Background
Methods
World Health Organization European Childhood Obesity Surveillance Initiative
Sampling of children
Exposure variables
Sleep duration
Screen time
Outcome variables
Food consumption frequencies
Covariates
Age-adjusted body mass index z-scores (BMI/A z-scores)
Outdoor play time
Educational level of parents
Statistical analyses
Results
Characteristics | Total study group | Thinness and normal weight* | Overweight (including obesity)* |
---|---|---|---|
n (%) | n (%) | n (%) | |
Age group (years)
| |||
6.0–6.9 | 1098 (10.5) | 803 (73.1) | 295 (26.9) |
7.0–7.9 | 5857 (56.0) | 4269 (72.9) | 1588 (27.1) |
8.0–8.9 | 3044 (29.1) | 2216 (72.8) | 828 (27.2) |
9.0–9.9 | 454 (4.3) | 353 (77.8) | 101 (22.3) |
Sex
| |||
Boys | 5290 (50.6) | 3788 (71.6) | 1502 (28.4) |
Girls | 5163 (49.4) | 3853 (74.6) | 1310 (25.4) |
Country
| |||
Bulgaria | 2251 (21.5) | 1592 (70.7) | 659 (29.3) |
Czech Republic | 1206 (11.5) | 960 (79.6) | 246 (20.4) |
Lithuania | 2767 (26.5) | 2081 (75.2) | 686 (24.8) |
Portugal | 1788 (17.1) | 1119 (62.6) | 669 (37.4) |
Sweden | 2441 (23.4) | 1889 (77.4) | 552 (22.6) |
Maximum educational level of parents
| |||
Primary school | 804 (7.7) | 589 (73.3) | 215 (26.7) |
Secondary school | 4808 (46.0) | 3443 (71.6) | 1365 (28.4) |
Undergraduate/bachelor’s degree | 3120 (29.9) | 2305 (73.9) | 815 (26.1) |
Master’s degree or higher | 1721 (16.5) | 1304 (75.8) | 417 (24.2) |
Variables under study | Total study group | Thinness and normal weight* | Overweight (including obesity)* | BUL† | CZE† | LTU† | PRT† | SWE† |
---|---|---|---|---|---|---|---|---|
Mean (SD) | ||||||||
Exposure variables (hours/day)
| ||||||||
Sleep duration | 9.7 (0.9) | 9.7 (0.9) | 9.6 (0.9) | 9.6 (1.1) | 10.0 (0.8) | 9.5 (0.8) | 9.7 (0.8) | 10.0 (0.7) |
Screen time | 2.2 (1.1) | 2.2 (1.0) | 2.3 (1.0) | 2.5 (1.0) | 1.7 (0.9) | 2.6 (1.0) | 1.8 (0.9) | 1.9 (0.8) |
TV time | 1.5 (0.7) | 1.5 (0.7) | 1.6 (0.7) | 1.8 (0.8) | 1.2 (0.6) | 1.8 (0.7) | 1.3 (0.7) | 1.3 (0.6) |
PC time | 0.7 (0.6) | 0.7 (0.6) | 0.7 (0.7) | 0.7 (0.7) | 0.5 (0.5) | 0.9 (0.7) | 0.5 (0.5) | 0.6 (0.5) |
Covariates
| ||||||||
Outdoor play time (hours/day) | 2.0 (0.8) | 2.0 (0.8) | 2.0 (0.8) | 2.2 (0.7) | 2.1 (0.6) | 2.2 (0.7) | 1.4 (0.8) | 2.1 (0.7) |
BMI-for-Age z-score | 0.36 (1.22) | -0.21 (0.78) | 1.91 (0.76) | 0.37 (1.36) | 0.11 (1.20) | 0.31 (1.19) | 0.72 (1.21) | 0.26 (1.06) |
Outcome variables – food consumption frequencies (days/week)
