Periodic Reporting for period 1 - OBCT (Obesity: Biological, socioCultural, and environmental risk Trajectories)
Reporting period: 2023-11-01 to 2025-04-30
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.
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.
The work is structured in Knowledge, Maps, and Tools. In terms of Knowledge, we set out to harness the extensive amount of research that has already been carried out but is scattered and requires structured reviewing. Hence, most of the work in the first 18 months was to identify the different causes of obesity through literature reviews. In particular, we have started five systematic reviews 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 ongoing systematic reviews 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. This was deemed essential for structuring the knowledge base, deepening our understanding, but also crucial for the development of the risk screener that we develop, a tool that will help health professionals calculate the risks of obesity in the general population. We also completed two systematic reviews in WP4 on successful obesity policies in low SEP communities. The first review focused on the types of policies, which showed that structural policies such as food composition policies and integration of physical activity into healthcare system tasks, combining with public education would probably be the most suitable for low SEP communities. The second review showed effective implementation strategies in low SEP communities, including local stakeholder engagement, planning tools, leadership training, incentive structures, monitoring systems, cultural adaptations, use of volunteers, and digital engagement of target groups. These identified policies as well as the knowledge from the various reviews will be used as input in the microsimulation models to assess potential impact on obesity in the European context.
In terms of Maps, we have successfully extracted and obtained geographic information systems (GIS) data on crucial components of the obesogenic environment (such as food environment, walkability and sports facilities) from different sources, and mapped these for neighbourhoods at high resolution across the entire European region. We are currently assessing their quality, validity and reliability by comparing them against local ‘silver standard’ benchmarks. We are also examining their association with health behaviours (dietary behaviours, walking and physical activity) in large population studies across Europe as a means of validation for these measures. With regards to our fourth objective, two OBCT-associated Lancet studies have shown that the prevalence of obesity in Europe has shown some recent plateau, however, these trends are not uniform across all European countries. With in-depth analyses at European scale we are currently zooming in to these country-specific trends.
In terms of Tools, we have recently created a tool to measure community’s readiness to take (policy) action against obesity. This measurement tool is part of the overall evaluation protocol for the pilot of the policy implementation tools which is currently being finalized and feed into the set of co-created implementation tools.
Internally, we organised three in-person consortium meetings (general assemblies): the kick-off in Amsterdam in November ‘23, the general assembly in Madrid in November ‘24; and currently preparing for Oslo GA in September ‘25. We have also organised two internal workshops, one on microsimulation (March ‘24) and the other on co-creation (September ‘24) to introduce these research tools to all researchers within the consortium.
In terms of Maps, we have successfully extracted and obtained geographic information systems (GIS) data on crucial components of the obesogenic environment (such as food environment, walkability and sports facilities) from different sources, and mapped these for neighbourhoods at high resolution across the entire European region. We are currently assessing their quality, validity and reliability by comparing them against local ‘silver standard’ benchmarks. We are also examining their association with health behaviours (dietary behaviours, walking and physical activity) in large population studies across Europe as a means of validation for these measures. With regards to our fourth objective, two OBCT-associated Lancet studies have shown that the prevalence of obesity in Europe has shown some recent plateau, however, these trends are not uniform across all European countries. With in-depth analyses at European scale we are currently zooming in to these country-specific trends.
In terms of Tools, we have recently created a tool to measure community’s readiness to take (policy) action against obesity. This measurement tool is part of the overall evaluation protocol for the pilot of the policy implementation tools which is currently being finalized and feed into the set of co-created implementation tools.
Internally, we organised three in-person consortium meetings (general assemblies): the kick-off in Amsterdam in November ‘23, the general assembly in Madrid in November ‘24; and currently preparing for Oslo GA in September ‘25. We have also organised two internal workshops, one on microsimulation (March ‘24) and the other on co-creation (September ‘24) to introduce these research tools to all researchers within the consortium.
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.
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.