The results: There were large variations in adolescent obesity, from 2.5 % in Lithuanian girls to 31.7 % in boys from Malta. The prevalence of obesity was higher among children from less affluent families in 21 of 24 western and five of 10 central European countries.
‘Obesity in adolescents is of major concern in many of these 35 countries. We will have huge problems in the future with diabetes and heart diseases as the most important consequences of a long life of overweight – and immobility due to physical limitations will be another expensive and damaging effect,’ she observed. Is there a risk-pattern for adolescent obesity? ‘We see generally a “high-income-countrypattern”. In these countries, the
highest risk for adolescent obesity is greatest in families with low affluence, especially for girls. On the other hand, there are very different patterns of inequality in middle-income countries. In some of these the obesity-pattern in
adolescents looks like that in highincome- countries, while in others it is opposite. For example, children from more affluent families are at higher risk of overweight in Croatia, Estonia and Latvia. In low-income-countries, there still exists the image of fat people being wealthy. This may also explain some of the patterns seen in some
middle-income countries. ‘In our study we discuss if the obesity-risk patterns may represent the phases of an economic development of a country. With a more westernised lifestyle, the prevalence of overweight increases and we found the highest prevalence of overweight in the USA and English-speaking countries.’
‘Girls from less affluent families living in Poland, Lithuania, Macedonia and Finland, for example, are more overweight, whereas the obesityrisk for boys is lower. Generally, boys from the Mediterranean area have a higher prevalence of overweight compared with boys from most other countries. Compared with boys, girls seem to be at lower risk for obesity. However, the data of our study used self-reported weight and height measures. We know people overestimate their height and underestimate their weight.’ The influence of local and individual habits: ‘Studies from the US have indicated that high prices on healthy food items may be a major source of obesity among low-income populations including children.
Another important factor is sleep. Research has indicated that young people sleep much less nowadays
and lack of sleep is associated with overweight. Eating patterns vary. In many countries, it is habit to eat at all times of day or to skip breakfast – both unhealthy habits. Fast-food also is a big concern, because it is favoured in this
age group, especially in Englishspeaking countries; parallel to that, fruit and vegetable intake has declined. Another point may be the varying attractiveness of physical activity and dieting in different countries.
‘Politicians should worry and take action now. They should help parents to support their children in healthier choices and create environments that make the right choice, the healthy one, create environments for play, sports, active transport and, for example, subsidise free fruit and vegetables in schools. Politicians should make restrictions for unhealthy items, like fast food, sweetened bread and sugared drinks. Action is needed at all levels – in families, schools, leisure time facilities for youngsters, in local communities and in national governments. Overweight in children is not an individual problem, but a major public health issue.’