ALADINO obesity prevalence study

For many years obesity has been seen as one of the worst epidemics of our society.Obesity and overweight are associated with serious health problems such as cardiovascular and cerebrovascular disease,diabetes,arterial hypertension,atherosclerosis,dyslipidemia,locomotive disorders and even some types of cancer.If such a situation in adults is worrying,then it is even more so in children and teenagers.Nowadays,childhood obesity poses a serious public health problem and,according to information that we have to hand,it is on the increase all over the world.In Europe and in Spain,it is alarmingly prevalent.

In Spain there is a lack of information on a national scale regarding the prevalence of obesity in adults and children and young people.Up until now the data available on the prevalence of obesity in adults and children and young people have come from National Health Surveys where data have been self-referred,which means that overweight is underestimated.Data on obesity prevalence in Spanish children and young people also have come from a relevant epidemiological study called the enKid study,which between 1998 and 2000 measured weight and height using standardised procedures.As a result,such data are now considered outdated given the notable demographic changes that have occurred in Spain in recent years.

Therefore,AESAN has developed an obesity prevalence study named ALADINO (standing for Nutrition,Physical Activity,Childhood Development and Obesity) which was performed during the academic year 2010/2011 on 7,659 children between 6 and 9.9 years of age belonging to all Autonomous Communities in Spain (including Ceuta and Melilla).Its aim was to estimate childhood obesity prevalence in Spain and attempt to characterise its most significant determinants while acting as a starting point for the subsequent evaluation of this epidemic’s tendency.

Field work was conducted in schools by specially trained personnel.They took anthropometric measurements of the children and collected information on their dietary habits and physical activity along with the same information from their families.Social,cultural and economic data were also collected,which provide a greater insight into childhood obesity and its determinants.To this end,the forms designed by WHO were given to schools,families and examiners.

Measuring obesity and overweight using Body Mass Index,which is calculated by taking a person’s weight and height,is the most common and widely accepted method.In adults some values that delimit overweight and obesity are fixed.However,in children this is not the case as they continuously grow.Therefore,values must be set for each period of the child’s life and this goes for both boys and girls.

In order to set these fixed values,the WHO has coordinated an initiative to monitor childhood obesity in Europe (WHO European Childhood Obesity Surveillance Initiative - COSI).The same methodology (design,time of execution,age groups,data capture,etc.)should be used for those 17 countries involved so as to ensure that information from different countries remain comparable.

The WHO has created some tables containing child growth standards for both boys and girls that suggest how they should develop in optimum conditions.Using these tables it is possible to calculate the percentage of children whose body mass index is above those set standards and obesity and overweight prevalence can therefore be estimated.Despite the fact that the WHO’s growth standards can provide obesity figures that are higher than other reference values,given the global nature of the obesity epidemic,it is advisable to have common measuring tools since many of the measures adopted are also common.This favours synergy between governments,regions and states in the fight against obesity.

Preliminary results

Taking WHO standards as a reference,according to the ALADINO study in children between 6 and 9.9 years of age,overweight prevalence amongst boys in Spain stood at 26.7%,whereas prevalence among girls was 25.7%.Obesity prevalence was 20.9% in boys and 15.5% in girls.

In order to evaluate obesity and overweight tendency,the results obtained from the ALADINO study were compared with those from the enKid study.Consequently,since there were no significant differences between the two studies,it was found that overweight growth seems to have stabilised.With respect to obesity,an increase was only found in girls whereas tendency in boys seems to have stabilised.

The study includes a large amount of additional information that should be utilised in greater detail.But,the preliminary results show that negative socioeconomic factors,such as low educational attainment of parents and poor economic conditions,imply a greater risk of obesity and overweight in both boys and girls.This information reinforces the need to provide educational programmes aimed at children belonging to these social groups,given that this is where information and education is most greatly required.On the other hand,such information means that we must push for measures that change the circumstances influencing a person’s food choices,making access to healthy foods easier and access to unhealthy foods harder.