• Overview
  • Obesity prevalence
  • Trends over time
  • Population breakdowns
  • Drivers
  • Comorbidities
  • Economic impact
  • Policies
  • Contextual factors
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National obesity risk *8/10This is a composite ‘obesity risk’ score (out of 10, the highest risk) based on obesity prevalence, rate of increase, likelihood of meeting the 2025 target, treatment indicator and childhood stunting levels.Childhood obesity risk *7.5/11This is a ‘risk score’ for each country’s likelihood of having or acquiring a major childhood obesity problem during the 2020s, taking account of current prevalence levels and risk for future obesity (based on stunting among infants, maternal obesity, maternal smoking, and breastfeeding rates).
* Based on estimated data. For more information see Publications

Obesity prevalence

Trends over time

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Population breakdowns

By education

By age

By region

By socio-economic group

Limited activity

Drivers

Insufficient activity

Sugar consumption

Soft drink consumption

Confectionery consumption

Sweet/savoury snack consumption

Fruit consumption

Vegetable consumption

Processed meat consumption

Grains consumption

Depression

Anxiety

Roots of obesity »

Like all chronic diseases, the root causes/drivers of obesity are complex. Select here to view 'other' root causes/drivers.

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Comorbidities

Oesophageal cancer

Breast cancer

Colorectal cancer

Pancreatic cancer

Gallbladder cancer

Kidney cancer

Cancer of the uterus

Raised blood pressure

Raised cholesterol

Raised fasting blood glucose

Diabetes prevalence

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Economic impact

Economic cost

Policies

Nutritional or Health Strategy

Marketing

Physical Activity

Community Interventions

Labelling

NCD Strategy

Health Effectiveness Reviews

School Food Regulations

Breastfeeding

Obesity Target

Multisectoral national mechanism for obesity

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Contextual factors

Contextual factors

Obesity prevalence

Adults, 2019

Survey type:Self-reported
Age:18+
Area covered:National
References:Eurostat 2019. Data available at https://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1i&lang=en (last accessed 09.08.21)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².
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Adults, 2019-2020

Survey type:Self-reported
Age:15+
Sample size:6410
Area covered:National
References:EHIS 2019 Preliminary Results Bulgaria. Available at: https://www.nsi.bg/en/content/18648/preliminary-data. Last accessed: 02.06.21.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².
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Adults, 2017

Survey type:Self-reported
Age:18+
Area covered:National
References:EUROSTAT Database http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=ilc_hch10&lang=en
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².
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Adults, 2014

Survey type:Self-reported
Age:18+
Area covered:National
References:Eurostat Database:http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1e&lang=en (last accessed 25.08.20)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².
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Adults, 2004

Survey type:Measured
Age:20+
Sample size:1031
Area covered:National
References:S. Petrova, K. Angelova (2006) Scientific background of Food-Based Dietary Guidelines for Bulgarians. Advances in Bulgarian Science, 4, pp.19 - 33.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².
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Adults, 2000-2003

Survey type:Self-reported
Age:15+
Area covered:National
References:Eurostat Yearbook 2006/07. A goldmine of statistical information. Available at https://ec.europa.eu/eurostat/documents/2995521/5059290/1-20022007-BP-EN.PDF.pdf/edab8c31-b9f3-4c8e-b4db-4137bd045efa?t=1414683510000 (last accessed 04.11.21)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².
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Adults, 1994

Survey type:Measured
Age:25-74
Sample size:1996
References:WHO Infobase Ref:Vasilevski N, Tulevski B, Vukov M, Ilieva P, Marinova P, Iordaiov L. Risk factors and health of the population aged 25-64 years in the demonstration area Lovech of the Programme CINDI-Bulgaria. 1998
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².
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Children, 2015-2017

Survey type:Measured
Age:7
Sample size:3,386
Area covered:National
References:WHO European Childhood Obesity Surveillance Initiative (COSI) Report on the fourth round of data collection, 2015–2017 (2021). Available at: https://www.euro.who.int/en/health-topics/disease-prevention/nutrition/activities/who-european-childhood-obesity-surveillance-initiative-cosi/cosi-publications/who-european-childhood-obesity-surveillance-initiative-cosi-report-on-the-fourth-round-of-data-collection,-20152017-2021. Accessed 19.05.21.
Cutoffs:WHO
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Children, 2011

