Abstract
Childhood obesity is growing as one of the most important public health issues that affects individual and population health but also puts heavy burden on the health systems. It is frequently associated with immediate adverse consequences, such as psychological problems, and a higher risk of many harmful comorbidities later in life, such as type 2 diabetes, dyslipidemia, non-alcoholic fatty liver disease, hypertension, and coronary heart disease. Comparability of anthropometric data is crucial to track the changes over time. The aim of this paper was to present prevalence of thinness, overweight, and obesity in 7-year-old schoolchildren in North Macedonia in 2010 and 2019, and the changes in their nutritional status during thatperiod. Material and methods: Anthropometric measurements of body height and body weight were performed to the nationally representative sample of 7-year-oldchildren in school years 2010/2011 and 2018/2019. Measurements followed the Childhood Obesity Surveillance Initiative (COSI) protocol and data collecting procedures. In total, 2737 children (1317 girls and 1420 boys) in 2010 and 2059 children (1045 girls and 1014 boys) in 2019 were measured. WHO Growth references were used to determine the growth and nutritional status of children. Results: The average height of children in the observed period has increased by 1.7 cm, weight for 1.2 kg and the BMI for 0.3 kg/m2. As for the weight classification, thinness prevalence is significantly increased for 0.3%. Overweight (including obesity) significantly increased (p=0.0377) from 34.4% (95% CI 32.6%-36.2%) in 2010 to 37.3% (95% CI 35.2%-39.5%) in 2019. Obesity significantly increased (p=0.040) from 16.3% (95% CI 14.9%-17.7%) in 2010 to 18.4% (95% CI 16.7%-20.1%) in 2019. The main driver of that increase was the highly significant (p=0.0004) increase of almost 7% of overweight (including obesity) in girls. Conclusion: There is unfavorable rising trend which indicates deterioration of the situation with childhood obesity in the country. Focused and more comprehensive public health nutrition actions are needed to plateau or reverse the trends. The childhood obesity national monitoring system is well established and should continue to beone of the key public health monitoring systems that provide evidence for actions.
Highlights
Changes in the anthropometric characteristics of children over time are affected by variety of factors including hereditary, nutritional, environmental, and societal factors
Using the probability proportional to size sampling for each stratum and considering the distribution of urban and rural schools, we performed the circular systematic sampling for primary sampling units (PSU) which resulted in 112 sampled schools in North Macedonia
Anthropometric variables of 7-yearold children in North Macedonia have significantly changed over the 2010-2019 period
Summary
Changes in the anthropometric characteristics of children over time are affected by variety of factors including hereditary, nutritional, environmental, and societal factors. There is an increasing evidence that in Europe, overweight and obesity has become more of a concern comparing to hunger and undernutrition.[1] Childhood obesity is growing as one of the most important public health issues that affects individual andpopulation health and puts heavy burden on the health systems.[2,3] It is frequently associated with immediate adverse consequences, such as psychological problems and lower educational attainment, and a higher risk of many harmful comorbidities later in life, such as type 2 diabetes, dyslipidemia, non-alcoholic fatty liver disease, hypertension, and coronary heart disease.[4,5,6,7] Data from the 2416 population-based measurement studies, for the period 1975 – 2016, showed that there was a rising trend in children’s and adolescents’ BMI. Rising BMI trends follow the rising height trajectories among children and adolescents in countries with developed or developing economies.[9]
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