Helena Križan

Background/Objectives: This study focused on the sub-national regional heterogeneity in childhood obesity prevalence across five countries in south-east Europe and the correlation between this heterogeneity and socioeconomic differences. Previous studies have mainly observed national or cross-national data but this study used a sub-national regional approach that may be beneficial in the further investigation of childhood obesity. Methods: Nationally representative samples of children from Croatia, Montenegro, North Macedonia, Serbia and Slovenia were selected using the COSI methodology and used to estimate regional childhood obesity prevalence values. The Sub-national Human Development Database provided data on the Sub-national Human Development Index (SHDI). The spatial autocorrelation analysis of childhood obesity prevalence in sub-national regions was performed and its association with sub-national human development was tested with an ordinary least squares regression model. Results: This study found statistically significant differences in childhood obesity prevalence across sub-national regions in Croatia, Slovenia and Serbia, while no such differences were observed in North Macedonia and Montenegro. There was moderate clustering in childhood obesity rates (Moran’s I = 0.337). The results indicated a significant negative association between SHDI and childhood obesity prevalence across the 48 regions (β = −66.63, p < 0.001). Conclusions: Future public health efforts should take into consideration regional differences in childhood obesity prevalence, and more targeted research is essential for understanding the mechanisms of resilience and vulnerability on a sub-national level.

Background: Childhood obesity remains a significant public health challenge globally. Croatia ranks among the leading European countries in terms of childhood overweight and obesity prevalence. Methods: The present cross-sectional study analysed overweight and obesity prevalence trends from 2003 to 2022 on a nationally representative sample containing data from five studies, two independent studies and three WHO COSI rounds. Data from a total of 11,817 children aged 7.00–8.99 were analysed. Weight categories were defined using the IOTF and WHO cut-offs. Overweight and obesity prevalence rates and trends overall and by sex and region were calculated, and binary regression models applied to investigate the relationship between the risk of overweight and several variables. p-value < 0.05 was used to define statistical significance. Results: Temporal trends and associations were investigated using the IOTF reference values. The prevalence of overweight (including obesity) had increased steadily from 2003 to 2015, thereafter continuing to increase at a slower rate, whereas the prevalence of severe obesity reduced over time. Even though boys had slightly higher prevalence rates of overweight, the growth in overweight prevalence in girls over time was significant. At the regional level, the lowest prevalence rates were detected in the capital (City of Zagreb region). The risk of overweight was at least 50% higher in all the other regions in Croatia, and a rising trend in overweight risk with time was particularly high among children in the Adriatic and Northern regions. Conclusions: Despite a deceleration in the rate of increase in overweight (including obesity) prevalence, Croatia is yet to reach a plateau observed in some other European countries. Unearthed regional differences warrant further investigation.

Childhood obesity is frequently linked to poor dietary habits, however, there are confl icting results regarding status of specifi c food groups consumptionand dietary habits like (un)regular breakfast consumption. The aim of this study was to explore food and beverages intakes associated with obesityamong children enrolled in the CroCOSI study as part of the WHO European Childhood Obesity Surveillance Initiative. This cross-sectional studyinvestigated dietary habits of school-aged children on a nationally representative sample (n=5608; 7-10 years). Parents or caregivers completeda questionnaire with indicators of dietary habits, and children’s body weight and height were measured. The 2007 WHO recommended growthreference for school-age children was used to compute BMI-for-age Z-scores. Descriptive statistics and logistic regression analyses were performed.The prevalence of obesity among Croatian children was 15.6%. Children who consume breakfast (OR 0.72, 95% CI 0.60–0.87), fruits (OR 0.82,95% CI 0.68–0.97) and cereals (OR 0.72, 95% CI 0.52–0.97) every day were less likely to have obesity. Further, children who had ≥4 servings of softdrinks weekly were 1.17 (95% CI 1.07–1.36) times more likely to have obesity. Other food groups showed no signifi cant associations with obesity.Daily consumption of fruits and cereals was associated with a lower risk of obesity in children. Skipping breakfast and the intake ≥4 servings of softdrinks per week was associated with a higher likelihood of obesity in this population of school-age children. Interventions with the aim to reduceprevalence of obesity in school-age children in Croatia can be based on the obtained results.