Survey type:Measured
Age:6-9
Sample size:4360
Area covered:National
References:Rangelova L, Petrova S, Konstantinova M, Duleva V, Dimitrov P. Overweight and obesity prevalence in Bulgarian schoolchildren: Acomparison between two international standards. International Journal of Biomedical And Advance Research (2014) ISSN: 2229-3809 (Online)
Notes:NB. Combined child data estimated. These estimates were calculated by weighting male and female survey results. Weighting based on World Bank Population % total female 2019 (https://data.worldbank.org/indicator/SP.POP.TOTL.FE.ZS - accessed 21.10.20)'
Cutoffs:IOTF
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Children, 2007-2008

Survey type:Measured
Age:7
Sample size:2917
Area covered:National
References:Lissner L, Wijnhoven TMA, Mehlig K, et al. Socioeconomic inequalities in childhood overweight: heterogeneity across five countries in the WHO European Childhood Obesity Surveillance Initiative (COSI–2008). International Journal of Obesity (2005). 2016;40(5):796-802. doi:10.1038/ijo.2016.12.
Notes:WHO Cut-offs
Cutoffs:WHO
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Children, 2007-2013

Survey type:Measured
Age:7
Sample size:5848
Area covered:National
References:Spinelli et al (2019). 'Childhood Severe Obesity in Europe', Obes Facts.12, pp. 244–258. (Data from COSI round 1-3)
Notes:NOTE - this data is from COSI round I and III (2007 - 2013) IOTF cut-offs used.
Cutoffs:IOTF
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Children, 2004

Survey type:Measured
Age:5-17
Sample size:1326
Area covered:National
References:Petrova S. (2005). Current problems in nutrition of children in Bulgaria. GP News, 12: 5 - 8.
Notes:IOTF Cut off. Reference: Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: International survey. BMJ. 2000 May 6;320(7244):1240-3.
Cutoffs:IOTF
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Boys, 2000

Survey type:Measured
Age:7-12
Sample size:1202
References:Personal communication from Maria Konstantinova
Notes:90/97th centile cut off
Cutoffs:Other
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Children, 1998

Survey type:Measured
Age:7-17
Sample size:6655
Area covered:National
References:Petrova S, Vatralova Kr, Ivanova L, et al. (2001). National Survey of Dietary and Nutritional Status of schoolchildren in Bulgaria. Anthropometric Nutritional status of schoolchildren aged 7 - 10 years. Hygiene and Public Health, vol XIV in press. (2) Petrova S, Vatralova Kr, Ivanova L, et al. (2001). National Survey of Dietary and Nutritional Status of schoolchildren in Bulgaria. Anthropometric Nutritional status of schoolchildren aged 10 - 18 years. Hygiene and Public Health, vol XIV.
Notes:IOTF Cut off. Reference: Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: International survey. BMJ. 2000 May 6;320(7244):1240-3.
Cutoffs:IOTF
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Overweight/obesity by age and education

Adults, 2019

Survey type:Self-reported
Area covered:National
References:Eurostat 2019. Available at https://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1e&lang=en (last accessed 09.08.21).
Notes:Insufficient sample size in 18-24 when broken down by gender and education
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².
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Men, 2019

Survey type:Self-reported
Area covered:National
References:Eurostat 2019. Available at https://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1e&lang=en (last accessed 09.08.21).
Notes:Insufficient sample size in 18-24 when broken down by gender and education
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².
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Women, 2019

Survey type:Self-reported
Area covered:National
References:Eurostat 2019. Available at https://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1e&lang=en (last accessed 09.08.21).
Notes:Insufficient sample size in 18-24 when broken down by gender and education
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².
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Men, 2017

Survey type:Self-reported
Area covered:National
References:Eurostat Database http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=ilc_hch10&lang=en (last accessed 25.08.20)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².
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Women, 2017

Survey type:Self-reported
Area covered:National
References:Eurostat Database http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=ilc_hch10&lang=en (last accessed 25.08.20)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².
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Men, 2014

Survey type:Self-reported
Area covered:National
References:Eurostat Database:http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1e&lang=en (last accessed 25.08.20)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².
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Women, 2014

Survey type:Self-reported
Area covered:National
References:Eurostat Database:http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1e&lang=en (last accessed 25.08.20)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².
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Overweight/obesity by education

Men, 2014

Survey type:Self-reported
Age:18+
Sample size:Total sample size in EU = 35100 (Age 18+)
Area covered:National
References:Eurostat Database:http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1e&lang=en (last accessed 9 November 2016)
Notes:Less than primary, primary and lower secondary education (levels 0-2) Upper secondary and post-secondary non-tertiary education (levels 3 and 4) Tertiary education (levels 5-8)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².
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Women, 2014

