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Prevalence and trends of underweight in European children and adolescents: a systematic review and meta-analysis

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Abstract

Purpose

This study aimed at providing prevalence trend estimates of underweight among children and adolescents in Europe from 2000 to 2017.

Methods

MEDLINE, Web of Science, Scopus and CINAHL were searched from their inception up to March 2020. Moreover, searches were conducted on health institutions’ websites to identify studies not published in scientific journals. Underweight was defined according to the body mass index (BMI) cut-offs proposed by the International Obesity Task Force (IOTF) and the World Health Organization (WHO) definition criteria. The Mantel–Haenszel method was used to compute the pooled prevalence estimates whenever there was no evidence of heterogeneity; otherwise, the DerSimonian and Laird random-effects method was used. Subgroup analyses by sex, age range (2–13 and 14–18 years old), study year (2000–2006 and 2007–2017), country and European region were conducted.

Results

A total of 49 studies with data from 323,420 children and adolescents aged 2 to 18 years, from 26 countries were included. From 2000 to 2017, according to the IOTF criteria, the prevalence of underweight showed an increasing trend in Eastern, Northern and Southern Europe, where the underweight prevalence ranged from 9.1 to 12.0%, from 4.1 to 6.8%, and from 5.8 to 6.7%, respectively. In Western Europe, the prevalence of underweight tended to decrease, from 14.0 to 11.8%. No significant differences were found by sex or age range.

Conclusion

The prevalence of underweight is considerable (overall, around 8–9%), particularly in Eastern Europe, and follows a slight upward trend during the past decade.

Systematic review registration

PROSPERO CRD42017056924.

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Funding

This study was funded by FEDER funds.

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Authors and Affiliations

  1. Universidad de Castilla-La Mancha, Health and Social Research Center, C/ Santa Teresa Jornet, s/n, 16071, Cuenca, Spain

    Miriam Garrido-Miguel, Vicente Martínez-Vizcaíno, María Martínez-Andrés, Irene Sequí-Domínguez, Luis Enrique Hernández-Castillejo & Iván Cavero-Redondo

  2. Universidad de Castilla-La Mancha, Faculty of Nursing, Albacete, Spain

    Miriam Garrido-Miguel & María Martínez-Andrés

  3. Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, Talca, Chile

    Vicente Martínez-Vizcaíno

  4. EPIUnit, Instituto de Saúde Pública da Universidade do Porto [Institute of Public Health, University of Porto], Porto, Portugal

    Andreia Oliveira

  5. Faculty of Medicine, University of Porto, Porto, Portugal

    Andreia Oliveira

  6. Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay

    Iván Cavero-Redondo

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  1. Miriam Garrido-Miguel
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  2. Vicente Martínez-Vizcaíno
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  3. Andreia Oliveira
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  4. María Martínez-Andrés
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  5. Irene Sequí-Domínguez
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Contributions

MG-M had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. MG-M and VM-V designed the study; MG-M and IC-R performed the data analysis, and AO, MM-A, IS-D AND LEH-C interpreted the findings. All authors approved the final manuscript.

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Correspondence to Vicente Martínez-Vizcaíno.

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Garrido-Miguel, M., Martínez-Vizcaíno, V., Oliveira, A. et al. Prevalence and trends of underweight in European children and adolescents: a systematic review and meta-analysis. Eur J Nutr 60, 3611–3624 (2021). https://doi.org/10.1007/s00394-021-02540-0

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