| ||||||||
Fresh fruit | 5.1 (2.1) | 5.0 (2.1) | 5.1 (2.1) | 4.2 (2.1) | 5.6 (1.8) | 4.4 (2.1) | 5.6 (2.0) | 5.9 (1.8) |
Vegetables (excluding potatoes) | 4.6 (2.1) | 4.6 (2.1) | 4.5 (2.2) | 4.2 (2.0) | 4.5 (2.1) | 4.0 (2.1) | 4.7 (2.3) | 5.6 (1.9) |
100% fruit juice | 2.8 (2.1) | 2.8 (2.1) | 2.7 (2.1) | 3.2 (2.3) | 2.0 (1.7) | 3.1 (1.9) | 2.5 (2.2) | 2.5 (2.1) |
Soft drinks containing sugar | 2.5 (2.1) | 2.5 (2.1) | 2.5 (2.1) | 3.1 (2.5) | 3.6 (2.5) | 2.4 (1.8) | 2.1 (2.1) | 2.0 (1.2) |
Diet/light soft drinks | 0.8 (1.3) | 0.8 (1.3) | 0.8 (1.4) | 0.7 (1.4) | 0.7 (1.5) | 1.1 (1.2) | 0.3 (1.0) | 0.8 (1.3) |
Low-fat/semi-skimmed milk | 3.3 (2.9) | 3.2 (2.9) | 3.5 (3.0) | 1.7 (2.0) | 1.3 (2.2) | 2.5 (2.5) | 6.1 (2.1) | 4.5 (2.8) |
Whole-fat milk | 2.2 (2.5) | 2.3 (2.6) | 1.9 (2.4) | 2.8 (2.2) | 2.6 (2.7) | 3.0 (2.6) | 0.7 (2.0) | 1.5 (2.4) |
Flavoured milk | 1.7 (2.0) | 1.7 (1.9) | 1.8 (2.0) | 1.2 (1.7) | 1.8 (1.9) | 1.5 (1.4) | 3.0 (2.7) | 1.6 (1.8) |
Cheese | 3.4 (2.2) | 3.3 (2.2) | 3.4 (2.2) | 4.2 (2.1) | 4.4 (2.1) | 3.1 (2.0) | 2.8 (2.3) | 2.9 (2.2) |
Yoghurt, cream cheese/quark or other dairy products | 4.7 (2.1) | 4.7 (2.2) | 4.8 (2.1) | 4.4 (2.1) | 5.5 (1.8) | 4.7 (2.1) | 5.4 (2.0) | 4.2 (2.3) |
Meat | 4.6 (1.9) | 4.6 (1.9) | 4.6 (1.9) | 4.3 (2.1) | 4.7 (1.7) | 5.0 (1.9) | 4.7 (1.9) | 4.4 (1.6) |
Fish | 2.4 (1.5) | 2.4 (1.4) | 2.5 (1.5) | 2.2 (1.4) | 1.9 (1.0) | 2.1 (1.2) | 3.7 (1.9) | 2.3 (1.1) |
Potato chips (crisps), corn chips, popcorn or peanuts | 2.2 (1.6) | 2.2 (1.6) | 2.1 (1.6) | 3.6 (2.1) | 1.6 (1.2) | 2.1 (1.2) | 1.5 (1.2) | 1.7 (0.8) |
Candy bars or chocolate | 3.0 (1.9) | 3.1 (1.9) | 3.0 (1.9) | 4.5 (2.2) | 2.8 (1.7) | 3.6 (2.0) | 2.1 (1.4) | 2.0 (0.6) |
Biscuits, cakes, doughnuts or pies | 2.8 (1.8) | 2.9 (1.8) | 2.8 (1.8) | 3.6 (2.1) | 2.7 (1.6) | 3.1 (1.8) | 2.7 (1.8) | 2.0 (1.0) |
Pizza, French fries (chips), hamburgers, sausages or meat pies | 2.1 (1.4) | 2.1 (1.4) | 2.1 (1.4) | 3.3 (2.0) | 1.5 (1.1) | 2.0 (1.1) | 1.7 (1.1) | 1.9 (0.7) |
Food items | Screen time | Sleep duration | ||
---|---|---|---|---|
< 2 h/day* | ≥ 2 h/day* | < 9.7 h/day† | ≥ 9.7 h/day† | |
(n=4870) | (n=5583) | (n=4782) | (n=5671) | |
Mean consumption frequencies in days per week (SD) | ||||
Fresh fruit | 5.4 (2.0) | 4.7 (2.2) | 4.8 (2.2) | 5.3 (2.1) |
Vegetables (excluding potatoes) | 4.9 (2.1) | 4.3 (2.1) | 4.4 (2.1) | 4.8 (2.1) |
100% fruit juice | 2.6 (2.1) | 2.9 (2.1) | 2.7 (2.1) | 2.8 (2.1) |
