{
    "abstract": "Consuming a healthy diet in childhood helps to protect against malnutrition and noncommunicable diseases (NCDs). This cross-sectional study described the diets of 132,489 children aged six to nine years from 23 countries participating in round four (2015-2017) of the WHO European Childhood Obesity Surveillance Initiative (COSI). Children's parents or caregivers were asked to complete a questionnaire that contained indicators of energy-balance-related behaviors (including diet). For each country, we calculated the percentage of children who consumed breakfast, fruit, vegetables, sweet snacks or soft drinks \"every day\", \"most days (four to six days per week)\", \"some days (one to three days per week)\", or \"never or less than once a week\". We reported these results stratified by country, sex, and region. On a daily basis, most children (78.5%) consumed breakfast, fewer than half (42.5%) consumed fruit, fewer than a quarter (22.6%) consumed fresh vegetables, and around one in ten consumed sweet snacks or soft drinks (10.3% and 9.4%, respectively); however, there were large between-country differences. This paper highlights an urgent need to create healthier food and drink environments, reinforce health systems to promote healthy diets, and continue to support child nutrition and obesity surveillance.",
    "authors": [
        {
            "affiliation": "WHO European Office for the Prevention and Control of Noncommunicable Diseases, 125009 Moscow, Russian Federation.",
            "firstname": "Julianne",
            "initials": "J",
            "lastname": "Williams"
        },
        {
            "affiliation": "WHO European Office for the Prevention and Control of Noncommunicable Diseases, 125009 Moscow, Russian Federation.",
            "firstname": "Marta",
            "initials": "M",
            "lastname": "Buoncristiano"
        },
        {
            "affiliation": "Italian National Institute of Health (Istituto Superiore Di Sanit\u00e0), 00161 Rome, Italy.",
            "firstname": "Paola",
            "initials": "P",
            "lastname": "Nardone"
        },
        {
            "affiliation": "National Institute of Health Dr. Ricardo Jorge, 1600 560 Lisbon, Portugal.",
            "firstname": "Ana Isabel",
            "initials": "AI",
            "lastname": "Rito"
        },
        {
            "affiliation": "Italian National Institute of Health (Istituto Superiore Di Sanit\u00e0), 00161 Rome, Italy.",
            "firstname": "Angela",
            "initials": "A",
            "lastname": "Spinelli"
        },
        {
            "affiliation": "Danish Health Authority, 2300 Copenhagen S, Denmark.",
            "firstname": "Tatjana",
            "initials": "T",
            "lastname": "Hejgaard"
        },
        {
            "affiliation": "National Institute of Public Health, University of Southern Denmark, 1455 Copenhagen K, Denmark.",
            "firstname": "Lene",
            "initials": "L",
            "lastname": "Kierkegaard"
        },
        {
            "affiliation": "Department of Nutrition Research, National Institute for Health Development, 11619 Tallinn, Estonia.",
            "firstname": "Eha",
            "initials": "E",
            "lastname": "Nurk"
        },
        {
            "affiliation": "Institute of Endocrinology, Obesity Unit, 116 94 Prague, Czechia.",
            "firstname": "Marie",
            "initials": "M",
            "lastname": "Kune\u0161ov\u00e1"
        },
        {
            "affiliation": "Croatian Institute of Public Health, University of Zagreb, School of Medicine, 10000 Zagreb, Croatia.",
            "firstname": "Sanja",
            "initials": "S",
            "lastname": "Musi\u0107 Milanovi\u0107"
        },
        {
            "affiliation": "Spanish Agency for Food Safety and Nutrition, 28014 Madrid, Spain.",
            "firstname": "Marta",
            "initials": "M",
            "lastname": "Garc\u00eda-Solano"
        },
        {
            "affiliation": "Spanish Agency for Food Safety and Nutrition, 28014 Madrid, Spain.",
            "firstname": "Enrique",
            "initials": "E",
            "lastname": "Guti\u00e9rrez-Gonz\u00e1lez"
        },
        {
            "affiliation": "Department of Public Health and Management, University of Medicine and Pharmacy Carol Davila, 030167 Bucharest, Romania.",
            "firstname": "Lacramioara Aurelia",
            "initials": "LA",
            "lastname": "Brinduse"
        },
        {