Survey type:Self-reported
Age:18+
Sample size:Total sample size in EU = 35100 (Age 18+)
Area covered:National
References:Eurostat Database:http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1e&lang=en (last accessed 9 November 2016)
Notes:Less than primary, primary and lower secondary education (levels 0-2) Upper secondary and post-secondary non-tertiary education (levels 3 and 4) Tertiary education (levels 5-8)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².
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Men, 2008

Survey type:Self-reported
Age:18+
Area covered:National
References:http://ec.europa.eu/eurostat/web/health/health-status-determinants/data/database# (last accessed 17th July 2015)
Notes:Definitions: Level 0-2 = Pre-primary, primary and lower secondary education, Level 3-4 = Upper secondary and post-secondary non-tertiary education, Level 5-6 = First and second stage of tertiary education.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².
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Women, 2008

Survey type:Self-reported
Age:18+
Area covered:National
References:http://ec.europa.eu/eurostat/web/health/health-status-determinants/data/database# (last accessed 17th July 2015)
Notes:Definitions: Level 0-2 = Pre-primary, primary and lower secondary education, Level 3-4 = Upper secondary and post-secondary non-tertiary education, Level 5-6 = First and second stage of tertiary education.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².
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Boys, 2012-2014

Survey type:Measured
Age:8-15
Sample size:881
Area covered:Smolyan region
References:Mladenova S, Andreenko E. Influence of socio-economic and demographic factors, feeding and physical activity on nutritional status of 8-15-year-old Bulgarian children and adolescents: preliminary results. Nutr Hosp. 2015;32(6):2559-2569.
Notes:Prevalence of obesity and overweight by Mother's level of Education. IOTF cut-off points used.
Cutoffs:IOTF
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Girls, 2012-2014

Survey type:Measured
Age:8-15
Sample size:881
Area covered:Smolyan region
References:Mladenova S, Andreenko E. Influence of socio-economic and demographic factors, feeding and physical activity on nutritional status of 8-15-year-old Bulgarian children and adolescents: preliminary results. Nutr Hosp. 2015;32(6):2559-2569.
Notes:Prevalence of obesity and overweight by Mother's level of Education. IOTF cut-off points used.
Cutoffs:IOTF
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Boys, 2012-2014

Survey type:Measured
Age:8-15
Sample size:881
Area covered:Smolyan region
References:Mladenova S, Andreenko E. Influence of socio-economic and demographic factors, feeding and physical activity on nutritional status of 8-15-year-old Bulgarian children and adolescents: preliminary results. Nutr Hosp. 2015;32(6):2559-2569.
Notes:Prevalence of obesity and overweight by Father's level of Education. IOTF cut-off points used.
Cutoffs:IOTF
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Girls, 2012-2014

Survey type:Measured
Age:8-15
Sample size:881
Area covered:Smolyan region
References:Mladenova S, Andreenko E. Influence of socio-economic and demographic factors, feeding and physical activity on nutritional status of 8-15-year-old Bulgarian children and adolescents: preliminary results. Nutr Hosp. 2015;32(6):2559-2569.
Notes:Prevalence of obesity and overweight by Father's level of Education. IOTF cut-off points used.
Cutoffs:IOTF
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Overweight/obesity by age

Adults, 2019

Survey type:Self-reported
Area covered:National
References:Eurostat 2019. Available at https://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1i&lang=en (last accessed 09.08.21).
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².
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Adults, 2019-2020

Survey type:Self-reported
Sample size:6410
Area covered:National
References:EHIS 2019 Preliminary Results Bulgaria. Available at: https://www.nsi.bg/en/content/18648/preliminary-data. Last accessed: 02.06.21.
Notes:Percentage of 15-24 year olds living with obesity data is missing.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².
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Adults, 2017

Survey type:Self-reported
Area covered:National
References:Eurostat Database http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=ilc_hch10&lang=en (last accessed 25.08.20)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².
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Adults, 2004

Survey type:Measured
Sample size:1031
Area covered:National
References:S. Petrova, K. Angelova (2006) Scientific background of Food-Based Dietary Guidelines for Bulgarians. Advances in Bulgarian Science, 4, pp.19-33
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².
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Children, 2017-2018

