Obesity: Biological, socioCultural, and environmental risk Trajectories

Project Information

OBCT

Grant agreement ID: 101080250

DOI

10.3030/101080250

EC signature date 23 October 2023

Start date 1 November 2023

End date 31 October 2028

Funded under

• Health

Total cost

€ 8 131 297,50

EU contribution

€ 8 131 295,00

Coordinated by

STICHTING AMSTERDAM UMC
Netherlands

Periodic Reporting for period 2 - OBCT (Obesity: Biological, socioCultural, and environmental risk Trajectories)

Reporting period: 2025-05-01 to 2026-04-30

Summary of the context and overall objectives of the project

Obesity is still increasingly prevalent, despite public health efforts in the previous decades. Epidemiological evidence suggests that obesity has a strong socioeconomic gradient where communities with disadvantaged socio-economic position (SEP) have the highest risk factors and prevalence of obesity; which complicates prevention and intervention efforts.

Within the five years of project OBCT (Obesity: Biological, socioCultural, and environmental risk Trajectories), we provide health professionals, policymakers, researchers and the public with knowledge, maps and tools that support sustainable prevention of obesity and the reduction of inequalities therein by socioeconomic position. We quantify biological, sociocultural and built environmental obesity risks and their interactions in and across various life stages and translate these to practical and effective tools to make policies work, for those who need them the most. The overall objectives of OBCT are to:1) Advance the current understanding of obesity risks and predictors, and the role of SEP across the life-course; 2) Determine the importance of specific obesity-related behaviours to prevent obesity at key life stage transitions; 3) Develop a holistic obesity risk screener for use by the public at large and by health professionals; 4) Provide country-specific estimates of trends in obesity; 5) Provide a digital atlas on the obesogenicity of environments; 6) Characterise obesity-related cardiometabolic risk profiles over gender, age and SEP; 7) Develop tailored lifestyle recommendations; 8) Determine the impact of obesity-related policies on inequality; 9) Provide a decision support dashboard for policy makers; 10) Provide co-developed toolboxes to support implementation of policy recommendations in low-SEP communities.

Work performed from the beginning of the project to the end of the period covered by the report and main results achieved so far

The work carried out within OBCT is structured by three main output groups: Knowledge, Maps, and Tools.
In terms of Knowledge, we initiated several reviews to identify the different causes of obesity through systematic literature reviews (SLRs) in RP1, including five SLRs in WP1 to understand the biological, sociocultural and environmental risks of obesity. Within each review, the role of SEP stays central in our research question. Three other SLRs in WP3 aim to understand the behavioural causes of obesity: one for dietary behaviours, one for physical activity and one for sedentary behaviours, with focus on crucial (transitioning) life stages. These eight systematic reviews will form the cornerstone of the integrated causal pathways from genes to environments, behaviours and, ultimately, obesity. Out of these eight reviews, five were completed and three are currently in advanced stages. All this synthesized knowledge would also serve as input for the development of the risk screener, an OBCT tool that will help health professionals calculate the risks of obesity in the general population. Complementary to these SLRs are ongoing original analyses that verify the associations between these domains of risks and obesity across the life stages using European cohort data. Moreover, we also initiated a series of original analyses within Task 1.4 that examine the intersection between genetics, biology and the environment for the development of obesity.
With regards to our fourth objective, another OBCT-associated NCD-risC landmark study examined the 45-year trend in obesity in children, adolescents and adults across Europe; showing encouraging signs in most European countries which experience plateau or even slowdown of obesity in children. In adults, the trend was more heterogenous and differ between countries, and between men and women.
In terms of Maps, we continue to extract and obtain large-scale geographic data on crucial components of the obesogenic environments (food environment, walkability, drivability and sports facilities) at high resolution across the entire European region. We established the validity of food environment data and sports facilities data against local ‘silver standard’ benchmarks and examined their association with health behaviours (dietary behaviours, walking and physical activity) in large population studies across Europe as a means of extra validation for these measures.
In terms of Tools, we have recently co-created an OBCT toolbox for the implementation of national policy recommendations for the prevention of obesity in children. Currently, this toolbox is being improved in terms of design and will be piloted in a few municipalities in Europe.
Internally, we organised a consortium-wide general assembly in Oslo GA in September ‘25 and are currently planning the general assembly in Bilbao in November '26. Externally, we continue to communicate our research output through professional, scientific conferences and social media channels for the general population.

Progress beyond the state of the art and expected potential impact (including the socio-economic impact and the wider societal implications of the project so far)

The reviews help to identify relevant risk factors for obesity, which will be further investigated in large European population health datasets to further contextualise risk for specific population and sub-populations (particularly those with a low SEP). While traditionally these risk factors are studied separately, in OBCT we will examine both domain-specific risk scores and composite risk scores combining all biological, sociocultural and environmental risks to have a full understanding of obesity risks in Europe.

Moreover, we take an evidence-based approach to implementing preventive policies by critically appraising current policies and incorporating co-creation into the process. This helps ensure that efforts in implementation are carefully considered, and supported by the various target stakeholders to ensure more effective implementation and impact.