# Trends in the Prevalence of Overweight, Obesity and Severe Obesity in Primary School Children in Croatia from 2003 to 2022

## TL;DR

Childhood overweight and obesity rates in Croatia increased until the mid-2010s, but have since slowed, while severe obesity rates decreased.

## Contribution

The study provides updated and region-specific trends in childhood overweight and obesity prevalence in Croatia from 2003 to 2022.

## Key findings

- Overweight and obesity prevalence increased steadily until the mid-2010s, then slowed.
- Severe obesity prevalence decreased over time.
- The capital region had the lowest prevalence rates, while other regions had significantly higher risks.

## Abstract

What are the main findings?
The prevalence of overweight (including obesity) steadily increased over time, particularly until the mid-2010s, whereas the prevalence of severe obesity had the opposite trend throughout.The lowest prevalence rates of overweight and obesity were observed in the capital, with other regions exhibiting significantly higher risks.

The prevalence of overweight (including obesity) steadily increased over time, particularly until the mid-2010s, whereas the prevalence of severe obesity had the opposite trend throughout.

The lowest prevalence rates of overweight and obesity were observed in the capital, with other regions exhibiting significantly higher risks.

What is the implication of the main finding?
Despite a slowdown in the growth of overweight (including obesity) prevalence in recent years, Croatia has yet to reach the plateau observed in some other European countries.Regional differences in the overweight and obesity risk require a follow-up.

Despite a slowdown in the growth of overweight (including obesity) prevalence in recent years, Croatia has yet to reach the plateau observed in some other European countries.

Regional differences in the overweight and obesity risk require a follow-up.

Background: Childhood obesity remains a significant public health challenge globally. Croatia ranks among the leading European countries in terms of childhood overweight and obesity prevalence. Methods: The present cross-sectional study analysed overweight and obesity prevalence trends from 2003 to 2022 on a nationally representative sample containing data from five studies, two independent studies and three WHO COSI rounds. Data from a total of 11,817 children aged 7.00–8.99 were analysed. Weight categories were defined using the IOTF and WHO cut-offs. Overweight and obesity prevalence rates and trends overall and by sex and region were calculated, and binary regression models applied to investigate the relationship between the risk of overweight and several variables. p-value < 0.05 was used to define statistical significance. Results: Temporal trends and associations were investigated using the IOTF reference values. The prevalence of overweight (including obesity) had increased steadily from 2003 to 2015, thereafter continuing to increase at a slower rate, whereas the prevalence of severe obesity reduced over time. Even though boys had slightly higher prevalence rates of overweight, the growth in overweight prevalence in girls over time was significant. At the regional level, the lowest prevalence rates were detected in the capital (City of Zagreb region). The risk of overweight was at least 50% higher in all the other regions in Croatia, and a rising trend in overweight risk with time was particularly high among children in the Adriatic and Northern regions. Conclusions: Despite a deceleration in the rate of increase in overweight (including obesity) prevalence, Croatia is yet to reach a plateau observed in some other European countries. Unearthed regional differences warrant further investigation.