Public health professionals from nine countries in Southern and Eastern Europe are equipped to use a stable isotope method to assess body composition following a four-year project to strengthen efforts to reduce childhood overweight and obesity, with IAEA support.
While the rates of undernutrition are small in most European countries, rates of childhood overweight and obesity are high – and isotope techniques can help provide the information policymakers need to tackle it.
With a long-term vision to halt future potential epidemics of diabetes and heart disease which can result from overweight, public health professionals from Albania, Bosnia & Herzegovina, Greece, Hungary, Latvia, Montenegro, Moldova, North Macedonia, Portugal and Ukraine have been exploring the use of the deuterium dilution technique, which goes beyond the measure of weight and height by assessing the fat and fat free mass proportions of body weight. The technique is based on measuring total body water using deuterium, a stable isotope of hydrogen. Because fat does not include water, the total body water is indicative of the fat free mass. Fat mass can then be calculated by subtracting fat free mass from body weight. For more information, see this page.
With this technique now in their toolbox, public health institutions can generate better data on body composition to inform public health programmes at both the national and regional levels.
“Detailed and accurate methods are needed to assess whether interventions are really effective,” said Cornelia Loechl, Head of the Nutritional and Health-Related Environmental Studies Section at the IAEA. “The deuterium dilution technique is the right technique to verify whether interventions to prevent or reduce overweight in children lead to the desired loss of fat.”
In 2014, the World Health Organization (WHO) estimated that every third 11-year-old child in Europe and Central Asia was overweight or obese. The WHO-supported Childhood Obesity Surveillance Initiative (COSI) is gathering data on the weight and height of several hundred thousands of school children in more than 40 countries and the numbers give cause for great concern, Loechl said. The COSI data has led to increased awareness and action, and improvements are observed in the most affected countries in Southern Europe. At the same time, the overall magnitude of overweight has not improved much. A continuous preventative effort to improve dietary habits, limit sedentary behaviour and increase physical activity of school children is needed, according to WHO.
“Even with COSI running regularly in the country and showing that childhood obesity is a growing public health problem, we do not yet have any programmes in place to combat this health risk in North Macedonia,” said Igor Spiroski from the country’s Institute of Public Health. “The deuterium dilution technique to measure body composition will support the assessment of the population’s health and ultimately shape policy propositions.”
The WHO Regional Office for Europe has welcomed the IAEA initiative. “We are very keen on this collaboration,” said João Breda, Head of the WHO European Office for the Prevention and Control of Noncommunicable Diseases. “While WHO continues to use the body mass index (BMI) for surveillance purposes, we fully acknowledge that body composition can complement the population surveillance and offer the extra mile. Body composition provides the opportunity to measure progress in weight loss interventions.”
The regional project, supported by the IAEA's Technical Cooperation Programme, involved capacity building in terms of training and laboratory equipment, and public health professionals from the region were able to network and exchange experiences with colleagues from other countries. Alban Ylli, a public health specialist from Albania, said: “We have been able to build a network of professionals who will continue to work together for a long time after the end of the project. In addition to sharing data and knowledge between institutions, it may provide an excellent opportunity for future consortiums to compete in European Union research and development programmes.”
