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

Visnja Djordjic 1 , Snezana Radisavljevic 2 , Ivana Milanovic 2 , Predrag Bozic 3 , Miljana Grbic 4 , Jagoda Jorga 5  and Sergej M. Ostojic 1 , 5
  • 1 Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
  • 2 Faculty of Sport and Physical Education, University of Belgrade, Belgrade, Serbia
  • 3 National Institute of Sport and Sports Medicine, Belgrade, Serbia
  • 4 World Health Organization National Office for Serbia, Belgrade, Serbia
  • 5 University of Belgrade School of Medicine, Belgrade, Serbia
Visnja Djordjic, Snezana Radisavljevic, Ivana Milanovic, Predrag Bozic, Miljana Grbic, Jagoda Jorga and Sergej M. Ostojic



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.

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The Journal of Pediatric Endocrinology and Metabolism (JPEM) is the only international journal dedicated exclusively to endocrinology in the neonatal, pediatric and adolescent age groups, and publishes the results of clinical investigations in pediatric endocrinology and basic research. JPEM publishes Review Articles, Original Research, Case Reports, Short Communications and Letters to the Editor.