            "affiliation": "Department of Public Health and Management, University of Medicine and Pharmacy Carol Davila, 030167 Bucharest, Romania.",
            "firstname": "Alexandra",
            "initials": "A",
            "lastname": "Cucu"
        },
        {
            "affiliation": "Department of Cardiology, Institute of Mother and Child, 01-211 Warsaw, Poland.",
            "firstname": "Anna",
            "initials": "A",
            "lastname": "Fija\u0142kowska"
        },
        {
            "affiliation": "Primary Health Care, Ministry for Health, 1940 Floriana, Malta.",
            "firstname": "Victoria",
            "initials": "V",
            "lastname": "Farrugia Sant'Angelo"
        },
        {
            "affiliation": "National Center of Public health, Ministry of Health of the Republic of Kazakhstan, 010000 Nur-Sultan City, Kazakhstan.",
            "firstname": "Shynar",
            "initials": "S",
            "lastname": "Abdrakhmanova"
        },
        {
            "affiliation": "Centre for Disease Prevention and Control, LV-1005 Latvia, Riga.",
            "firstname": "Iveta",
            "initials": "I",
            "lastname": "Pudule"
        },
        {
            "affiliation": "National Center of Public Health and Analyses, 1431 Sofia, Bulgaria.",
            "firstname": "Vesselka",
            "initials": "V",
            "lastname": "Duleva"
        },
        {
            "affiliation": "Turkish Ministry of Health, Public Health General Directorate, 34400 Istanbul, Turkey.",
            "firstname": "Nazan",
            "initials": "N",
            "lastname": "Yardim"
        },
        {
            "affiliation": "Health Authority, Department of Health and Social Security, 47893 San Marino, San Marino.",
            "firstname": "Andrea",
            "initials": "A",
            "lastname": "Gualtieri"
        },
        {
            "affiliation": "National Nutrition Surveillance Centre, University College Dublin, Dublin, Ireland.",
            "firstname": "Mirjam",
            "initials": "M",
            "lastname": "Heinen"
        },
        {
            "affiliation": "National Nutrition Surveillance Centre, University College Dublin, Dublin, Ireland.",
            "firstname": "Silvia",
            "initials": "S",
            "lastname": "Bel-Serrat"
        },
        {
            "affiliation": "Republican Center for Health Promotion and Mass Communication, 720040 Bishkek, Kyrgyzstan.",
            "firstname": "Zhamyla",
            "initials": "Z",
            "lastname": "Usupova"
        },
        {
            "affiliation": "Institute of Paediatric Endocrinology, National Medical Research Centre for Endocrinology of the Ministry of Health of the Russian Federation, 117036 Moscow, Russian Federation.",
            "firstname": "Valentina",
            "initials": "V",
            "lastname": "Peterkova"
        },
        {
            "affiliation": "National Center for Disease Control and Public Health of Georgia, 0198 Tbilisi, Georgia.",
            "firstname": "Lela",
            "initials": "L",
            "lastname": "Shengelia"
        },
        {
            "affiliation": "Institute of Public Health, 1007 Tirana, Albania.",
            "firstname": "Jolanda",
            "initials": "J",
            "lastname": "Hyska"
        },
        {
            "affiliation": "Internal Diseases Department of the Scientific Clinical Centre of Mother and Child Health, 744036 Ashgabat, Turkmenistan.",
            "firstname": "Maya",
            "initials": "M",
            "lastname": "Tanrygulyyeva"
        },
        {
            "affiliation": "Department of Preventive Medicine, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania.",
            "firstname": "Ausra",
            "initials": "A",
            "lastname": "Petrauskiene"
        },
        {
            "affiliation": "Department for Organization of Health Services to Children, Mothers, Adolescents and Family Planning, Ministry of Health and Social Protection of Population, 734025 Dushanbe, Tajikistan.",
            "firstname": "Sanavbar",
            "initials": "S",
            "lastname": "Rakhmatullaeva"
        },
        {
            "affiliation": "Institute of Public Health of Montenegro, 81 000 Podgorica, Montenegro.",
            "firstname": "Enisa",
            "initials": "E",
            "lastname": "Kujundzic"
        },
        {
            "affiliation": "Applied Bioenergetics Lab, University of Novi Sad, 21000 Novi Sad, Serbia.",
            "firstname": "Sergej M",
            "initials": "SM",
            "lastname": "Ostojic"
