Abstract
BackgroundThere have been previous representative nutritional status surveys conducted in Hungary, but this is the first one that examines overweight and obesity prevalence according to the level of urbanization and in different geographic regions among 6–8-year-old children. We also assessed whether these variations were different by sex.MethodsThis survey was part of the fourth data collection round of World Health Organization (WHO) Childhood Obesity Surveillance Initiative which took place during the academic year 2016/2017. The representative sample was determined by two-stage cluster sampling. A total of 5332 children (48.4% boys; age 7.54 ± 0.64 years) were measured from all seven geographic regions including urban (at least 500 inhabitants per square kilometer; n = 1598), semi-urban (100 to 500 inhabitants per square kilometer; n = 1932) and rural (less than 100 inhabitants per square kilometer; n = 1802) areas.ResultsUsing the WHO reference, prevalence of overweight and obesity within the whole sample were 14.2, and 12.7%, respectively. According to the International Obesity Task Force (IOTF) reference, rates were 12.6 and 8.6%. Northern Hungary and Southern Transdanubia were the regions with the highest obesity prevalence of 11.0 and 12.0%, while Central Hungary was the one with the lowest obesity rate (6.1%). The prevalence of overweight and obesity tended to be higher in rural areas (13.0 and 9.8%) than in urban areas (11.9 and 7.0%). Concerning differences in sex, girls had higher obesity risk in rural areas (OR = 2.0) but boys did not. Odds ratios were 2.0–3.4 in different regions for obesity compared to Central Hungary, but only among boys.ConclusionsOverweight and obesity are emerging problems in Hungary. Remarkable differences were observed in the prevalence of obesity by geographic regions. These variations can only be partly explained by geographic characteristics.Trial registrationStudy protocol was approved by the Scientific and Research Ethics Committee of the Medical Research Council (61158–2/2016/EKU).
Highlights
There have been previous representative nutritional status surveys conducted in Hungary, but this is the first one that examines overweight and obesity prevalence according to the level of urbanization and in different geographic regions among 6–8-year-old children
The majority of studies found higher overweight and obesity prevalence in rural areas compared to urban areas [5,6,7], others have found the opposite [7, 8]
Given that the social [17], cultural [18] and economic context [19] as well as the built environment [20] seem to have great impact on weight status, and the fact that these factors differ both between rural versus urban areas and by regions, this paper aimed to study the overweight and obesity prevalence both according to urbanization level and in different geographic regions
Summary
There have been previous representative nutritional status surveys conducted in Hungary, but this is the first one that examines overweight and obesity prevalence according to the level of urbanization and in different geographic regions among 6–8-year-old children. Overweight and obesity among children are one of the most important public health issues of our time [1]. Several studies investigated the differences in obesity prevalence between urban and rural areas, but results are controversial. The majority of studies found higher overweight and obesity prevalence in rural areas compared to urban areas [5,6,7], others have found the opposite [7, 8]. The pathways that lead to differences in the prevalence between urban and rural areas are not well understood. Residents in rural areas may lack access to primary prevention efforts [14]
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