Background: While previous research on children’s diets has primarily focused on individual nutrients or foods, recent years have seen increasing attention to the analysis of dietary patterns. In school-aged children enrolled in the CroCOSI study, this research focused on identifying the dietary patterns and examining their potential links with childhood obesity. Methods: Data were collected from a nationally representative sample comprising 5608 children aged 7–10 years and their parents in this cross-sectional study. To evaluate the nutritional status of the children, BMI-for-age was assessed using z-score values. Results: A factor analysis using data from the FFQ revealed three dietary patterns: Western, Healthy, and Breakfast. Children who scored high for consumption of fruits, vegetables, fish, cheese, dairy products, and 100% fruit juice were categorized into the Healthy dietary pattern, whereas those with high scores for cereals and milk were assigned to the Breakfast dietary pattern. Conclusions: The Western dietary pattern did not show a significant relationship with obesity among school-aged children (OR = 1.00, 95% CI: 0.98–1.00; p = 0.11). The risk of obesity was lower among children following the Healthy (OR = 0.98, 95% CI: 0.98–0.99; p = 0.045) and Breakfast (OR = 0.96, 95% CI: 0.95–0.99; p = 0.001) dietary patterns.The results can help in creating food policies with the aim of reducing childhood obesity in Croatia.

Background: There has yet to be an agreement on which specific socioeconomic status (SES) indicator most effectively reflects disparities in children’s diets. However, children from lower SES backgrounds are particularly vulnerable, as research in other countries indicates that their diets contain fewer fruits and vegetables and more sweetened beverages. This paper aims to evaluate the associations between dietary habits and various SES indicators (education, occupation, income, and household size) among a representative sample of children in Croatia aged 7–10. Methods: Parents of children were asked to complete a questionnaire that contained indicators of their children’s dietary habits and socioeconomic status (n = 5608). Associations between SES and children’s dietary habits were assessed using logistic regression models. Results: The mother and father’s educational attainment were strongly positively associated with breakfast consumption. Children of parents with a lower educational level consumed sweetened beverages, sweet snacks, and fast food slightly more often than children in families with a higher educational background. The mother’s education was inversely associated with vegetable and cereal consumption, while the father’s education was inversely associated with fruit and bakery product consumption. Meanwhile, household income per unit had a significant influence on the consumption of soft drinks and bakery products. Household size had a significant influence solely on sweet snack consumption. Conclusions: Each SES indicator showed an independent association with at least one particular dietary habit, except for the parent’s employment status.

The coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus (SARS-CoV-2) has had a global effect on mortality. Many attempts were made to identify those at the highest risk of death if infected with SARS-CoV-...

The Circumplex Model of Marital and Family Systems is one of the most widely used approaches in family studies. This model assumes that family communication is an important element in achieving positive family functioning because it allows family members to alter their levels of flexibility and cohesion. While this theoretical approach has been widely used and tested there are still some gaps in the empirical evidence on the universality of its assumptions. Considering that adolescents today live in a wide variety of families, that are very diverse according to their structures, it is important from an ethical standpoint to test the universality of any theoretical framework that is used in family interventions. This study therefore sought to investigate whether there are differences in satisfaction with family life and family communication in families with different structures and whether family communication is an important correlate of satisfaction with family life in all types of families, using data from a study of adolescents from Zagreb, Croatia (N = 4 821). Linear regression was used to evaluate the association of family satisfaction (dependent variable) with family communication and parental marital status (predictor variables) with the additional inclusion of interaction effects between family communication and parental marital status. The results of this study have shown that adolescents are generally satisfied with their family life and that there are differences in perceived family satisfaction and family communication between adolescents regarding the marital status of their parents. The results presented in this paper support the main hypothesis that in families with adolescents, family communication is strongly associated with family satisfaction, independently of parental marital status. The findings suggest that interventions aimed at improving family communication skills inadolescent families could benefit all families with adolescents.

Given the importance of physical activity for the prevention of overweight, this study sought to determine the type and number of physical activity risk behaviours that were associated with overweight in Croatian school children and their association...

Objectives To determine the relationship between socioeconomic development (SD) of local administrative units (LAU) and the height and body mass index (BMI) of second- and third-grade children in Croatia. Methods We analyzed average height-for-age and BMI-for-age z-scores of 99 LAUs, based on the measurement of 5662 children participating in the Childhood Obesity Surveillance Initiative Croatia. SD was defined according to the governmental Development index. Pearson’s correlations between average height and BMI z-scores and SD were calculated. We used ANOVA to test differences in average height and BMI z-scores among LAUs from different SD quartiles and multiple linear regression to investigate the association between average height-for-age z-scores and SD. Results Height-for-age was significantly correlated with SD. We found a difference in average height-for-age between the least and more developed LAUs. A multiple linear regression model showed significant association between Development index and the average height-for-age z-score (F = 13.085, p < 0.001, R² = 0.119). Conclusions This finding is important for creators of policies worldwide as socioeconomic inequalities in children’s height may exist in other countries that, like Croatia, have recently gone through the transition process.

Drug use is a phenomenon which seriously disturbs the health and the ability to function socially and in a balanced manner for a large number of young people in Croatia who are at the most sensitive stage of their individual development...