Data analysis of 7-year-old Moscow children according to the WHO research program (COSI): anthropometry and lifestyle indicators

BACKGROUND: Overweight and obesity in children are associated with diseases in adulthood: metabolic syndrome, type 2 diabetes mellitus, coronary artery disease, hypertension, and some types of cancer. In 2006, WHO initiated the European Childhood Obesity Surveillance Initiative COSI, according to which a survey of Moscow first-graders was conducted in 2017. The Initiative’s publications provided general characteristics of the Russian sample along with those of other countries participating in the Initiative, while the collected Russian data allowed for analysis that is more detailed.

AIM: To characterize the population of 7-year-old children in Moscow based on anthropometric parameters and lifestyle indicators.

MATERIALS AND METHODS: An epidemiological study was conducted at the National Medical Research Center for Endocrinology of the Russian Ministry of Health in 2017 as part of the COSI program. We examined 7-year-old children studying in one of the 1st grade 68 randomly selected Moscow schools. The study was carried out in accordance with the COSI study protocol, and child, parent and school questionnaire forms were completed. WHO and International Obesity Task Force (IOTF) criteria were used to assess body weight.

RESULTS: 2166 children aged 7 years (1068 boys and 1098 girls) were examined. In total, 24.42% of children are overweight or obese according to WHO criteria, 95% CI (22.63%; 26.29%), according to IOTF criteria — 19.21%, 95% CI (17.57%; 20. 93%). 3.0% of children (2.3%; 3.8%) are underweight according to WHO criteria, 2.8% (2.2%; 3.6%) are underweight according to IOTF criteria. The median duration of breastfeeding, (BF) is 8 months, exclusive breastfeeding is 4 months. No relationship was found between the duration of breastfeeding and the child’s weight. Fathers’ BMI is higher than mothers’ BMI. Parents more often believe that their child is normal or underweight than is actually observed. About 2/3 of children go to school on foot or by mechanical transport, participate in sports or dance sections, and spend 1–2 hours a day in outdoor games on weekdays. The duration of reading and preparing lessons on weekdays and weekends does not differ, while the duration of walks on weekends is higher. Screen time on weekends is almost double that on weekdays.

CONCLUSION: For the first time, detailed results of an epidemiological study of 7-year-old children in Moscow under the COSI program are presented: assessments of weight, height and other anthropometric indicators, as well as the results of a survey of parents regarding their anthropometric parameters, family history, and children’s lifestyle.

1. Llewellyn A, Simmonds M, Owen CG, Woolacott N. Childhood obesity as a predictor of morbidity in adulthood: A systematic review and meta-analysis. Obes Rev. 2016. doi: https://doi.org/10.1111/obr.12316

2. Reilly JJ, Kelly J. Long-term impact of overweight and obesity in childhood and adolescence on morbidity and premature mortality in adulthood: Systematic review. Int J Obes. 2011. doi: https://doi.org/10.1038/ijo.2010.222

3. Umer A. et al. Childhood obesity and adult cardiovascular disease risk factors: a systematic review with meta-analysis // BMC public health. — 2017. — Т. 17. — С. 1-24.

4. Kim J, Lee I, Lim S. Overweight or obesity in children aged 0 to 6 and the risk of adult metabolic syndrome: A systematic review and meta‐analysis. J Clin Nurs. 2017;26(23-24):3869-3880. doi: https://doi.org/10.1111/jocn.13802

5. Spinelli A, Buoncristiano M, Nardone P, et al. Thinness, overweight, and obesity in 6- to 9-year-old children from 36 countries: The World Health Organization European Childhood Obesity Surveillance Initiative-COSI 2015-2017. Obes Rev. 2021;22 Suppl 6:e13214. doi: https://doi.org/10.1111/obr.13214

6. Whiting S, Buoncristiano M, Gelius P, et al. Physical Activity, Screen Time, and Sleep Duration of Children Aged 6-9 Years in 25 Countries: An Analysis within the WHO European Childhood Obesity Surveillance Initiative (COSI) 2015-2017. Obes Facts. 2021;14(1):32-44. doi: https://doi.org/10.1159/000511263

7. Ramos Salas X, Buoncristiano M, Williams J, et al. Parental Perceptions of Children’s Weight Status in 22 Countries: The WHO European Childhood Obesity Surveillance Initiative: COSI 2015/2017. Obes Facts. 2021;14(6):658-674. doi: https://doi.org/10.1159/000517586

8. Fismen AS, Buoncristiano M, Williams J, et al. Socioeconomic differences in food habits among 6- to 9-year-old children from 23 countries-WHO European Childhood Obesity Surveillance Initiative (COSI 2015/2017). Obes Rev. 2021;22 Suppl 6:e13211. doi: https://doi.org/10.1111/obr.13211

9. Williams J, Buoncristiano M, Nardone P, et al. 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. doi: https://doi.org/10.3390/nu12082481

10. Breda J, McColl K, Buoncristiano M, et al. Methodology and implementation of the WHO European Childhood Obesity Surveillance Initiative (COSI). Obes Rev. 2021;22 Suppl 6:e13215. doi: https://doi.org/10.1111/obr.13215

11. Gritsinskaya VL, Novikova VP, Khavkin AI. Epidemiology of obesity in children and adolescents (systematic review and metaanalysis of publications over a 15-year period). Vopr. prakt. pediatr. (Clinical Practice in Pediatrics). 2022;17(2):126–135. (In Russian). doi: https://doi.org/10.20953/1817-7646-2022-2-126-135

12. Rito AI, Buoncristiano M, Spinelli A, et al. Association between Characteristics at Birth, Breastfeeding and Obesity in 22 Countries: The WHO European Childhood Obesity Surveillance Initiative - COSI 2015/2017. Obes Facts. 2019;12(2):226-243. doi: https://doi.org/10.1159/000500425