 36 year birth cohort study. BMJ 1986; 293: 299–303.CrossRefGoogle Scholar
55Garn, SM, Lavelle, M, Rosenburg, KR, Hawthorne, VM. Maturational timing as a factor in female fatness and obesity. Am. J. Clin. Nutr. 1986; 43: 879–83.CrossRefGoogle ScholarPubMed
56Van Lenthe, FJ, Kemper, HCG, van Mechelen, W. Rapid maturation in adolescence results in greater obesity in adulthood: The Amsterdam Growth and Health Study. Am. J. Clin. Nutr. 1996; 64: 18–24.CrossRefGoogle ScholarPubMed
57Van Lenthe, FJ, Kemper, HCG, van Mechelen, W, Post, GB, Twisk, JWR, Welten, DC, Snel, J. Biological maturation and the distribution of subcutaneous fat from adolescence into adulthood: The Amsterdam Growth and Health Study. Int. J. Obes. Relat. Metab. Disord. 1996; 20: 121–9.Google ScholarPubMed
58Birch, L, Johnson, S, Andresen, G, Peters, J, Schulte, M. The variability of young children's energy intake. N. Eng. J. Med. 1991; 24: 232–5.CrossRefGoogle Scholar
59Shea, S, Stein, A, Basch, C, Contento, I, Zybert, P. Variability and self-regulation of energy intake in young children in their everyday environment. Pediatrics 1992; 90: 542–6.CrossRefGoogle ScholarPubMed
60Lissau, I, Breum, L, Sorensen, TIA. Maternal attitude to sweet eating habits and risk of overweight in offspring: a ten-year prospective population study. Int. J Obes. Relat. Metab. Disord. 1993; 17: 125–9.Google ScholarPubMed
61Birch, LL, Fisher, JO. Development of eating behaviours among children and adolescents. Pediatrics 1998; 101: 539–49.CrossRefGoogle ScholarPubMed
62Livingstone, MBE, Robson, PJ. Measurement of dietary intake in children. Proc. Nut. Soc. 2000; 59: 279–93.CrossRefGoogle ScholarPubMed
63Bandini, LG, Schoeller, DA, Cyr, HN, Dietz, WH. Validity of reported energy intake in obese and nonobese adolescents. Am. J. Clin. Nutr. 1990; 52: 421–5.CrossRefGoogle ScholarPubMed
64Gazzaniga, JM, Burns, TL. Relationship between diet composition and body fatness, with adjustment for resting energy expenditure and physical activity, in pre-adolescent children. Am. J. Clin. Nutr. 1993; 58: 21–8.CrossRefGoogle Scholar
65Maffeis, C, Pinelli, L, Schutz, Y. Fat intake and adiposity in 8 to 11-year-old obese children. Int. J. Obes. Relat. Metab. Disord. 1996; 20: 170–4.Google ScholarPubMed
66Ortega, RM, Requejo, AM, Andrés, P, López-Sobaler, AM, Redondo, R, González-Fernández, M. Relationship between diet composition and body mass index in a group of Spanish adolescents. Br. J. Nutr. 1995; 74: 765–73.Google Scholar
67Eck, LH, Klesges, RC, Hanson, CL, Slawson, D. Children at familial risk of obesity: an examination of dietary intake, physical activity and weight status. Int. J. Obes. Relat. Metab. Disord. 1992; 16: 71–8.Google ScholarPubMed
68Rolland-Cachera, MF, Deheeger, M, Akrout, M, Bellisle, F. Influence of macronutrients on adiposity development: a follow-up study of nutrition and growth from 10 months to 8 years of age. Int. J. Obes. Relat. Metab. Disord. 1995; 19: 573–8.Google ScholarPubMed
69Maffeis, C, Provera, S, Filippi, L, Sidoti, G, Schena, S, Pinelli, L, Tatò, L. Distribution of food intake as a risk factor for childhood obesity. Int. J. Obes. Relat. Metab. Disord. 2000; 24: 75–80.CrossRefGoogle ScholarPubMed
70Prentice, AM, Jebb, SA. Obesity in Britain: gluttony or sloth? BMJ 1995; 311: 437–9.CrossRefGoogle ScholarPubMed
71Molnár, D, Livingstone, MBE. Physical activity in relation to overweight and obesity in children and adolescents. Eur. J Pediatr. 2000; 159: S45–55.CrossRefGoogle ScholarPubMed
72King, A, Coles, B. The health of Canada's youth: views and behaviours of 11, 13, and 15 year olds from 11 countries. Canada: Ministry of National Health and Welfare, 1992.Google Scholar
73Riddoch, CJ, Boreham, CAG. The health-related physical activity of children. Sports Med. 1995; 19: 86–102.CrossRefGoogle ScholarPubMed
74Raitakari, OT, Porkka, KVK, Taimela, S, Rasanen, L, Viikara, JSA. Effect of persistent physical activity and inactivity on coronary risk factors in children and young adults. The Cardiovascular Risk in Young Finns Study. Am. J. Epidemiol. 1994; 140: 195–205.CrossRefGoogle Scholar
75Hillman, M. One false move … an overview of the findings and issues they raise. In: Hillman, M, ed. Children, Transport and the Quality of Life. London: Policy Studies Institute, 1993.Google Scholar