Survey type:Measured
Sample size:4548
Area covered:National
References:World Health Organization (2020). Spotlight on adolescent health and well-being - Findings from the 2017/2018 Health Behaviour in School-aged Children (HBSC) survey in Europe and Canada. Available at: https://apps.who.int/iris/bitstream/handle/10665/332091/9789289055000-eng.pdf. Last accessed: 20.05.21.
Cutoffs:WHO
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Children, 2004

Survey type:Measured
Sample size:1059
Area covered:National
References:Petrova S. (2005). Current problems in nutrition of children in Bulgaria. GP News, 12: 5 - 8.
Cutoffs:IOTF
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Children, 1998

Survey type:Measured
Sample size:6115
Area covered:National
References:Provided by personal communication from S Petrova. Published in S. Petrova, Kr. Vatralova, L. Ivanova et al. National Survey of Dietary and Nutritional Status of Schoolchildren in Bulgaria. Anthropometric Nutritional Status of schoolchildren aged 7-10 years. Hygiene and Public Health, 2001, vol. XIV 2) S. Petrova, Kr. Vatralova, L. Ivanova et al. National Survey of Dietary and Nutritional Status of Schoolchildren in Bulgaria. Anthropometric Nutritional Status of Schoolchildren aged 10-18 years. Hygiene and Public Health, 2001, vol. XIV,
Cutoffs:IOTF
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Overweight/obesity by age and region

Men, 2014

Survey type:Self-reported
Area covered:National
References:Eurostat Database http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1u&lang=en (last accessed 25.08.20)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².
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Women, 2014

Survey type:Self-reported
Area covered:National
References:Eurostat Database http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1u&lang=en (last accessed 25.08.20)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².
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Overweight/obesity by age and socio-economic group

Adults, 2019

Survey type:Self-reported
Area covered:National
References:Eurostat 2019. Available at https://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1i&lang=en (last accessed 09.08.21).
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².
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Men, 2019

Survey type:Self-reported
Area covered:National
References:Eurostat 2019. Available at https://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1i&lang=en (last accessed 09.08.21).
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².
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Women, 2019

Survey type:Self-reported
Area covered:National
References:Eurostat 2019. Available at https://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1i&lang=en (last accessed 09.08.21).
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².
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Adults, 2014

Survey type:Self-reported
Area covered:National
References:Eurostat Database http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1i&lang=en (last accessed 25.08.20)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².
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Men, 2014

Survey type:Self-reported
Area covered:National
References:Eurostat Database http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1i&lang=en (last accessed 25.08.20)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².
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Women, 2014

Survey type:Self-reported
Area covered:National
References:Eurostat Database http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1i&lang=en (last accessed 25.08.20)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².
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Overweight/obesity by socio-economic group

Men, 2014

Survey type:Self-reported
Age:18+
Area covered:National
References:EUROSTAT Database: http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1i&lang=en (last accessed 9 November 2016)
Notes:Total sample number in EU: 35100 (Age 18+) 1st Quintile (lowest income), 5th Quintile (highest income) Please note where data = zero, there were insufficient data.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².
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Women, 2014

Survey type:Self-reported
Age:18+
Area covered:National
References:EUROSTAT Database: http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1i&lang=en (last accessed 9 November 2016)
Notes:Total sample number in EU: 35100 (Age 18+) 1st Quintile (lowest income), 5th Quintile (highest income) Please note where data = zero, there were insufficient data.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².
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Men, 2008

Survey type:Self-reported
Age:18+
Area covered:National
References:http://ec.europa.eu/eurostat/web/health/health-status-determinants/data/database# (last accessed 17th July 2015)
Notes:SES assessed using annual income
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².
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Women, 2008

Survey type:Self-reported
Age:18+
Area covered:National
References:http://ec.europa.eu/eurostat/web/health/health-status-determinants/data/database# (last accessed 17th July 2015)
Notes:SES assessed using annual income
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².
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Boys, 2017-2018

Survey type:Self-reported
Age:11-15
Sample size:4548
Area covered:National
References:World Health Organization (2020). Spotlight on adolescent health and well-being - Findings from the 2017/2018 Health Behaviour in School-aged Children (HBSC) survey in Europe and Canada. Available at: https://apps.who.int/iris/bitstream/handle/10665/332091/9789289055000-eng.pdf. Last accessed: 20.05.21.
Notes:HBSC Family Affluence Scale (FAS) - "HBSC uses an alternative measure, the Family Affluence Scale, which asks young people about material assets such as family cars, number of foreign holidays, computers, bathrooms and dishwashers in the household, holidays and having a bedroom to oneself. The scale, which enables users to add up how many of these assets a young person has in their home compared with other adolescents in their country/region, has been shown to provide a valid indicator of relative affluence."
Definitions:HBSC Family Affluence Scale (FAS)
Cutoffs:WHO
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Girls, 2017-2018

