Globesity — Norway and the Netherlands

Taking the World by Storm

In the Netherlands, only 4% of the children are overweight, according to NBC News. Apparently the source is the Institute for Health Metrics and Evaluation, although a visit to their data visualization page seems to indicate that the percentage is 17.2. This particular microcosm illustrates the problems inherent in keeping current with, and conglomerating, obesity statistics.

To be relevant, numbers need to match in the ways they were collected and the populations they were collected from. Different countries have different ways of gathering statistics, and vastly different resources with which to do it. The attitudes of various governments toward statistics-gathering range from meticulous to lackadaisical, and their reporting requirements — and penalties for missing the mark — reflect this.

If one place defines “children” as aged 2-16 and another place defines them as aged 5-18, how can the collected numbers be compared in any meaningful way? To grasp the worldwide picture is very difficult, and experts must depend on approximations in reporting, because precision is not obtainable.

A new study

In the Netherlands, the National Institute for Public Health and the Environment collaborated with the World Health Organization to assess how community-based initiatives (CBIs) to reduce childhood obesity are working out. The study looked at measures begun in the years 2005-2011. The areas of inquiry were the CBIs’ general characteristics, applied strategies, and reported effects.

The researchers sorted through a lot of available data sets to select the ones that matched their study’s criteria. The 71 selected included projects originating in 15 different countries. Almost all of them “implemented both environmental and individual strategies.” About half were public-private partnerships, and more than half carried out activities in multiple locations, or throughout a neighborhood.

The initiatives varied in nature — heavy on the professional training and offering many programs for parents, with plenty of attention to making changes in the social and physical environments. Much interesting information can be gleaned from this report, whose conclusions are:

Despite diversity of included CBIs, common characteristics were the application of integrated actions at a local level, aimed at changing the environment and the children’s behavior directly. Evidence supporting effectiveness on weight indicators is available, although the design and conduct of most of these studies were suboptimal (i.e. no control group, a small sample size, not random).

From the Norwegian Institute of Public Health, the good news is that between 2008 and 2012, Norwegian third-graders did not get any bigger on the average. The Institute’s Child Growth Study also identified some factors affecting child obesity, including the educational level of the child’s mother, whether the parents are married, and whether the family lives in a rural or urban environment. As might be expected, children with undereducated mothers and divorced parents do not fare as well.

Perhaps surprisingly, because of the stereotypical picture of hard-working country kids, the rural Norwegian children experience more overweight and obesity than city kids. But unlike their counterparts in other countries, the majority of Norwegian children get back and forth to school either on foot or via bicycle. Also unlike their counterparts in other countries, Norwegian officials are very concerned about social justice and fairness. The Child Growth Study’s project manager, Ragnhild Hovengen, is quoted as saying:

Health clinics and school health services have a unique opportunity to identify children and families at risk of developing obesity and other health problems and they must be encouraged to introduce preventive activities among children and young people in their municipalities…. There is a danger that trends in overweight and obesity in some groups will help to maintain and increase social inequalities in the years to come.

Your responses and feedback are welcome!

Source: “The Whole World is Getting Fatter, New Survey Finds,”, 05/27/14
Source: “Overview of 71 European community-based initiatives,”, 07/28/14
Source: “Childhood obesity unevenly distributed in Norway,”, 08/20/14
Image by JD Hancock

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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