Soft drinks containing sugar | 2.3 (2.0) | 2.8 (2.1) | 2.5 (2.1) | 2.5 (2.1) |
Diet/light soft drinks | 0.6 (1.2) | 0.9 (1.4) | 0.8 (1.3) | 0.8 (1.3) |
Low-fat/semi-skimmed milk | 3.6 (3.0) | 3.0 (2.8) | 3.1 (2.9) | 3.4 (3.0) |
Whole-fat milk | 2.0 (2.6) | 2.4 (2.5) | 2.2 (2.5) | 2.2 (2.6) |
Flavoured milk | 1.8 (2.1) | 1.7 (1.9) | 1.7 (2.0) | 1.7 (2.0) |
Cheese | 3.3 (2.3) | 3.4 (2.2) | 3.3 (2.2) | 3.4 (2.3) |
Yoghurt, cream cheese/quark or other dairy products | 4.9 (2.2) | 4.6 (2.1) | 4.6 (2.1) | 4.8 (2.2) |
Meat | 4.6 (1.8) | 4.7 (1.9) | 4.6 (1.9) | 4.6 (1.9) |
Fish | 2.5 (1.5) | 2.3 (1.4) | 2.4 (1.4) | 2.5 (1.5) |
Potato chips (crisps), corn chips, popcorn or peanuts | 1.8 (1.4) | 2.5 (1.7) | 2.2 (1.6) | 2.1 (1.6) |
Candy bars or chocolate | 2.6 (1.6) | 3.5 (2.1) | 3.2 (2.0) | 2.9 (1.9) |
Biscuits, cakes, doughnuts or pies | 2.6 (1.6) | 3.1 (1.9) | 2.9 (1.9) | 2.8 (1.8) |
Pizza, French fries (chips), hamburgers, sausages or meat pies | 1.9 (1.2) | 2.4 (1.5) | 2.2 (1.5) | 2.1 (1.4) |
Outcome variables (Categorization: ≥ 4 days/week vs. < 4 days/week; exceptions in brackets) | Exposure variables | |
---|---|---|
Screen time†(hours/day) | Sleep duration#(hours/day) | |
OR (99% CI) | OR (99% CI) | |
Fresh fruit (Daily vs. < 7 days/week) | 0.91 (0.86;0.97)** | 1.11 (1.04;1.18)** |
Vegetables (excluding potatoes) (Daily vs. < 7 days/week) | 0.89 (0.83;0.95)** | 1.14 (1.07;1.23)** |
100% fruit juice | 1.07 (1.01;1.14)* | 1.14 (1.06;1.22)** |
Soft drinks containing sugar (≥ 1 day/week vs. never) | 1.28 (1.19;1.39)** | 0.99 (0.91;1.07) |
Diet/light soft drinks (≥ 1 day/week vs. never) | 1.21 (1.14;1.29)** | 0.97 (0.90;1.04) |
Low-fat/semi-skimmed milk | 1.07 (1.00;1.15) | 0.97 (0.90;1.05) |
Whole-fat milk | 0.97 (0.91;1.04) | 1.10 (1.02;1.18)** |
Flavoured milk | 1.18 (1.08;1.28)** | 0.98 (0.89;1.08) |
Cheese | 1.02 (0.97;1.09) | 1.13 (1.06;1.20)** |
Yoghurt, cream cheese/quark or other dairy products | 0.95 (0.89;1.01) | 1.16 (1.08;1.24)** |
Meat | 1.12 (1.05;1.19)** | 1.04 (0.97;1.12) |
Fish | 0.95 (0.88;1.03) | 1.06 (0.97;1.16) |
Potato chips (crisps), corn chips, popcorn or peanuts | 1.32 (1.20;1.45)** | 1.07 (0.98;1.18) |
Candy bars or chocolate | 1.31 (1.22;1.40)** | 1.03 (0.96;1.11) |
Biscuits, cakes, doughnuts or pies | 1.22 (1.14;1.30)** | 1.03 (0.96;1.10) |
Pizza, French fries (chips), hamburgers, sausages or meat pies | 1.30 (1.18;1.43)** | 1.03 (0.93;1.14) |