Survey type:Self-reported
Age:11-15
Sample size:4548
Area covered:National
References:World Health Organization (2020). Spotlight on adolescent health and well-being - Findings from the 2017/2018 Health Behaviour in School-aged Children (HBSC) survey in Europe and Canada. Available at: https://apps.who.int/iris/bitstream/handle/10665/332091/9789289055000-eng.pdf. Last accessed: 20.05.21.
Notes:HBSC Family Affluence Scale (FAS) - "HBSC uses an alternative measure, the Family Affluence Scale, which asks young people about material assets such as family cars, number of foreign holidays, computers, bathrooms and dishwashers in the household, holidays and having a bedroom to oneself. The scale, which enables users to add up how many of these assets a young person has in their home compared with other adolescents in their country/region, has been shown to provide a valid indicator of relative affluence."
Definitions:HBSC Family Affluence Scale (FAS)
Cutoffs:WHO
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Overweight/obesity by age and limited activity

Adults, 2014

Survey type:Self-reported
Area covered:National
References:Eurostat 2014 available at https://appsso.eurostat.ec.europa.eu/nui/submitViewTableAction.do (last accessed 06.10.21)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².
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Women, 2014

Survey type:Self-reported
Area covered:National
References:Eurostat 2014 available at https://appsso.eurostat.ec.europa.eu/nui/submitViewTableAction.do (last accessed 06.10.21)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².
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Men, 2014

Survey type:Self-reported
Area covered:National
References:Eurostat 2014 available at https://appsso.eurostat.ec.europa.eu/nui/submitViewTableAction.do (last accessed 06.10.21)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².
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Insufficient physical activity

Adults, 2016

References:Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1.9 million participants. Lancet 2018 http://dx.doi.org/10.1016/S2214-109X(18)30357-7
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Men, 2016

References:Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1.9 million participants. Lancet 2018 http://dx.doi.org/10.1016/S2214-109X(18)30357-7
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Women, 2016

References:Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1.9 million participants. Lancet 2018 http://dx.doi.org/10.1016/S2214-109X(18)30357-7
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Children, 2016

Survey type:Self-reported
Age:11-17
References:Global Health Observatory data repository, World Health Organisation, https://apps.who.int/gho/data/node.main.A893ADO?lang=en (last accessed 16.03.21)
Notes:% of school going adolescents not meeting WHO recommendations on Physical Activity for Health, i.e. doing less than 60 minutes of moderate- to vigorous-intensity physical activity daily.
Definitions:% Adolescents insufficiently active (age standardised estimate)
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Boys, 2016

Survey type:Self-reported
Age:11-17
References:Global Health Observatory data repository, World Health Organisation, https://apps.who.int/gho/data/node.main.A893ADO?lang=en (last accessed 16.03.21)
Notes:% of school going adolescents not meeting WHO recommendations on Physical Activity for Health, i.e. doing less than 60 minutes of moderate- to vigorous-intensity physical activity daily.
Definitions:% Adolescents insufficiently active (age standardised estimate)
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Girls, 2016

Survey type:Self-reported
Age:11-17
References:Global Health Observatory data repository, World Health Organisation, https://apps.who.int/gho/data/node.main.A893ADO?lang=en (last accessed 16.03.21)
Notes:% of school going adolescents not meeting WHO recommendations on Physical Activity for Health, i.e. doing less than 60 minutes of moderate- to vigorous-intensity physical activity daily.
Definitions:% Adolescents insufficiently active (age standardised estimate)
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Children, 2010

Age:11-17
References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A893?lang=en
Notes:% of school going adolescents not meeting WHO recommendations on Physical Activity for Health, i.e. doing less than 60 minutes of moderate- to vigorous-intensity physical activity daily.
Definitions:% Adolescents insufficiently active (age standardised estimate)
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Boys, 2010

Age:11-17
References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A893?lang=en
Notes:% of school going adolescents not meeting WHO recommendations on Physical Activity for Health, i.e. doing less than 60 minutes of moderate- to vigorous-intensity physical activity daily.
Definitions:% Adolescents insufficiently active (age standardised estimate)
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Girls, 2010

