Effects of a practice-focused nutrition intervention in Hungarian adolescents.

INTRODUCTION: This work evaluated the impact of a nutrition intervention in school children of 6th and 7th grade and assessed whether changes persisted after the summer break. MATERIALS AND METHODS: Eight classes of Hungarian adolescents (45% boys; 12.6 ± 0.1 years) were randomized into intervention (n = 117) and control (n = 112) groups. The 9-month long intervention included: 1) weekly classroom-based education with strong focus on practical elements such as tasting and meal preparation; 2) five sessions of after-school cooking classes (open to children, parents and grandparents); and 3) online education materials. Anthropometric parameters (weight, height, waist circumference and body fat), aerobic fitness (Cooper test, 20-meter shuttle run test), nutrition knowledge and behaviors (questionnaires) were measured three times at baseline, post-intervention and after the summer holiday. RESULTS: Slight improvement in dietary knowledge and habits from baseline to post-intervention which did not persist after summer. Aerobic fitness increased in the intervention group, while did not change among controls. Anthropometric parameters remained unchanged in the intervention group, but waist circumference increased in controls, particularly in summer. CONCLUSIONS: Findings suggest a positive impact of this intervention. Measures to mitigate unhealthy changes during the summer break are needed.

Prevalence of Severe Obesity among Primary School Children in 21 European Countries.

BACKGROUND: The World Health Organization (WHO) European Childhood Obesity Surveillance Initiative (COSI) was established more than 10 years ago to estimate prevalence and monitor changes in overweight and obesity in children aged 6-9 years. Since then, there have been five rounds of data collection in more than 40 countries involving more than half a million children. To date, no comparative studies with data on severe childhood obesity from European countries have been published. OBJECTIVES: The aim of this work was to present the prevalence of severe obesity in school-aged children from 21 countries participating in COSI. METHOD: The data are from cross-sectional studies in 21 European WHO member states that took part in the first three COSI rounds of data collection (2007/2008, 2009/2010, 2012/2013). School-aged children were measured using standardized instruments and methodology. Children were classified as severely obese using the definitions provided by WHO and the International Obesity Task Force (IOTF). Analyses overtime, by child's age and mother's educational level, were performed in a select group of countries. RESULTS: A total of 636,933 children were included in the analysis (323,648 boys and 313,285 girls). The prevalence of severe obesity varied greatly among countries, with higher values in Southern Europe. According to the WHO definition, severe obesity ranged from 1.0% in Swedish and Moldovan children (95% CI 0.7-1.3 and 0.7-1.5, respectively) to 5.5% (95% CI 4.9-6.1) in Maltese children. The prevalence was generally higher among boys compared to girls. The IOTF cut-offs lead to lower estimates, but confirm the differences among countries, and were more similar for both boys and girls. In many countries 1 in 4 obese children were severely obese. Applying the estimates of prevalence based on the WHO definition to the whole population of children aged 6-9 years in each country, around 398,000 children would be expected to be severely obese in the 21 European countries. The trend between 2007 and 2013 and the analysis by child's age did not show a clear pattern. Severe obesity was more common among children whose mother's educational level was lower. CONCLUSIONS: Severe obesity is a serious public health issue which affects a large number of children in Europe. Because of the impact on educational, health, social care, and economic systems, obesity needs to be addressed via a range of approaches from early prevention of overweight and obesity to treatment of those who need it.