Epidemiology in Europe: the problem starts in childhood

September 05, 2005

Overweight and overt obesity are increasing in both sexes and at all ages in nearly all European countries, as the WHO-MONICA study and other WHO recent estimates have shown. The problem especially affects women and children of the Mediterranean and of Central and Eastern Europe.

Reasons for this growing problem are the steady increase of total caloric intake over the last decades and the absence of sufficient daily physical exercise. The resulting energy unbalance inevitably leads to obesity. In Southern Europe the departure from traditional Mediterranean diets toward manufactured foods over the years may be contributing to the trend. In particular, the high marketing pressure to consume foods high in total fat, refined sugar and salt makes children especially vulnerable, as a recent report of the European Heart Network, the Federation of Heart Foundations, recently pointed out.

As part of the general trend in the population, cardiac patients are also currently more obese than before, as the ESC Euroaspire and other surveys have showed, carrying a greater difficulty for patients and doctors to control risk factors and symptoms and a greater probability of adverse disease outcomes. Obese persons are also more likely to suffer from heart failure.

Scientific evidence of the health consequences of mass obesity is growing year after year. These are multiple, but most importantly due to their frequency and consequences are raised blood pressure, insulin resistance and increased blood glucose, high non-HDL cholesterol and tryglicerides. The cluster of these abnormalities, with other risk factors, form what is called the metabolic syndrome , which often is a preliminary step for overt type2 diabetes. In women, additionally, obesity has adverse effects in sexual hormones and pregnancy outcomes and carries a greater risk for breast cancer.

Increasing numbers of children in Europe are suffering the classic health problems often associated with adult and older life due to overweight and obesity. The International Obesity Task Force estimates that the numbers of children already affected by frank type 2 diabetes are 210,000.

Preliminary estimates of the numbers at risk for obesity associated disease among EU childrenLast but not least, obesity is not evenly distributed in society and it greatly affects the less socio-economically favoured. As a matter of fact, the gap in obesity between the high and the less educated has grown in recent years.

The consequences resulting from this modern epidemic represent an enormous burden upon European health services, although fortunately not to the magnitude of that in the US. Resources are urgently needed to research and undertake the most effective public health measures to prevent the situation from getting much worse, including resolute action to protect children. This means vigorously pursuing the WHO global and European strategies to achieve real improvements in diet and physical activity and combatting those changes in the social environment that are conducive to poor diets with too much fat and sugar and little opportunity to be active. As IOTF has pointed out: "This is more than just a warning signal - it is the red light: We can no longer afford to delay the introduction of strong prevention strategies throughout Europe."
For further information contact:
Susana Sans
International Obesity Task Force and WHO MONICA Project

More information on the folllowing web pages:
http://www.ktl.fi/ monica

Silventoinen K, Sans S, Tolonen H, Monterde D, Kuulasmaa K, Kesteloot H, Tuomilehto J. Trends in obesity and energy supply: an ecological analysis from the WHO MONICA Project. Int J Obesity 2004

Molarius A et al Molarius A, Seidell J C, Sans S, Tuomilehto J, Kuulasmaa, K. Educational level, relative body weight and changes in their association over 10 years: An international perspective from the WHO MONICA ProjectAm J Public Health 2000; 90: 1260-1268.

DeBacquer D, de Backer G, Cokkinos D, Keil U, Montaye M, Ostör E, Pyorälä K, Sans S. Overweight and obesity in patients with established cardiovascular disease: are we meeting the challenge? Eur Heart J 2003.

Cole T et al. Establishing a standard definition for childhood overweight and obesity worlwide: international survey. BMJ 2005; 320:1240

European Heart Network. The marketing of unhealthy food to children in Europe. 2005

European Society of Cardiology

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