Age:11-17
References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A893?lang=en
Notes:% of school going adolescents not meeting WHO recommendations on Physical Activity for Health, i.e. doing less than 60 minutes of moderate- to vigorous-intensity physical activity daily.
Definitions:% Adolescents insufficiently active (age standardised estimate)
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Sugar consumption

Adults, 2016

References:Source: Euromonitor International
Definitions:Sugar consumption (Number of 500g sugar portions/person/month)
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Estimated per capita sugar sweetened beverages intake

Adults, 2016

References:Source: Euromonitor International
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Prevalence of at least daily carbonated soft drink consumption

Children, 2014

Survey type:Measured
References:World Health Organization. (2017). Adolescent obesity and related behaviours: Trends and inequalities in the who european region, 2002-2014: observations from the Health Behavior in School-aged Children (HBSC) WHO collaborative cross-national study (J. Inchley, D. Currie, J. Jewel, J. Breda, & V. Barnekow, Eds.). World Health Organization. Sourced from Food Systems Dashboard http://www.foodsystemsdashboard.org
Notes:15-year-old adolescents
Definitions:Prevalence of at least daily carbonated soft drink consumption (% of at least daily carbonated soft drink consumption)
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Prevalence of confectionery consumption

Adults, 2016

References:Source: Euromonitor International
Definitions:Prevalence of confectionery consumption (Number of 50g confectionery portions/person/month)
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Prevalence of sweet/savoury snack consumption

Adults, 2016

References:Source: Euromonitor International
Definitions:Prevalence of sweet/savoury snack consumption (Number of 35g sweet/savoury snack portions/person/month)
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Estimated per capita fruit intake

Adults, 2017

Survey type:Measured
Age:25+
References:Global Burden of Disease, the Institute for Health Metrics and Evaluation http://ghdx.healthdata.org/
Definitions:Estimated per-capita fruit intake (g/day)
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Prevalence of less than daily fruit consumption

Children, 2014

Survey type:Measured
References:Global School-based Student Health Surveys. Beal et al (2019). Global Patterns of Adolescent Fruit, Vegetable, Carbonated Soft Drink, and Fast-food consumption: A meta-analysis of global school-based student health surveys. Food and Nutrition Bulletin. https://doi.org/10.1177/0379572119848287. Sourced from Food Systems Dashboard http://www.foodsystemsdashboard.org/food-system
Definitions:Prevalence of less-than-daily fruit consumption (% less-than-daily fruit consumption)
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Prevalence of less than daily vegetable consumption

Children, 2014

Survey type:Measured
Age:12-17
References:Beal et al. (2019). Global Patterns of Adolescent Fruit, Vegetable, Carbonated Soft Drink, and Fast-food consumption: A meta-analysis of global school-based student health surveys. Food and Nutrition Bulletin. https://doi.org/10.1177/0379572119848287 sourced from Food Systems Dashboard http://www.foodsystemsdashboard.org/food-system
Definitions:Prevalence of less-than-daily vegetable consumption (% less-than-daily vegetable consumption)
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Estimated per-capita processed meat intake

Adults, 2017

Survey type:Measured
Age:25+
References:Global Burden of Disease, the Institute for Health Metrics and Evaluation http://ghdx.healthdata.org/
Definitions:Estimated per-capita processed meat intake (g per day)
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Estimated per capita whole grains intake

Adults, 2017

Survey type:Measured
Age:25+
References:Global Burden of Disease, the Institute for Health Metrics and Evaluation http://ghdx.healthdata.org/
Definitions:Estimated per-capita whole grains intake (g/day)
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Mental health - depression disorders

Adults, 2015

References:Prevalence data from Global Burden of Disease study 2015 (http://ghdx.healthdata.org) published in: Depression and Other Common Mental Disorders: Global Health Estimates. Geneva:World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO.
Definitions:% of population with depression disorders
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Mental health - anxiety disorders

Adults, 2015

References:Prevalence data from Global Burden of Disease study 2015 (http://ghdx.healthdata.org) published in: Depression and Other Common Mental Disorders: Global Health Estimates. Geneva:World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO.
Definitions:% of population with anxiety disorders
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Oesophageal cancer

Men, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, oesophagus, adults ages 20+. ASR (World) per 100,000
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Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, oesophagus, adults ages 20+. ASR (World) per 100,000
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Breast cancer

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, breast, females, ages 20+. ASR (World) per 100,000
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Colorectal cancer

