2007 following a pilot phase in May 2007.
It aims to record the prevalence of several clinical conditions related to obesity as well as to identify those lifestyle and behavioural patterns that interact for their manifestation. The under study population comprised primary schoolchildren (10-12 years old).
The sampling of schools was random, multistage and stratified by parental educational level and the total population of students attending schools in six counties from the central, northern, southern and western parts of Greece, namely Attica, Aitoloakarnania, Iraklio, Lasithi and Thessalonica. More specifically, all municipalities in these counties were divided into 3 groups based on the average educational level of their adult population (25 to 65 years old) (Census 2001). This procedure yielded two parental education cut-off points that were used to categorize municipalities into 3 categories with different socio- economic level (SEL) i.e. Higher, Medium and Lower SEL.
Consequently, based on data provided by National Statistical Service of Greece, a certain number of municipalities that was proportional to the size of their childhood population (10-13 years old) was randomly selected from each one of these three SEL groups. Finally, an appropriate number of schools was randomly selected from each one of these municipalities in relation to the population of schoolchildren registered in the 5th and 6th class in each municipality (data obtained from the Greek Ministry of National Education).
An extended letter explaining the aims of the study and a consent form was provided to each parent or guardian having a child in these schools. Those parents that assented participation of their child in the study had to sign the consent form and return it to the research team members. Until June 2008 signed parental consent forms were collected for 754 children and complete data became available for 729 children. The study will be completed by June 2009, envisioning to assess a cohort of minimum 2500 children.
Aim: The primary aim of the current study was to record the prevalence of
several clinical conditions (i.e. insulin resistance, hyperlipidemias, hypertension, obesity, metabolic syndrome, iron and other micronutrient deficiencies etc) as well as to identify those lifestyle and behavioural patterns that interact for their manifestation. Increasing our knowledge and understanding on the effect and interaction of such patterns will pave the way for the implementation of appropriate public health initiatives to tackle these adverse health issues early in life.
Support: Approval to conduct the study was granted by the Greek Ministry of
National Education and the Ethical Committee of Harokopio University of Athens.
Targeted Communities: The under study population comprised schoolchildren
aged 10-12 years attending primary schools located in municipalities within six counties in Greece.
Evaluation: Several presentations (both oral and poster) derived from the
preliminary data of the PROGRESS study have been presented in several congresses so far (1-4), while an original research paper is under consideration for publication in a special issue of the journal “Public Health Nutrition” (5). These reports indicated a considerably high prevalence of overweight and obesity, hyperlipidemias, insulin resistance, hypertension, metabolic syndrome and iron deficiency in children, specific dietary and physical activity patterns, perinatal indices, socio-economic, cultural and demographic characteristics were some of the parameters that were found to exert a significant effect.
64 References:
1. Moschonis G, Grammatikaki E, Argyropoulou D, et al. (2008). Obesity, Insulin Resistance, metabolic syndrome and iron status in prepubertal children. The PROGRESS study. International Journal of Obesity (London), Suppl 1:S36-234 (S195)
2. Siatitsa PE, Moschonis G, Koumpitski A, et al. Pre- and postnatal predictors of childhood obesity. The PROGRESS study. Presented in the 3rd Balkan Congress on Obesity, Thessaloniki-Greece, 17-19 October 2008.
3. Moschonis G, Grammatikaki E, Kallanioti K, et al. (2008). Prevalence of obesity and metabolic syndrome in Greek preadolescents. The PROGRESS study. International Journal of Obesity (London), Suppl 1:S36-234 (S150) 4. Moschonis G, Grammatikaki E, Kallanioti K, et al. (2008). Association
between insulin resistance, cardiovascular risk factors diet and physical activity in Greek preadolescents. The PROGRESS study. International
Journal of Obesity (London), Suppl 1:S36-234 (S154)
5. Moschonis G, Tanagra S, Vandorou A, et al. Social, economic and demographic correlates of overweight and obesity in primary schoolchildren in Greece. Preliminary data from the “Prediabetes, Obesity and Growth Epidemiological Study in Schoolchildren” (PROGRESS Study). Public Health Nutrition, 2009. (In press)
Contact Details: For more information, please contact:
Dr. Yannis Manios, Assistant Professor Department of Nutrition & Dietetics Harokopio University (Athens) +30 210 9549 156 / 353 [email protected]
Ireland
(Extra information was provided by the Health Promotion Unit of the Department of
Health and Children – EuroHealthNet member)
National Strategy:
The National health promotion strategy 2000-2005 was set up by the Ministry of Health and Children, one of its issues to tackle being lifestyle behaviour / food and nutrition, and exercise. It also recognizes the existence of social variations in health and lifestyle behaviours between the lower and higher socio-economic groups and the challenge for health promotion to narrow this gap [37].In March 2004 the Minister for Health and Children established the National Taskforce on Obesity as a direct response to the emerging problem of overweight and obesity in Ireland, particularly in children. The aim was to develop a strategy to halt the rise in and reverse the prevalence of obesity. The Taskforce report set out a series of recommendations directed at a number of sectors – High level Government, Education; Social & community; Health; Food, commodities, production & supply; and Physical environment [38].
Ninety-three recommendations were made, related to actions across six broad boarders. One of them – ‘Social and Community’ – includes a recommendation (number 8) concerning disadvantaged communities. It states that:
‘Peer-led community development programmes should be fostered and developed to encourage healthy eating and active living. These programmes should be prioritised for lower socio-economic groups, ethnic minority groups, early school leavers, people with learning and physical disabilities and they should be based on the principle of developing self-esteem and empowerment such as is evident for example in the community mothers programme.’
Also the ‘Physical Environment’ sector refers to lower socio-economic groups in two of its recommendations (number 15 and 20):
65
‘The private leisure industry should be encouraged to make its facilities more accessible to lower socio-economic and minority groups through partnership with local communities, local authorities and health boards.’
‘Community development programmes which encourage healthy eating and active living should be developed in partnership with local authorities and businesses. These programmes should be prioritised for lower socio-economic groups, ethnic minority groups, early school leavers, and people with learning and physical disabilities.’
The Department of Health & Children (DoHC) has recently established an intersectoral group to monitor and evaluate implementation of the strategy, and this group is due to report in April 2009.
In accordance with one of the key recommendations of the Taskforce, the DoHC is currently finalising a National Nutrition Policy. The aim of the NNP is to achieve better nutritional health for the total population, but it will focus particularly on children and young people, to help halt the increase in obesity and to reduce food poverty.