COSI: l’obesità infantile in Europa

Dr João Breda

Head European Office Prevention & Control of Noncommunicable Diseases, Moscow

1

Noncommunicable diseases in WHO/Europe

2

Projected prevalence of obesity (≥30 kg/m2) to 2025 WHO/Europe model 14 with best quality data

0% 10% 20% 30% 40% 50% 60% 70%

England

Estonia

Finland

Germany

Greece

Republic of Ireland

Italy

Lithuania

Netherlands

Russian Federation

Scoltand

Sweden

Turkey

Wales

Prevalence

2015

2025

2025 approx. 9% women will be severely obese

Adolescents - overweight (including obesity) prevalence

in youth according to “sub-region”

14,1

20,2

11,5

15,5 14,7

21,3

15,6 16,2

15,3

22,5

18,5 17,3

0

5

10

15

20

25

30

Western Europe Southern Europe Eastern Europe Northern Europe

%

2002

2006

2010

Overweight prevalence distribution according to geographical region in 32 countries within WHO European Region, considering both boys and girls with 11, 13, 15 (Source: HBSC).

Highest Levels

0

10

20

30

40

50

60

70

80

90

100

ITA DNK FRA CHE RUS PRT SWE EST GRC NOR ISR ISL LTU DEU BEL TUR MLT NLD HUN ROM SVN LVA POL HRV GBR LUX SVK ESP UKR MKD FIN CZE ARM AUT BGR IRL

%

2010

Prevalence of insufficient physical activity

among school-going adolescents

Global Health Observatory Data Repository. Geneva: World Health Organization (http://apps.who.int/gho/data/view.main.2463ADO?lang=en, accessed 1 May 2015). No data for ALB, AND, AZE, BLR, BIH, CYP, GEO, KAZ, KGZ, MNE, MDA, SMR, SRB, TJK, TKM, UZB

Childhood obesity – a challenge for Region and most vulnerable

Childhood Obesity Surveillance Initiative

• Routine measurements • Standardized protocol and

methods • Highly comparable • Flexible system • Ever-expanding number of

countries

COSI – 10 years on - unique feature of the European

surveillance response to NCD challenge

COSI expansion - participating countries ROUND 1

14 countries ROUND 2 18 countries

ROUND 3 22 countries

ROUND 4 39 countries

Belgium, Bulgaria, Cyprus, Czech Republic, Ireland, Italy, Latvia, Lithuania, Malta, Norway, Portugal, Slovenia, Sweden, United Kingdom (Wales)

+ Greece, Hungary,

Spain, FYRM

+ Albania, Republic of

Moldova, Romania, Turkey

+ Austria, Croatia,

Denmark, Estonia, Kazakhstan, Poland, San Marino, Slovakia, Serbia, RF, TJK, MNE, TKM, KGZ, France, UKR

COSI 2012-13: Obesity – boys vs girls Obesity prevalence among boys and girls by age group and country*

* All data from 2012-13 round but those of Sweden (2007-8) and Hungary (2010-2011). Data from Greece and Lithuania are preliminary

6 yrs 7 yrs 8 yrs 9 yrs

Boys

Girls

WHO European Region MS achieving global targets around

nutrition & physical inactivity by 2025 - updated

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Childhood obesity

Physical inactivity

Breastfeeding

Salt reduction

Adult obesity

On track off track

WHO Mandate in Europe

Selected examples of policy options in WHO European Food and Nutrition Action

Plan relevant to childhood obesity

Priority policy options

Strong controls on marketing, incl. but not limited to TV advertising

Price policies applied to foods and drinks

Consumer-friendly front of pack labelling

Reformulation, calorie reduction, smaller portions

Healthier food retail environment, incl. in schools

Special challenge: Children and adolescents

Cognitive performance and physical activity

17

Mandatory hours of physical education in

schools in EU member states

Source: CFS-2015

4

18

6

5

15

8

0

5

10

15

20

25

30

35

<2 per week 2 per week >2 per week

Mandatory hours of PE in secondary schools Mandatory hours of PE in primary schools

• 20 or 40 min/d of aerobic training improved

fitness and demonstrated dose-response

benefits for insulin resistance and general and

visceral adiposity in sedentary overweight or

obese children

19

Davis CL et al.

WHO GUIDELINES

Innovation to tackle childhood obesity

• Monitoring and surveillance can be improved….

– Support to WHO from Italy and ISS

• Reduce children’s exposure to food marketing (digital)

• Considering economic tools and improve information to consumers

• Food product reformulation can only be successful if mainstreamed

• Measure of an environment nature are crucial notably healthier food environments in

schools

• Dramatically increase PA levels

From COSI to ending childhood obesity