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WHO European Childhood Obesity Surveillance Initiative in Serbia: a prevalence of overweight and obesity among 6–9-year-old school children

  • Visnja Djordjic , Snezana Radisavljevic , Ivana Milanovic , Predrag Bozic , Miljana Grbic , Jagoda Jorga and Sergej M. Ostojic EMAIL logo



The World Health Organization (WHO) European Childhood Obesity Surveillance Initiative (COSI) is a public health program established in order to understand the progress of the obesity epidemic in young populations and gain inter-country comparisons within the European region, yet the data from a number of East European countries, including Serbia, were not available then. Therefore, the main aim of this cross-sectional study was to collect data about the prevalence of overweight and obesity among 6–9-year-old school children in Serbia according to the standardized protocol during the Fourth COSI Implementation Round.


From September 2015 to November 2015, 5102 first- and second-grade primary-school children (age 7.7±0.6 years) were assessed for weight, height, and body mass index (BMI) in 14 Serbian school districts.


The prevalence rates of obesity, as calculated using the International Obesity Task Force (IOTF) cut-off points, vary across different age groups, with the lowest obesity rates reported in 7-year-old boys (6.2%), while the highest obesity prevalence rates were observed in 6-year-old boys (9.7%). In addition, being overweight was strongly associated with poor local community development and lower level of urbanization. The overall prevalence of overweight (23.1%, including obesity) and obesity (6.9%) in Serbian primary-school children seem to be comparable to rather high rates previously reported in other countries participating in the COSI program, indicating an obesity epidemic in Serbian children.


This surveillance system should be regularly implemented throughout Europe, providing comparable data on rates of overweight/obesity in primary schools that might drive prudent actions to reverse the pandemic trend of childhood obesity.

Corresponding author: Professor Sergej M. Ostojic, MD, PhD, Biomedical Sciences Department, Faculty of Sport and Physical Education, University of Novi Sad, Lovcenska 16, Novi Sad 21000, Serbia, Phone: (+381)-21-450-188, Fax: (+381)-21-450-199

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: This study was supported by the World Health Organization (Ref. File 2015-540940), the Serbian Ministry of Education, Science and Technological Development (Grant No. 175037), the Faculty of Sport and Physical Education, University of Novi Sad (2015 Annual Award) and the Center for Health, Exercise and Sports Sciences (Award No. 16-08-15).

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.


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Received: 2016-4-7
Accepted: 2016-7-18
Published Online: 2016-8-22
Published in Print: 2016-9-1

©2016 Walter de Gruyter GmbH, Berlin/Boston

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