Obesity prevention must start early in life The ENERGY project was established to promote healthy energy balance-related behaviours in children across Europe. Efforts in this direction represent an important approach to addressing health problems related to being overweight or obese. Health © Shutterstock Obesity prevention should start early in life given that being overweight or obese in adulthood are phenomena predicted by childhood and adolescent overweight. One important target group for obesity prevention is school-aged children. As such, the school environment is a good setting for health promotion interventions. For obesity prevention, schools have additional relevance as a health promotion setting as most children eat a significant volume of food at school and schools offer physical education facilitities. The 'European energy balance research to prevent excessive weight gain among youth' (ENERGY) project was developed through the cooperation of 15 partners across Europe. A review of the relevant literature revealed a number of pertinent points. In particular, parents' physical activities, doing physical activities with parents and parental logistic support are the most important predictors of physical activity in children. A cross-European large-scale survey was carried out among more than 1 000 children aged 10–12 in seven European countries — Belgium, Greece, Hungary, the Netherlands, Norway, Slovenia and Spain. The surveys included the measurement of children's height and weight, and questions about a range of energy balance-related behaviours, including key dietary behaviours, physical activity and sedentary lifestyle. Results showed high levels of obesity and overweight among Europe's children, with nearly 1 in 20 children obese and a further four in 20 overweight (averaged across all seven countries surveyed). Lowest levels were found in Norway where only 1 child in 70 is obese, and highest levels where 1 child in 10 is obese were found in Greece, where children have the lowest levels of sports activities. Social differences were also found to play an important role. Generally, children of more highly educated parents tend to engage in more favourable energy balance-related behaviours, and also tend to be slimmer, except in Greece and Spain. Further data analysis revealed that obesogenic behaviours are associated with a range of important potential determinants, at the individual, home and school environment levels. In particular, the impact of parents, as role models, facilitators, by setting rules and boundaries, and specific parenting behaviours are of crucial importance. Interventions to effect changes in behaviour need to be sensitive to these differences. Cultural and lifestyle differences, in particular, must be set in the context of family resources, including skills and education as well as financial resources and access to support and health information. ENERGY project members developed an intervention specifically aimed at reducing sedentary behaviours. This was tested in Belgium, Germany, Greece, Hungary and Norway. The intervention was well-liked and appreciated by the stakeholders (children, teachers and school staff). Results of the ENERGY initiative provide important data for stakeholders in the health domain, working towards more effective obesity prevention for a healthy Europe.
