The National Strategic Plan to Reduce Childhood Obesity in Spain: the Key is the Creation of Health Promoting Ecosystems

[This post has been written by Sarah Warkentin, Postdoctoral Fellow at ISGlobal, and Martine Vrijheid, Head of the ISGlobal Childhood and Environment Program]

Four in every ten children and three in every ten adolescents are affected by excess weight in Spain, a country with one of the highest prevalences of overweight and obesity in Europe. Consequences of excess weight during childhood are largely known, and include greater risk of type 2 diabetes mellitus, dyslipidemia, hypertension, sleep apnea, asthma, mental health problems (such as depression, anxiety and disturbed eating behaviors), cardiovascular diseases, certain types of cancers, a greater likelihood of tracking obesity from childhood into adulthood, and adverse direct and indirect socioeconomic effects, which are derived from associated health problems, loss of productivity and/or premature morbidity and mortality.

In order to address childhood overweight and obesity, it is necessary to take into account its complexity, not only because of its multiple consequences, but also because of its multiple causes. One of these causes that is worth mentioning is the digital era we live in, with the widespread use of the internet among children and adolescents (94.8% of 11-18-year-olds in Spain have a mobile phone and 31.6% of them are more than five hours connected on a daily basis, for example), which may have important impacts on their physical, mental and social health.

Four in every ten children and three in every ten adolescents are affected by excess weight in Spain, a country with one of the highest prevalences of overweight and obesity in Europe

Ensuring that children and adolescents have access to healthy lifestyles in their closest surroundings, where they live and spend their time, this is, within the family, in schools, in their neighborhood, town or city, is crucial. Their daily environments should promote an active lifestyle, a healthy diet, emotional well-being and adequate sleeping habits.

Photo: Jill Wellington / Pixabay

The recently released (June 10^th 2022) National Strategic Plan to reduce childhood obesity aims to embrace this mission, by empowering and working together with families, teachers, health professionals, companies, third-sector entities, public administrations at all levels, and, of course, children and adolescents themselves to control and reduce the alarming rates of excess weight in Spain. This plan has been promoted by the Spanish government and coordinated by the High Comission against Child Poverty (“Alto Comisionado contra la Pobreza Infantil”) with the Gasol Foundation as a key ally. A national alliance is detailed in the plan, aiming to generate multilevel and cascading actions in different public administrations, scientific sector, third sector, companies and civil society, with a primary aim to achieve, within the next ten years, a reduction of 25% of overweight and obesity among children and adolescents in Spain.

National Strategic Plan aims to achieve, within the next ten years, a reduction of 25% of overweight and obesity among children and adolescents in the country

The key to achieve this goal is to act in their surroundings, by promoting an ecosystem that promotes healthy lifestyles. The plan addresses six strategic lines:

• generating ecosystems that promote:
  • physical activity
  • healthy diets
  • emotional well-being and sleep quality
• strengthen systems to promote healthy lifestyles
• ensuring health protection of childhood
• creating a cultural shift towards healthier lifestyles

In total, 200 multisectoral actions are proposed in the plan. Regarding, for example, the generation of an ecosystem that promotes physical activity, actions such as ensuring universal economic access to sports, increasing extracurricular physical activity in schools and using school sports facilities as open spaces are described.

Photo: Martí Petit / Barcelona City Council

It is essential to continue advancing in the generation of scientific knowledge on childhood obesity, its determinants, risk and protective factors, consequences and most effective interventions for the reduction of obesity. Taking this into account, the National Strategic Plan includes the creation of a multidisciplinary network of experts in the research and study of childhood obesity, which will actively collaborate with national and international scientific evidence in areas such as physical activity, mental health, public health and social sciences.

It is essential to continue advancing in the generation of scientific knowledge on childhood obesity, its determinants, risk and protective factors, consequences and most effective interventions for the reduction of obesity

The project UrbanKids, which collaborates with the Gasol Foundation, will help with this essential scientific evidence. UrbanKids will evaluate how changes in the urban and social environment affect weight gain and obesity in children and adolescents in Catalonia. This project aims to characterize urban exposures, such as air pollution, access to green spaces, population density, walkability, access to facilities, and food environment that have a role in the development of childhood overweight and obesity, besides disentangling the effects of the social environment. This will allow the focus on modifiable aspects of the urban environment and inform policy-level decisions about how healthy ecosystems, as described in the National Strategic Plan to reduce childhood obesity, should be designed.