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WHO Childhood Obesity Surveillance Initiative (COSI) in Serbia in 2019: Monitoring obesity in young children

Markovic L., Djordjic V., Trajkovic N., Cvejic D., Bozic, Halasi S, Ostojić SM

The aim of the second national round of the Childhood Obesity Surveillance Initiative (COSI), a program of the World Health Organization (WHO) European Office, was to sustain the childhood obesity surveillance system launched in Serbia in the previous round in 2015. In 2015, 4857 first- and second- grade primary school children (age 7.7 ± 0.6 years) were assessed for height, weight, and BMI. During the 2019 data collection round, 3179 first-to-third grade primary-school children (age 8.5 ± 0.8 years) were assessed for basic anthropometric measures. Additional information on school nutrition and physical activity environment, as well as simple indicators of children’s dietary intake and physical activity, were collected. The sample was stratified by region, district and level of urbanization. The WHO recommended cut-offs for school-age children and adolescents were used to compute and interpret body mass index for-age (BMI/A) Z-scores. The obesity prevalence reaches 17.3% and 11.7% in 6-9-year old boys and girls, respectively. Overweight (including obesity) rate is 5 percentage points higher in primary school boys (37.7%) in comparison to girls (33.2%). In comparison to the first round, the prevalence of obesity in boys increased by 2.6 percentage, while 2.1 percentage points increase in overweight prevalence was registered. During the same period, the prevalence of both overweight and obesity, increased by 5.5 percentage points in girls. The obtained data provide quality information on childhood obesity for policymakers, health professionals, and the general public, which makes the COSI program an efficient strategy in monitoring obesity trends in primary school children.