WHO European Childhood Obesity Surveillance Initiative: Impact of Type of Clothing Worn during Anthropometric Measurements and Timing of the Survey on Weight and Body Mass Index Outcome Measures in 6–9-Year-Old Children
Table 4
Unadjusted and clothes-adjusted prevalence of overweight (including obesity) and prevalence of obesity in children aged 6–9 years and relative difference between the unadjusted and clothes-adjusted values, by COSI round and country.
Round and country
Prevalence of overweight (%)
Relative difference between unadjusted and clothes-adjusted prevalence of overweight (%)
Prevalence of obesity (%)
Relative difference between unadjusted and clothes-adjusted prevalence of obesity (%)
Unadjusted
Clothes-adjusted country-specific
Clothes-adjusted non-country-specific
Country-specific
Non-country-specific
Unadjusted
Clothes-adjusted country-specific
Clothes-adjusted non-country-specific
Country-specific
Non-country-specific
Round 1
Belgium
22.8
NA
21.9
NA
−3.9
7.4
NA
7.2
NA
−2.7
Bulgaria
29.4
28.3
28.8
−3.7
−2.0
13.1
12.6
12.7
−3.8
−3.1
Czech Republic
21.0
NA
21.0
NA
0
7.9
NA
7.9
NA
0
Ireland
31.4
NA
29.5
NA
−6.1
9.8
NA
9.3
NA
−5.1
Italy
48.4
45.2
45.4
−6.6
−6.2
23.1
21.8
21.8
−5.6
−5.6
Latvia
24.3
21.6
22.4
−11.1
−7.8
7.4
6.7
7.0
−9.5
−5.4
Lithuania
25.8
23.0
24.1
−10.9
−6.6
9.3
8.4
8.6
−9.7
−7.5
Malta
35.1
32.4
32.7
−7.7
−6.8
14.5
13.9
13.9
−4.1
−4.1
Norway
25.2
23.0
22.3
−8.7
−11.5
7.2
6.7
6.5
−6.9
−9.7
Portugal
38.1
38.1
38.0
0
−0.3
14.8
14.8
14.7
0
−0.7
Slovenia
31.3
NA
30.3
NA
−3.2
12.7
NA
12.4
NA
−2.4
Sweden
24.2
24.1
23.3
−0.4
−3.7
7.4
7.3
7.2
−1.4
−2.7
Round 2
Belgium
22.4
NA
21.5
NA
−4.0
7.5
NA
7.3
NA
−2.7
Czech Republic
24.2
NA
24.2
NA
0
9.1
NA
9.1
NA
0
Greece
51.2
NA
50.4
NA
−1.6
24.4
NA
23.6
NA
−3.3
Hungary
28.0
NA
27.0
NA
−3.6
12.6
NA
12.3
NA
−2.4
Ireland
31.3
NA
29.5
NA
−5.8
8.7
NA
8.2
NA
−5.7
Italy
45.0
42.0
42.2
−6.7
−6.2
20.5
18.9
19.0
−7.8
−7.3
Latvia
24.8
23.4
23.8
−5.6
−4.0
9.7
9.2
9.3
−5.2
−4.1
Lithuania
24.8
23.5
24.0
−5.2
−3.2
9.1
8.5
8.8
−6.6
−3.3
Norway
29.5
27.7
27.0
−6.1
−8.5
9.4
9.0
8.7
−4.3
−7.4
Portugal
35.1
34.1
34.5
−2.8
−1.7
13.8
13.5
13.6
−2.2
−1.4
Slovenia
31.5
29.5
30.5
−6.3
−3.2
13.3
12.5
12.9
−6.0
−3.0
Spain
43.7
NA
41.9
NA
−4.1
17.8
NA
17.1
NA
−3.9
The former Yugoslav Republic of Macedonia
35.0
31.2
33.6
−10.9
−4.0
16.9
15.7
16.3
−7.1
−3.6
BMI/: body mass index-for-age; COSI: Childhood Obesity Surveillance Initiative; NA: not applicable because the country did not use its own clothes adjustment weights; WHO: World Health Organization. Only children whose age fell within the country-specific targeted age group(s) were included (see Table 1). Prevalence estimates were based on the 2007 WHO recommended growth reference for school-age children and adolescents [13]. Overweight and obesity were defined as the proportion of children with a BMI/ value above +1 -score and above +2 -scores, respectively. Body weight was adjusted for the clothes worn when measured using country-specific adjustment weights for all four predefined types of clothing and the clothing answer option “other.” Body weight was adjusted for the clothes worn when measured using the average non-country-specific adjustment weights for the four predefined types of clothing “underwear only,” “gym clothes,” “light clothing,” and “heavy clothing” and country-specific adjustment weights for the clothing answer option “other.”
