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A Snapshot of European Children’s Eating Habits: Results from the Fourth Round of the WHO European Childhood Obesity Surveillance Initiative (COSI)

WHO European Office for the Prevention and Control of Noncommunicable Diseases, 125009 Moscow, Russian Federation
Italian National Institute of Health (Istituto Superiore Di Sanità), 00161 Rome, Italy
National Institute of Health Dr. Ricardo Jorge, 1600 560 Lisbon, Portugal
Danish Health Authority, 2300 Copenhagen S, Denmark
National Institute of Public Health, University of Southern Denmark, 1455 Copenhagen K, Denmark
Department of Nutrition Research, National Institute for Health Development, 11619 Tallinn, Estonia
Institute of Endocrinology, Obesity Unit, 116 94 Prague, Czechia
Croatian Institute of Public Health, University of Zagreb, School of Medicine, 10000 Zagreb, Croatia
Spanish Agency for Food Safety and Nutrition, 28014 Madrid, Spain
Department of Public Health and Management, University of Medicine and Pharmacy Carol Davila, 030167 Bucharest, Romania
Department of Cardiology, Institute of Mother and Child, 01-211 Warsaw, Poland
Primary Health Care, Ministry for Health, 1940 Floriana, Malta
National Center of Public health, Ministry of Health of the Republic of Kazakhstan, 010000 Nur-Sultan City, Kazakhstan
Centre for Disease Prevention and Control, LV-1005 Latvia, Riga
National Center of Public Health and Analyses, 1431 Sofia, Bulgaria
Turkish Ministry of Health, Public Health General Directorate, 34400 Istanbul, Turkey
Health Authority, Department of Health and Social Security, 47893 San Marino, San Marino
National Nutrition Surveillance Centre, University College Dublin, Dublin, Ireland
Republican Center for Health Promotion and Mass Communication, 720040 Bishkek, Kyrgyzstan
Institute of Paediatric Endocrinology, National Medical Research Centre for Endocrinology of the Ministry of Health of the Russian Federation, 117036 Moscow, Russian Federation
National Center for Disease Control and Public Health of Georgia, 0198 Tbilisi, Georgia
Institute of Public Health, 1007 Tirana, Albania
Internal Diseases Department of the Scientific Clinical Centre of Mother and Child Health, 744036 Ashgabat, Turkmenistan
Department of Preventive Medicine, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
Department for Organization of Health Services to Children, Mothers, Adolescents and Family Planning, Ministry of Health and Social Protection of Population, 734025 Dushanbe, Tajikistan
Institute of Public Health of Montenegro, 81 000 Podgorica, Montenegro
Applied Bioenergetics Lab, University of Novi Sad, 21000 Novi Sad, Serbia
Department of Pediatrics, Paracelsus Medical University, 5020 Salzburg, Austria
Arabkir Medical Centre-Institute of Child and Adolescent Health, 0014 Yerevan, Armenia
Institute of Public Health, Faculty of Medicine, Ss. Cyril and Methodius University, 1000 Skopje, North Macedonia
Faculty of Sport, University of Ljubljana, 1000 Ljubljana, Slovenia
Department of Social and Policy Sciences, University of Bath, Bath BA2 7AY, UK
WHO Country Office for Tajikistan, 734019 Dushanbe, Tajikistan
WHO Child and Adolescent Health and Development, WHO Regional Office for Europe, 2100 Copenhagen, Denmark
Author to whom correspondence should be addressed.
Nutrients 2020, 12(8), 2481;
Received: 3 July 2020 / Revised: 23 July 2020 / Accepted: 4 August 2020 / Published: 17 August 2020
(This article belongs to the Special Issue Child Obesity and Nutrition Promotion Intervention)
Consuming a healthy diet in childhood helps to protect against malnutrition and noncommunicable diseases (NCDs). This cross-sectional study described the diets of 132,489 children aged six to nine years from 23 countries participating in round four (2015–2017) of the WHO European Childhood Obesity Surveillance Initiative (COSI). Children’s parents or caregivers were asked to complete a questionnaire that contained indicators of energy-balance-related behaviors (including diet). For each country, we calculated the percentage of children who consumed breakfast, fruit, vegetables, sweet snacks or soft drinks “every day”, “most days (four to six days per week)”, “some days (one to three days per week)”, or “never or less than once a week”. We reported these results stratified by country, sex, and region. On a daily basis, most children (78.5%) consumed breakfast, fewer than half (42.5%) consumed fruit, fewer than a quarter (22.6%) consumed fresh vegetables, and around one in ten consumed sweet snacks or soft drinks (10.3% and 9.4%, respectively); however, there were large between-country differences. This paper highlights an urgent need to create healthier food and drink environments, reinforce health systems to promote healthy diets, and continue to support child nutrition and obesity surveillance. View Full-Text
Keywords: nutrition; child; obesity; surveillance; health; noncommunicable diseases; children; fruit; vegetables; soft drinks nutrition; child; obesity; surveillance; health; noncommunicable diseases; children; fruit; vegetables; soft drinks
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MDPI and ACS Style