76Gortmaker, SL, Must, A, Sobol, AM, Peterson, K, Colditz, GA, Dietz, WH. Television watching as a cause of increasing obesity among children in the United states, 1986–1990. Arch. Pediatr. Adolesc. Med. 1996; 150: 356–62.CrossRefGoogle ScholarPubMed
77Deheeger, M, Rolland-Cachera, MF, Fonvieille, AM. Physical activity and body composition in 10 year old French children: linkage with nutritional intake. Int. J. Obes. Relat. Metab. Disord. 1997; 21: 372–9.CrossRefGoogle ScholarPubMed
78Andersen, RE, Crespo, CJ, Bartlett, SJ, Cheskin, LJ, Pratt, M. Relationship of physical activity and television watching with body weight and level of fatness among children: results from the Third National Health and Nutrition Examination Survey. JAMA 1998; 279: 938–42.CrossRefGoogle ScholarPubMed
79Fogelholm, M, Nuutinen, O, Pasanen, M, Myöhänen, E, Säätelä, T. Parent-child relationship of physical activity patterns and obesity. Int. J. Obes. Relat. Metab. Disord. 1999; 23: 1262–8.CrossRefGoogle ScholarPubMed
80Dietz, WH, Gortmaker, SL. Factors within the physical environment associated with childhood obesity. Am. J. Clin. Nutr. 1984; 39: 619–24.CrossRefGoogle ScholarPubMed
81Duran-Tauleria, E, Rona, RJ, Chinn, S. Factors associated with weight for height and skinfold thickness in British children. J. Epidemiol. Community Health 1995; 49: 466–73.CrossRefGoogle ScholarPubMed
82Locard, E, Mamelle, N, Billette, A, Miginiac, M, Munoz, F, Rey, S. Risk factors of obesity in a five year old population. Parental versus environmental factors. Int. J. Obes. Relat. Metab. Disord. 1992; 16: 721–9.Google Scholar
83Keiller, SM, Colley, JR, Carpenter, RG. Obesity in school-children and their parents. Ann. Hum. Biol. 1979; 6: 443–55.CrossRefGoogle Scholar
84Lissau, I, Sorensen, TIA. Prospective study of the influence of social factors in childhood on risk of overweight in young adulthood. Int. J. Obes. Relat. Metab. Disord. 1992; 16:169–75.Google Scholar
85Rona, RJ, Chinn, S. National study of health and growth: social and family factors and obesity in primary schoolchildren. Ann. Hum. Biol. 1982; 9: 131–45.CrossRefGoogle ScholarPubMed
86Rolland-Cachera, MF, Bellisle, F. No correlation between adiposity and food intake: why are working class children fatter? Am. J. Clin. Nutr. 1986; 44: 779–87.CrossRefGoogle ScholarPubMed
87Vuille, JC, Mellbin, T. Obesity in 10-year-olds: an epidemio-logic study. Pediatrics 1979; 64: 564–72.Google Scholar
88Maffeis, C, Micciolo, R, Must, A, Zaffanello, M, Pinelli, L. Parental and perinatal factors associated with childhood obesity in north-east Italy. Int. J. Obes. Relat. Metab. Disord. 1994; 18: 301–5.Google ScholarPubMed
89Wenstrate, JA, van Klaveren, S, Deurenberg, P. Changes in skinfold thicknesses and body mass index in 171 children, initially 1 to 5 years of age: a 5 1/2-year follow-up study. Int. J. Obes. Relat. Metab. Disord. 1986; 10: 313–21.Google Scholar
90Power, C, Moynihan, C. Social class and changes in weight-for-height between childhood and early adulthood. Int. J. Obes. Relat. Metab. Disord. 1988; 12: 445–53.Google ScholarPubMed
91De Spiegelaere, M, Dramaix, M, Hennart, P. The influence of socioeconomic status on the incidence and evolution of obesity during early adolescence. Int. J. Obes. Relat. Metab. Disord. 1998; 22: 268–74.CrossRefGoogle ScholarPubMed
92Hardy, R, Wadsworth, M, Kuh, D. The influence of childhood weight and socioeconomic status on change in adult body mass index in a British national birth cohort. Int. J. Obes. Relat. Metab. Disord. 2000; 24: 725–34.CrossRefGoogle Scholar
93Garn, S, Bailey, S, Cole, P, Higgins, ITT. Evidence for the social inheritance of obesity in childhood and adolescence. In: Gedda, L, Parisi, P, eds. Auxology: human growth in health and disorder. London: Academic Press, 1978.Google Scholar
94Stunkard, AJ, Sorensen, TIA, Hanis, C, Teasdale, TW, Chakra-borty, R, Schull, WJ, Schülsinger, F. An adoption study of human obesity. N. Eng. J. Med. 1986; 314: 193–8.CrossRefGoogle ScholarPubMed
95Ravelli, GP, Belmont, L. Obesity in nineteen-year-old men: family size and birth order associations. Am. J. Epidemiol. 1979; 109: 66–70.CrossRefGoogle ScholarPubMed