        },
        {
            "affiliation": "Department of Pediatrics, Paracelsus Medical University, 5020 Salzburg, Austria.",
            "firstname": "Daniel",
            "initials": "D",
            "lastname": "Weghuber"
        },
        {
            "affiliation": "Arabkir Medical Centre-Institute of Child and Adolescent Health, 0014 Yerevan, Armenia.",
            "firstname": "Marina",
            "initials": "M",
            "lastname": "Melkumova"
        },
        {
            "affiliation": "Institute of Public Health, Faculty of Medicine, Ss. Cyril and Methodius University, 1000 Skopje, North Macedonia.",
            "firstname": "Igor",
            "initials": "I",
            "lastname": "Spiroski"
        },
        {
            "affiliation": "Faculty of Sport, University of Ljubljana, 1000 Ljubljana, Slovenia.",
            "firstname": "Gregor",
            "initials": "G",
            "lastname": "Starc"
        },
        {
            "affiliation": "Department of Social and Policy Sciences, University of Bath, Bath BA2 7AY, UK.",
            "firstname": "Harry",
            "initials": "H",
            "lastname": "Rutter"
        },
        {
            "affiliation": "WHO European Office for the Prevention and Control of Noncommunicable Diseases, 125009 Moscow, Russian Federation.",
            "firstname": "Giulia",
            "initials": "G",
            "lastname": "Rathmes"
        },
        {
            "affiliation": "WHO European Office for the Prevention and Control of Noncommunicable Diseases, 125009 Moscow, Russian Federation.",
            "firstname": "Anne Charlotte",
            "initials": "AC",
            "lastname": "Bunge"
        },
        {
            "affiliation": "WHO European Office for the Prevention and Control of Noncommunicable Diseases, 125009 Moscow, Russian Federation.",
            "firstname": "Ivo",
            "initials": "I",
            "lastname": "Rakovac"
        },
        {
            "affiliation": "WHO Country Office for Tajikistan, 734019 Dushanbe, Tajikistan.",
            "firstname": "Khadichamo",
            "initials": "K",
            "lastname": "Boymatova"
        },
        {
            "affiliation": "WHO Child and Adolescent Health and Development, WHO Regional Office for Europe, 2100 Copenhagen, Denmark.",
            "firstname": "Martin",
            "initials": "M",
            "lastname": "Weber"
        },
        {
            "affiliation": "WHO European Office for the Prevention and Control of Noncommunicable Diseases, 125009 Moscow, Russian Federation.",
            "firstname": "Jo\u00e3o",
            "initials": "J",
            "lastname": "Breda"
        }
    ],
    "conclusions": null,
    "copyrights": null,
    "doi": "10.3390/nu12082481\n10.1111/j.1467-789X.2012.01015.x\n10.1186/1471-2458-14-806\n10.1016/S0140-6736(19)30041-8\n10.1056/NEJMe1811305\n10.1017/S1368980017003457\n10.1056/NEJMoa1614362\n10.1038/sj.ejcn.1601929\n10.1056/NEJMoa1304127\n10.3945/ajcn.113.058362\n10.1177/0022034513508954\n10.1111/j.2047-6310.2012.00090.x\n10.3390/nu11020387\n10.1093/eurpub/ckv012\n10.1016/j.numecd.2019.03.003\n10.3390/nu10060706\n10.3390/nu11040875\n10.1371/journal.pone.0194555\n10.1377/hlthaff.2016.1231\n10.1017/S1368980008003376\n10.1016/S2468-2667(18)30240-8\n10.1111/ecca.12192\n10.1016/S0140-6736(14)60200-2\n10.1016/j.appet.2012.04.017\n10.1002/14651858.CD008552.pub5\n10.1111/obr.12310\n10.1111/obr.12727\n10.1002/14651858.CD009315.pub2\n10.1136/jech.2010.122333\n10.1159/000500436\n10.3305/nh.2015.31.sup3.8755\n10.1371/journal.pone.0178921\n10.1186/s12889-017-4189-8\n10.1038/sj.ejcn.1600620",
    "journal": "Nutrients",
    "keywords": [
        "child",
        "children",
        "fruit",
        "health",
        "noncommunicable diseases",
        "nutrition",
        "obesity",
        "soft drinks",
        "surveillance",
        "vegetables"
    ],
    "methods": null,
    "publication_date": "2020-08-23",
    "pubmed_id": "32824588\n22731928\n25099430\n30954305\n30281997\n29233202\n28604169\n15220946\n25905159\n25119608\n23966427\n24323509\n23001989\n30781797\n25805780\n31078365\n29857549\n31003489\n29596440\n28228484\n18671891\n30522681\n24629282\n22561190\n32449203\n26252417\n30160009\n29482264\n21148819\n31030201\n25719775\n28594899\n28330465\n9756123",
    "results": null,
    "title": "A Snapshot of European Children's Eating Habits: Results from the Fourth Round of the WHO European Childhood Obesity Surveillance Initiative (COSI).",
    "xml": "<Element 'PubmedArticle' at 0x788504232700>"
}