title: Socioeconomic inequalities in childhood overweight: heterogeneity across five countries in the WHO European Childhood Obesity Surveillance Initiative (COSI-2008).
abstract: Excess risk of childhood overweight and obesity occurring in socioeconomically disadvantaged families has been demonstrated in numerous studies from high-income regions, including Europe. It is well known that socioeconomic characteristics such as parental education, income and occupation are etiologically relevant to childhood obesity. However, in the pan-European setting, there is reason to believe that inequalities in childhood weight status may vary among countries as a function of differing degrees of socioeconomic development and equity.
  
  
  
  In this cross-sectional study, we have examined socioeconomic differences in childhood obesity in different parts of the European region using nationally representative data from Bulgaria, the Czech Republic, Lithuania, Portugal and Sweden that were collected in 2008 during the first round of the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative.
  
  
  
  Heterogeneity in the association between parental socioeconomic indicators and childhood overweight or obesity was clearly observed across the five countries studied. Positive as well as negative associations were observed between parental socioeconomic indicators and childhood overweight, with statistically significant interactions between country and parental indicators.
  
  
  
  These findings have public health implications for the WHO European Region and underscore the necessity to continue documenting socioeconomic inequalities in obesity in all countries through international surveillance efforts in countries with diverse geographic, social and economic environments. This is a prerequisite for universal as well as targeted preventive actions.
authors.affiliation: Section for Epidemiology and Community Medicine (EPSO), Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden.
authors.forename: L
authors.initials: L
authors.lastname: Lissner
authors.affiliation: Division of Noncommunicable Diseases and Promoting Health through the Life-Course, WHO Regional Office for Europe, Copenhagen Ø, Denmark.
authors.forename: T M A
authors.initials: TM
authors.lastname: Wijnhoven
authors.affiliation: Section for Epidemiology and Community Medicine (EPSO), Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden.
authors.forename: K
authors.initials: K
authors.lastname: Mehlig
authors.affiliation: Department of Food and Nutrition and Sport Science, University of Gothenburg, Gothenburg, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Sjöberg
authors.affiliation: Obesity Management Centre, Institute of Endocrinology, Prague, Czech Republic.
authors.forename: M
authors.initials: M
authors.lastname: Kunesova
authors.affiliation: School of Hospitality, Culinary Arts and Meal Science, Örebro University, Grythyttan, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Yngve
authors.affiliation: Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: A
authors.initials: A
authors.lastname: Petrauskiene
authors.affiliation: Department of Food and Nutrition, National Center of Public Health and Analyses, Sofia, Bulgaria.
authors.forename: V
authors.initials: V
authors.lastname: Duleva
authors.affiliation: Instituto Nacional de Saúde Dr Ricardo Jorge, Lisbon, Portugal.
authors.forename: A I
authors.initials: AI
authors.lastname: Rito
authors.affiliation: Division of Noncommunicable Diseases and Promoting Health through the Life-Course, WHO Regional Office for Europe, Copenhagen Ø, Denmark.
authors.forename: J
authors.initials: J
authors.lastname: Breda
mesh_terms: D000704:Analysis of Variance; D015992:Body Mass Index; D002648:Child; D003430:Cross-Sectional Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D009752:Nutritional Status; D010290:Parents; D063766:Pediatric Obesity / Q000191:economics* / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D011050:Policy Making; D011159:Population Surveillance; D015995:Prevalence; D011634:Public Health; D012959:Socioeconomic Factors; D044465:White People; D014944:World Health Organization