Obesity is one of the greatest public health challenges of the 21st century. Its prevalence has tripled in many countries in Europe since the 1980s, and the numbers of those affected continue to rise at an alarming rate. In addition to causing various physical disabilities and psychological problems, excess weight drastically increases a person’s risk of developing a number of noncommunicable diseases (NCDs), including cardiovascular disease, cancer and diabetes.
The challenge of obesity
The worldwide prevalence of obesity nearly doubled between 1980 and 2008. According to country estimates for 2008, over 50% of both men and women in the European Region were overweight, and roughly 23% of women and 20% of men were obese.
Based on the latest estimates in European Union countries, overweight affects 30-70% and obesity affects 10-30% of adults.
Estimates of the number of overweight infants and children in the European Region rose steadily from 1990 to 2008. Over 60% of children who are overweight before puberty will be overweight in early adulthood. Childhood obesity is strongly associated with risk factors for cardiovascular disease, type 2 diabetes, orthopaedic problems, mental disorders, underachievement in school and lower self-esteem.
Physical activity and diet
Participation in 150 minutes of moderate physical activity each week (or equivalent) is estimated to reduce the risk of ischaemic heart disease by approximately 30%, the risk of diabetes by 27%, and the risk of breast and colon cancer by 21–25%. Physical activity also lowers the risk of stroke, hypertension and depression.
Country estimates of 2008 revealed that approximately 35% of all people in Europe are insufficiently physically active. Men were more active than women, particularly in high-income countries, where nearly every second woman was insufﬁciently physically active. The increased automation of work and other aspects of life in higher-income countries is a likely determinant of insufﬁcient physical activity.
The Health Behaviour in School-aged Children (HBSC) 2009/2010 survey of countries in the Europe and North America found that girls across all countries and age groups report being less active than boys, with the gender gap increasing with age. The survey found that in general 15-year-olds (average 15%) were less likely to report meeting the physical activity guidelines than 11-year-olds (average 23%) in the majority of countries. Only 19% of 11-year-old girls report engaging in moderate-to-vigorous physical activity for at least 60 minutes per day. For boys, the figure is 28%.
Family afﬂuence was signiﬁcantly associated with overweight or obesity in around half of the countries surveyed in the HBSC study: those from lower afﬂuence families were more likely to be overweight or obese. This pattern was strongest in western Europe.
A daily breakfast and at least daily fruit consumption are seen as two of the most important healthy eating habits. In the HBSC study, eating breakfast daily was signiﬁcantly associated with higher family afﬂuence in the majority of countries for boys and over half for girls. Similarly, low family afﬂuence was signiﬁcantly associated with lower levels of fruit consumption among boys and girls in the majority of countries surveyed.
World Helath Organization (WHO) recommendations for preventing and managing obesity emphasize the need for early prevention to ensure lifelong healthy eating and physical activity patterns. They also point to the need for coordinated partnerships involving different government sectors, communities, the mass media and the private sector to ensure that diet and everyday levels of physical activity can be changed effectively and sustainably.