One in Three Teens in Europe Is Overweight or Obese; Rates Still Rising

PORTO, Portugal — A new World Health Organization (WHO) report unveiled today reveals that the number of obese adolescents is continuing to rise in many countries across Europe and is a "critical public-health concern."

"Despite sustained efforts to tackle childhood obesity, one in three adolescents is still estimated to be overweight or obese in Europe, with the highest rates found in southern European and Mediterranean countries," said Dr Zsuzsanna Jakab, WHO regional director for Europe.

And "What is of particular concern is that the epidemic is on the rise in Eastern European countries, where historically rates have been lower," she explained.

Lead author of the report, Jo Inchley, PhD, of University of St Andrews, Scotland, told Medscape Medical News that 40 countries were included in the study, although not every one of these had data available on all of the outcomes.

The report was launched today at the European Congress on Obesity in Portugal.

Most Marked Increases in Eastern Europe

The highest levels of obesity among adolescents are currently found in Greece, Macedonia, Slovenia, Croatia, and Portugal, for boys and girls combined, Dr Inchley noted.

And "the most marked increases have been in Eastern Europe, but that's because they started off pretty low and are now catching up," she explained.

Overall, there have been increases in obesity in 16 of the countries studied, since 2002. And while these latest data indicate "we are not seeing the sharp increases we had initially seen, this should not be seen as a sign for complacency," she emphasized.

The mean rate for obesity specifically was 5% of the adolescent population studied, rising to about 10% in EU countries and as high as 14% in Macedonia, for example.

The lowest prevalence's of obesity recorded in the region are in Norway, Denmark, the Netherlands, Switzerland, and the Ukraine. And there has even been a fall in obesity among boys at the age of 13 in Norway, Dr Inchley noted.

Refusing to be drawn on why this might be, observing that "obesity is complex and many factors play a role," she nevertheless said there may be lessons to learn from some countries. For example, Norway "has quite strict policies regarding [healthy] food in school," she noted.

Dr Nathalie Farpour-Lambert, a pediatrician and head of the Obesity Prevention and Care Program, University Hospital of Geneva, Switzerland, who is also president-elect of the European Association for the Study of Obesity, told Medscape Medical News: "We knew about the problem in Southern Europe, but we didn't realize the quick transition to [overweight and obesity] in Eastern Europe."

The report is "an important reminder for policymakers that the battle is not yet finished," she stressed, adding that despite the introduction of some public-health measures, "there are very few data confirming a decline in overweight and obesity."

She said the problem is "like a tsunami," and "in the majority of countries, the public-health measures are having no effect, so we need more regulation."

Screen Time on the Rise Despite Reduction in TV Viewing

Overweight and obese children are at greater risk of conditions such as type 2 diabetes and future cardiovascular disease, as well as school absence, psychological problems, and social isolation.

"Most young people will not outgrow obesity: about four in every five adolescents who become obese will continue to have weight problems as adults," observed João Breda, PhD, program manager for nutrition, physical activity and obesity at the WHO regional office for Europe.

In general, younger adolescents, boys, and those living in families of lower socioeconomic position are more likely to be obese, the report reveals.

Those from less affluent backgrounds report less healthy diets, lower levels of physical activity, and more time spent on screens.

And even in countries and regions in which inequalities have reduced over time, improvements tend to be slower among the most disadvantaged groups, say the report authors.

Despite some small improvements in physical activity in some countries and regions, these appear to be "overshadowed by rapid increases in sedentary behavior, which has the potential not only to displace time available for physically active pursuits but is also independently associated with a range of negative health outcomes," the report authors' note.

While TV viewing is decreasing across Europe, one of the biggest contributors to increased screen time has been a "massive rise in computer and device use over time," Dr Inchley told Medscape Medical News, noting that girls are now catching up with boys in terms of screen time, since "social media has taken off."

The current guideline of less than 2 hours per day of recreational screen time "is met only by a minority of European adolescents," she and her coauthors observe.

Some Improvements in Nutrition, but Much More Action Needed

While there have been improvements in fruit and vegetable intake in some regions, this must be seen in the context of "very low overall intake, which falls way below current recommendations," the authors note.

And some reduction in sugary drinks consumption has been documented, which is also "encouraging," but again, further action is required "in light of the wide range of sugar-sweetened drinks now available and widely marketed to children and adolescents."

"Legislation is needed around issues such as the 'sugar' tax," while improvements in the social environments that children are growing up in will be key, says Dr Inchley.

"Children need access to cheap and healthy foods and accessible places to be active in," she emphasized, noting that physical-activity guidelines of 60 minutes per day are not being met, "and the daily habitual physical activity that used to be part of everyday life," such as walking to school, is in danger of disappearing among adolescents.

But she stressed, it's important "that we don't point the finger of blame at adolescents."

Dr Nathalie Farpour-Lambert said that two countries in Europe have introduced sugar taxes on drinks, France and Denmark, and five more are planning to.

"But this is not the only method. We need incentives to increase water consumption — including reducing the price of water, and if possible providing free access to water at schools and work places."

"We also need reformulation of processed foods and improved labeling on foods, to help consumers make healthy choices."

The authors report no relevant financial relationships.

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