title: Greek children living in rural areas are heavier but fitter compared to their urban counterparts: a comparative, time-series (1997-2008) analysis.
abstract: OBJECTIVE
  To compare 12-year (1997-2008) trends in the distribution of Body Mass Index (BMI) status and physical fitness test performances among 8- to 9-year-old Greek children living in rural and urban areas.
  
  
  METHODS
  Population data derived from 11 national school-based health surveys conducted from 1997 to 2008. Anthropometric measurements and physical fitness test performances (ie, multistage shuttle run, vertical jump, small ball throw, and 30-meter sprint) from 725,163 children were analyzed. Distribution between rural and urban areas was based on the Hellenic National Statistics Service (HNSS) criteria.
  
  
  RESULTS
  Trend analysis showed an increase in the prevalence of obesity in children living in urban areas from 7.2% in 1997 to 11.3% in 2008 for girls (P < .001) and from 8.1% to 12.4% (P < .001) for boys. In rural areas, obesity increased from 7% in 1997 to 13% in 2008 for girls (P < .001), and from 8.2% to 14.1% (P < .001) for boys. The annual rate of obesity increase was 40%-50% higher in children from rural areas. Nevertheless, rural children presented better performances in all of the physical fitness tests examined. Specifically, mean values of aerobic performance decreased from 3.58 ± 1.9 stages in 1997 to 3.02 ± 2.1 stages in 2007 for boys (P < .001), and from 2.97 ± 1.5 stages to 2.53 ± 1.7 stages (P < .001) for girls in urban areas, whereas in rural areas, the correspondent values were not significantly different between 1997 and 2007.
  
  
  CONCLUSIONS
  Childhood obesity rates are higher in rural compared with urban areas in Greece, despite an apparent higher fitness level of children living in rural areas.
authors: Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
authors: Konstantinos D
authors: KD
authors: Tambalis
authors: Demosthenes B
authors: DB
authors: Panagiotakos
authors: Labros S
authors: LS
authors: Sidossis
mesh_terms: D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D002669:Child Welfare / Q000706:statistics & numerical data*; D015444:Exercise; D005260:Female; D006115:Greece / Q000453:epidemiology; D006304:Health Status; D006801:Humans; D008297:Male; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology*; D010809:Physical Fitness; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data*