Men, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, colorectum, adults, ages 20+. ASR (World) per 100,000
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Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, colorectum, adults, ages 20+. ASR (World) per 100,000
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Pancreatic cancer

Men, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, pancreas, adults, ages 20+. ASR (World) per 100,000
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Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, pancreas, adults, ages 20+. ASR (World) per 100,000
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Gallbladder cancer

Men, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, gallbladder, adults, ages 20+. ASR (World) per 100,000
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Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, gallbladder, adults, ages 20+. ASR (World) per 100,000
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Kidney cancer

Men, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, kidney, adults, ages 20+. ASR (World) per 100,000
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Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, kidney, adults, ages 20+. ASR (World) per 100,000
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Cancer of the uterus

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, cervix uteri, females, ages 20+. ASR (World) per 100,000
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Raised blood pressure

Adults, 2015

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A875?lang=en
Definitions:Age Standardised estimated % Raised blood pressure 2015 (SBP>=140 OR DBP>=90).
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Men, 2015

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A875?lang=en
Definitions:Age Standardised estimated % Raised blood pressure 2015 (SBP>=140 OR DBP>=90).
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Women, 2015

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A875?lang=en
Definitions:Age Standardised estimated % Raised blood pressure 2015 (SBP>=140 OR DBP>=90).
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Raised cholesterol

Adults, 2008

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A885
Definitions:% Raised total cholesterol (>= 5.0 mmol/L) (age-standardized estimate).
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Men, 2008

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A885
Definitions:% Raised total cholesterol (>= 5.0 mmol/L) (age-standardized estimate).
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Women, 2008

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A885
Definitions:% Raised total cholesterol (>= 5.0 mmol/L) (age-standardized estimate).
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Raised fasting blood glucose

Men, 2014

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A869?lang=en
Definitions:Age Standardised % raised fasting blood glucose (>= 7.0 mmol/L or on medication).
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Women, 2014

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A869?lang=en
Definitions:Age Standardised % raised fasting blood glucose (>= 7.0 mmol/L or on medication).
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Diabetes prevalence

Adults, 2021

Age:20-79
Area covered:National
References:Reproduced with kind permission International Diabetes Federation.  IDF Diabetes Atlas, 10th edn. Brussels, Belgium:International Diabetes Federation, 2021. http://www.diabetesatlas.org
Definitions:Age-adjusted comparative prevalence of diabetes, %
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Adults, 2019

Age:20-79
References:Reproduced with kind permission International Diabetes Federation. IDF Diabetes Atlas, 9th edn. Brussels,Belgium: 2019. Available at: https://www.diabetesatlas.org
Definitions:Diabetes age-adjusted comparative prevalence (%).
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Adults, 2017

References:Reproduced with kind permission of IDF, International Diabetes Federation. IDF Diabetes Atlas, 8th edition. Brussels, Belgium: International Diabetes Federation, 2017. http://www.diabetesatlas.org
Definitions:Diabetes age-adjusted comparative prevalence (%).
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Total economic cost as % of GDP

Country comparisons

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Policies, Interventions and Actions

Annex III to Regulation (EC) No 1925/2006 of the European Parliament and of the Council as regards trans fat, other than trans fat naturally occurring in fat of animal origin

Measures to limit or virtually eliminate industrially-produced trans fatty acids in food intended for the final consumer and/or for supply to retail. Adopted by The European Commission from April 2019. (Available in multiple languages)

Categories:Evidence of Marketing Guidelines/Policy
Year(s):2019 (ongoing)
Target age group:Adults and children
Organisation:The European Commission
Linked document:Download linked document
References:Information provided with kind permission of WHO Global database on the Implementation of Nutrition Action (GINA): https://extranet.who.int/nutrition/gina/en/node/36162 (last accessed 12.07.22)

Bulgarian Food Act

In 2017, the Bulgarian Parliament passed an amendment to the Food Act which prohibits the advertisement and marketing of genetically modified and 'unhealthy' foods to children - including via television, print, and online.

