Public health interventions tackling childhood obesity at European level: A literature review.

Childhood obesity pandemic, a form of malnutrition including undernutrition, and other food-regime associated risks, has universally been on the rise during the chronic period of the past 4-5 decades and is now acknowledged as one of the most "toxic fuel" accounting for poor health in the majority of countries. In order to find remedies to heal this alarming issue, a corpus of European interventions have been brought to light in the recent years. Since the vague influence and effectiveness of these measures / policies is to be further identified, their evaluation screening is underlined as a pivotal necessity. Within this framework this paper aims to critically report on the development and evaluation of the implementation of the European Union, World Health Organization Regional Office for Europe, and European Union countries' national public health policy interventions and action plans in the fight against childhood obesity. Thus, this is a narrative review synthesizing the results -following a qualitative interpretation and analysis- of recent scientific epidemiological research and review studies evidence concerning European public health interventions tackling childhood obesity, through computer-assisted literature search -via PubMed, Scopus, and Google Scholar- scientific databases. According to the literature data, it is concluded that despite the unprecedented public health challenge of addressing childhood obesity, the extent to which related European policies and programs targeting healthy nutrition, increased physical activity, and healthy lifestyle ethos are truly efficacious is still under inquiry.

Inverse Association Between Health Literacy and Obesity Among Children in Greece: A School-Based, Cross-Sectional Epidemiological Study.

Children's health literacy is a crucial pillar of health. This study is aimed to examine the association between health literacy and weight status among Greek schoolchildren aged 10 to 12 years old. A population-based, cross-sectional observational study enrolling 1,728 students (795 boys), aged 10 to 12 years old, was conducted during school years 2014-2016. A health literacy index (range 0-100) was created through an item response theory hybrid model, by combining a variety of beliefs and perceptions of children about health. The mean health literacy score was 70.4 (±18.7). The majority of children (63.8%) had a "high" level (i.e., >67/100) of health literacy, 30.5% had a "medium" level (i.e., 34-66/100) of health literacy, while a small proportion of children (5.7%) had a "low" level (i.e., <33/100). Girls exhibited a higher level of health literacy than boys (71.7 ± 18.3 vs. 68.8 ± 19.1, p < .01). Regarding body weight status, 21.7% of children was overweight and 5.0% was obese. Linear regression models showed that the health literacy score was inversely associated with children's body mass index (regression coefficient [95% CI]: -0.010 [-0.018, -0.001]), after adjusting for dietary habits, physical activity levels, and other potential confounders. Health literacy seems to be a dominant characteristic of children's weight status; therefore, school planning, as well as public health policy actions should emphasize on the ability of children's capacity to obtain, process, and understand basic health information.

Health literacy as a determinant of childhood and adult obesity: a systematic review.

OBJECTIVES: To assess whether Health Literacy (HL) acts as a determinant of obesity in adults and children by synthesizing the results of recent scientific evidence. CONTENT: This is a systematic qualitative review following the MOOSE guidelines. A systematic, computer-assisted literature search via PubMed scientific database, between January 1st, 2000, and September 30th 2020, was conducted. Only cross-sectional epidemiologic research studies that were published in the English language, investigating HL's possible role as a determinant of childhood and adult obesity, were included. SUMMARY: After screening 725 citations from the PubMed database, 39 (n=39) studies in total were included in this literature review; Four (n=4) studies were conducted in the children population, seven (n=7) studies were performed in children-parent/caregiver dyads, and 28 studies (n=28) enrolled adults. There is significant evidence that HL knowledge and skills determine the consequent management of obesity and BMI rates in children and adult populations. OUTLOOK: Despite policies and action plans put in place by countries globally, overweight and obesity continue to be a pressing public health issue and one of the critical drivers of non-communicable diseases, constituting a health, social and economic burden worldwide. Health Literacy as an essential health policy and promotion agenda item and a critical empowerment strategy could increase children's and adults' control over their overall health and awareness to overcome obesity issues. Initiatives to improve HL levels could be useful tools in managing the obesity epidemic, starting from integrating HL in the school curriculum and further in family and community action plans.