The percentage of overweight (including obesity) among 6-9-year-old children differs between European countries, ranging from 18 to 57%. Percentages are highest in southern European countries. These findings come from the WHO European Childhood Obesity Surveillance Initiative (COSI) performed by Member States of the WHO European Region and coordinated by the WHO Regional Office for Europe. The WHO Collaborating Centre for Nutrition at RIVMNational Institute for Public Health and the Environment is a partner and collaborator in this unique initiative.

School setting

School can be an important setting to promote healthy lifestyles in children. The extent to which healthy food choices are made available on school premises differs largely in Europe. Results indicate that in 12–95% of the primary schools fresh fruit can be obtained by pupils. The provision of physical education lessons and the availability of school playgrounds are more uniformly present across European countries: 76–100%. Not only are there differences between countries, but also between schools within the same country. 

Health related behaviours

The COSI project also researched the children’s health related behaviours, such as having breakfast, types of food eaten and the amounts of physical activity, screen time and sleep duration. There was a clear connection between not having breakfast daily and obesity as well as between spending screen time more than 2 hours daily and obesity. The same applies to eating junk food more than 3 days per week and to  outdoor playing less than 1 hour per day. These results emphasize the importance of not only focusing on diet in prevention of obesity, but also stimulating physical activity and discouraging sedentary behavior. 

Childhood Obesity Surveillance Initiative

The WHO Regional Office for Europe launched the WHO European Childhood Obesity Surveillance Initiative (COSI) in 2007 at the time with support from countries like Italy and Portugal. COSI is a joint effort of the WHO Regional Office for Europe (and interested European Region Member States) and aims to monitor the magnitude of overweight and obesity among primary-school children in European countries. At 2 or 3 year intervals COSI collects data on weight and height of primary-school children and on their nutrition and physical activity behaviours, as well as on school environmental characteristics supportive to healthy diets and physical activity. Currently about 30 countries participate in COSI. A PhD student from Wageningen University and RIVMNational Institute for Public Health and the Environment , and at the same time a staff member of the WHO Regional Office for Europe worked on the COSI-dataset and prepared her PhD thesis based on it. Trudy Wijnhoven and the WHO Regional Office for Europe received support in this Project from the WHO Collaborating Centre for Nutrition at RIVM, which provided relevant advice and support. This PhD thesis defense will take place at Wageningen University on 6 October 2015.