Upstream Determinants of Overweight and Obesity in Europe

Vandevijvere, Stefanie; De Pauw, Robby; Djojosoeparto, Sanne; Gorasso, Vanessa; Guariguata, Leonor; Løvhaug, Anne Lene; Mialon, Melissa; Van Dam, Iris; von Philipsborn, Peter

doi:10.1007/s13679-023-00524-1

Cited by 8 publications

(3 citation statements)

References 107 publications

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“…Vandevijvere et al have illustrated that individuals from lower socioeconomic backgrounds are disproportionately exposed to unhealthy food environments and marketing (35). According to the Healthy Food Environment Policy Index (Food-EPI), national governments possess the greatest potential to enhance food and school environments (36).…”

Section: Discussionmentioning

confidence: 99%

Rising socioeconomic disparities in childhood overweight and obesity in Belgium

Drieskens,

Charafeddine,

Vandevijvere

et al. 2024

Preprint

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Background Childhood overweight, especially obesity, significantly impacts children’s health and poses an increased risk of adult-onset diseases. This study aims to analyse the evolution of childhood overweight and obesity in Belgium from 1997 to 2018 and assess its variation across parental socioeconomic status (SES). Methods The Health Interview Survey, a cross-sectional survey representative of the Belgian population, has been conducted since 1997, with the latest survey conducted in 2018. This study focuses on children aged 2-17 years. Body Mass Index (BMI, kg/m²) was derived from self-reported data, supplemented with proxy reports for children under 15 years old. Overweight and obesity were classified using age/sex-specific cut-off points. Highest parental educational level served as the indicator of SES. In addition to reporting the overall prevalence and the 95% confidence interval (95%CI) of childhood overweight and obesity by year, this study examines the absolute difference in prevalence between SES groups (low minus high) and calculates the Odds Ratio (OR, adjusted for age and sex) to evaluate the relative difference. Results The overall prevalence of childhood overweight rose from 13.6% (95%CI =11.2%-16.1%) in 1997 to 18.9% (95%CI=16.3%-21.5%) in 2018; while it remained stable for obesity, fluctuating between 5.4% and 6.3% over the same period. This increase was more pronounced among children with low SES compared to those with high SES. Consequently, the absolute difference between children with low and high SES increased over time from 8.0 percentage points (pp) in 1997 to 14.9 pp in 2018 for overweight, and from 3.1 pp to 6.8 pp for obesity. In terms of relative inequalities, overall, children with low SES exhibited significantly higher odds of overweight and of obesity than those with high SES (OR varying between 2 à 3 for overweight and between 2 and 4 for obesity). Conclusions The escalating disparities over time highlight SES as a significant risk factor for childhood overweight and obesity. Addressing these inequalities requires interventions such as providing healthy meals and increasing sports opportunities at school. Additionally, it is recommended to regulate fast food outlets near schools and limit unhealthy food marketing, particularly because children with low SES are more exposed to such influences.

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Section: Discussionmentioning

confidence: 99%

Rising socioeconomic disparities in childhood overweight and obesity in Belgium

Drieskens,

Charafeddine,

Vandevijvere

et al. 2024

Preprint

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“…Reductionist approaches that focus on nutrient reformulation alone or completely isolate food properties (e.g. texture, taste and energy density) from ultra-processing fail to acknowledge the environmental drivers of obesity and influence of TNCs [ 11 ].…”

Section: Time To Act On Upf?mentioning

confidence: 99%

“…Indeed, one major recent environmental change has been to the food environment, with increased availability and consumption of ultra-processed food (UPF). This has shifted the types of food and drink available and consumed [ 11 , 12 •], with potentially important impacts on obesity.…”

Section: Introductionmentioning

confidence: 99%

Ultra-processed Food and Obesity: What Is the Evidence?

Dicken,

Batterham

2024

Curr Nutr Rep

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Purpose of Review Obesity is a growing global healthcare concern. A proposed driver is the recent increase in ultra-processed food (UPF) intake. However, disagreement surrounds the concept of UPF, the strength of evidence, and suggested mechanisms. Therefore, this review aimed to critically appraise the evidence on UPF and obesity. Recent Findings Observational studies demonstrate positive associations between UPF intake, weight gain, and overweight/obesity, more clearly in adults than children/adolescents. This is supported by high-quality clinical data. Several mechanisms are proposed, but current understanding is inconclusive. Summary Greater UPF consumption has been a key driver of obesity. There is a need to change the obesogenic environment to support individuals to reduce their UPF intake. The UPF concept is a novel approach that is not explained with existing nutrient- and food-based frameworks. Critical analysis of methodologies provides confidence, but future observational and experimental research outputs with greater methodological rigor will strengthen findings, which are outlined.

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