Scale and Dynamics of Overweight and Obesity Epidemic in Croatia

The prevalence of overweight and obesity is showing a strong increasing trend in most countries. We aimed to investigate the scale and dynamics of the overweight and obesity epidemic in Croatia, by comparing the data from the Croatian Health Survey (CHS) from 1997-1999 (N=5, 048) with the Croatian Adult Health Survey (CAHS) from 2003 (N=9, 070). Weighted data from the CAHS were used, based on a complex seven steps scheme employed to ensure the creation of representative sample of the adult Croatian population in terms of regional, urban-rural and household characteristics and in order to adjust for nonresponders [1]. Both surveys were previously shown to be representative for the Croatian adult population, compared to the 2001 official Census data [2]. Gender and age groups (18-34, 35-49, 50-64 and 65 and more) stratified prevalence of overweight and obesity were calculated in both surveys. Interestingly, the prevalence of overweight (BMI≥25 kg/m2) in men of all ages decreased from 45.7% in 1997-1999 to 43.3% in 2003 (-5.3% of percent change), while the prevalence of obesity (BMI≥30 kg/m2) increased from 12.6% to 20.2% (+60.3%). In women the prevalence of overweight increased from 31.6% to 33.6% (+6.3%), while the prevalence of obesity increased from 14.9% to 20.6% (+38.3%). However, the age stratified prevalence of obesity showed the highest increase in the youngest age group (18-34), where the increase in men was 83.6%, while in women the prevalence of obesity increased 320%, from 1.5% to 6.3%. Notably, the estimates for the youngest age groups were based on the sufficient sample sizes (a total of 1, 398 in the CHS and 1, 414 respondents in the CAHS), thus reducing the possibility that these changes were the consequence of the small sample size. In contrast to commonly referred lack of information for policy on cardiovascular diseases [3], the results of this study suggest that the youngest adults (especially women) should be treated as a priority population group that requires substantial public health intervention aiming to reduce the epidemic of overweight and obesity. Without such an intervention, we are most likely to expect substantial increase in the prevalence of obesity in the years to come. However, it should be pointed out that in some countries obesity rates have recently seemingly plateaued at a high level.