Williams, J.; Buoncristiano, M.; Nardone, P.; Rito, A.I.; Spinelli, A.; Hejgaard, T.; Kierkegaard, L.; Nurk, E.; Kunešová, M.; Musić Milanović, S.; García-Solano, M.; Gutiérrez-González, E.; Brinduse, L.A.; Cucu, A.; Fijałkowska, A.; Farrugia Sant’Angelo, V.; Abdrakhmanova, S.; Pudule, I.; Duleva, V.; Yardim, N.; Gualtieri, A.; Heinen, M.; Bel-Serrat, S.; Usupova, Z.; Peterkova, V.; Shengelia, L.; Hyska, J.; Tanrygulyyeva, M.; Petrauskiene, A.; Rakhmatullaeva, S.; Kujundzic, E.; Ostojic, S.M.; Weghuber, D.; Melkumova, M.; Spiroski, I.; Starc, G.; Rutter, H.; Rathmes, G.; Bunge, A.C.; Rakovac, I.; Boymatova, K.; Weber, M.; Breda, J. A Snapshot of European Children’s Eating Habits: Results from the Fourth Round of the WHO European Childhood Obesity Surveillance Initiative (COSI). Nutrients 2020, 12, 2481.

AMA Style

Williams J, Buoncristiano M, Nardone P, Rito AI, Spinelli A, Hejgaard T, Kierkegaard L, Nurk E, Kunešová M, Musić Milanović S, García-Solano M, Gutiérrez-González E, Brinduse LA, Cucu A, Fijałkowska A, Farrugia Sant’Angelo V, Abdrakhmanova S, Pudule I, Duleva V, Yardim N, Gualtieri A, Heinen M, Bel-Serrat S, Usupova Z, Peterkova V, Shengelia L, Hyska J, Tanrygulyyeva M, Petrauskiene A, Rakhmatullaeva S, Kujundzic E, Ostojic SM, Weghuber D, Melkumova M, Spiroski I, Starc G, Rutter H, Rathmes G, Bunge AC, Rakovac I, Boymatova K, Weber M, Breda J. A Snapshot of European Children’s Eating Habits: Results from the Fourth Round of the WHO European Childhood Obesity Surveillance Initiative (COSI). Nutrients. 2020; 12(8):2481.

Chicago/Turabian Style

Williams, Julianne, Marta Buoncristiano, Paola Nardone, Ana Isabel Rito, Angela Spinelli, Tatjana Hejgaard, Lene Kierkegaard, Eha Nurk, Marie Kunešová, Sanja Musić Milanović, Marta García-Solano, Enrique Gutiérrez-González, Lacramioara Aurelia Brinduse, Alexandra Cucu, Anna Fijałkowska, Victoria Farrugia Sant’Angelo, Shynar Abdrakhmanova, Iveta Pudule, Vesselka Duleva, Nazan Yardim, Andrea Gualtieri, Mirjam Heinen, Silvia Bel-Serrat, Zhamyla Usupova, Valentina Peterkova, Lela Shengelia, Jolanda Hyska, Maya Tanrygulyyeva, Ausra Petrauskiene, Sanavbar Rakhmatullaeva, Enisa Kujundzic, Sergej M. Ostojic, Daniel Weghuber, Marina Melkumova, Igor Spiroski, Gregor Starc, Harry Rutter, Giulia Rathmes, Anne Charlotte Bunge, Ivo Rakovac, Khadichamo Boymatova, Martin Weber, and João Breda. 2020. "A Snapshot of European Children’s Eating Habits: Results from the Fourth Round of the WHO European Childhood Obesity Surveillance Initiative (COSI)" Nutrients 12, no. 8: 2481.

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