Findings from the study conducted under the European Childhood Obesity Surveillance Initiative (COSI) show significant challenges related to nutrition and body weight among children aged 6 to 9 years in N. Macedonia.

Body weight

31.2% of children have excess body weight, and 13.7% live with obesity—which is above the average for the World Health Organization European region, at 25% and 11%, respectively.
Excess body weight and obesity are more common among boys than girls.

Dietary habits

Only 25% of children eat fresh fruit daily—the lowest daily fruit consumption in the entire European Region.
20% consume fresh vegetables every day, which is also among the lowest levels in Europe.
40% of children consume salty snacks, the highest proportion among the countries included in the COSI study in the European region.
More than half (51%) of children regularly consume sweet snacks three or more days per week.

Physical activity

40% of children spend more than two hours per day in front of screens (television or electronic devices).
63.3% of children walk or cycle to school; among those who live within 2 km, this habit is practiced by as many as 89%.
94% of children have at least one hour of active play daily at moderate to vigorous intensity.
48.2% actively participate in sports or dancing for more than two hours per week.
A large majority, 88.6%, sleep at least 9 hours per night.

Social factors and parental perception

Children with excess body weight and obesity tend to live in families where parents have low or medium levels of formal education.
Children who practice health-supporting habits more often live with parents who have a higher level of education.

There is low parental awareness in recognizing excess body weight and obesity in their children. For more than half of the children living with excess body weight and/or obesity, parents perceived their children’s weight as being within the recommended “normal weight” range.

Conclusion

These results highlight the urgent need for systemic interventions in children’s school and family environments in order to promote healthy growth and development.

Interventions are also needed in other areas. Food reformulation, food-related information, advertising, the urban environment, and opportunities for safe movement and physical activity are just some of them.