Categories:Evidence of Marketing Guidelines/Policy
Year(s):2017 (ongoing)
Target age group:Children
Find out more:sustainablepulse.com
References:https://www.cms-lawnow.com/ealerts/2020/08/new-bulgarian-food-act-to-guarantee-quality-of-foodstuffs-and-implement-eu-food-regulations?cc_lang=en

NATIONAL STRATEGY ON THE IMPLEMENTATION OF A KINDERGARTEN AND SCHOOL FRUIT, VEGETABLES, MILK AND MILK PRODUCTS SCHEME IN THE REPUBLIC OF BULGARIA

Educating children, teachers and parents on achieving a healthy balanced diet and undertaking physical activity by delivering lectures. The general objective of the school fruit/vegetables and milk and milk products scheme is to provide legal and financial conditions for the long-term increase in the share of theseproducts in children's diets, especially at the age when their nutritional habits are formed.

Categories:Evidence of Nutritional or Health Strategy/ Guidelines/Policy/Action plan
Categories (partial):Evidence of Community Interventions/Campaign
Year(s):2017-2022
Target age group:Children
Organisation:REPUBLIC OF BULGARIA MINISTRY OF AGRICULTURE, FOOD AND FORESTRY
Find out more:ec.europa.eu
Linked document:Download linked document
References:REPUBLIC OF BULGARIA MINISTRY OF AGRICULTURE, FOOD AND FORESTRY VALIDATED BY: (Signature) RUMEN POROZHANOV MINISTER OF AGRICULTURE, FOOD AND FORESTRY NATIONAL STRATEGY ON THE IMPLEMENTATION OF A KINDERGARTEN AND SCHOOL FRUIT, VEGETABLES, MILK AND MILK PRODUCTS SCHEME IN THE REPUBLIC OF BULGARIA FROM 2017/2018 SCHOOL YEAR TO 2022/2023 SCHOOL YEAR [Internet]. 2017b. Available from: https://ec.europa.eu/info/sites/info/files/food-farming-fisheries/key_policies/documents/bg-school-scheme-strategy-2017-23_en.pdf ‌

NCD Country Profiles 2018 (Obesity Targets)

The profiles also provide data on the key metabolic risk factors, namely raised blood pressure, raised blood glucose and obesity and National Targets on Obesity (as of 2017)

Categories:Evidence of Obesity Target
Year(s):2017 (ongoing)
Target age group:Adults and children
Organisation:World Health Organisation
References:Noncommunicable diseases country profiles 2018. Geneva: World Health Organization; 2018. Licence: CC BY-NC-SA 3.0 IGO.

School Fruit, Vegetables and Milk Scheme

"Applicable since 1 August 2017, the EU school fruit, vegetables and milk scheme combines two previous schemes (the school fruit and vegetables scheme and the school milk scheme) under a single legal framework for more efficiency and an enhanced focus on health and educational. The scheme supports the distribution of products, educational measures and information measures. The scheme supports the distribution of fruit, vegetables, milk and certain milk products to schoolchildren, from nursery to secondary school. EU countries approve a list of products (in collaboration with their health and nutrition authorities) which will help achieve the schemes objective of helping children to follow a healthy diet. Priority is for fresh fruit and vegetables and for plain milk. In order to support a varied diet and/or specific nutritional needs, EU countries may also make processed fruit and vegetables such as juices and soups and certain milk products such as yoghurt and cheese, available. Additionally, under stricter conditions, milk-based drinks may be included." - EU Commission

Categories:Evidence of Nutritional or Health Strategy/ Guidelines/Policy/Action plan
Year(s):2017 (ongoing)
Organisation:European Commission
Find out more:ec.europa.eu
References:https://ec.europa.eu/info/food-farming-fisheries/key-policies/common-agricultural-policy/market-measures/school-fruit-vegetables-and-milk-scheme/school-scheme-explained_en

Feel4Diabetes

The overall aim of the Feel4Diabetes programme was "developing and implementing a community-based intervention to promote behavioural changes and creating a more supportive social and physical environment to prevent diabetes in vulnerable families across Europe". The programme was in place in Finland, Belgium, Spain, Hungary, Bulgaria, and Greece.

Categories:Evidence of Community Interventions/Campaign
Year(s):2016-2018
Target age group:Adults and children
Find out more:feel4diabetes-study.eu
Linked document:Download linked document
References:https://feel4diabetes-study.eu/

GNPR 2016-2017: Infant and young child nutrition - Breastfeeding promotion and/or counselling

This programme was reported by countries for the 2nd WHO Global Nutrition Policy Review 2016-2017 module on actions related to infant and young child nutrition. Information provided by WHO GINA Programme.

Categories:Evidence of Breastfeeding promotion or related activity
Year(s):2016 (ongoing)
Target age group:Children
Find out more:extranet.who.int
References:Information provided with kind permission of WHO Global database on the Implementation of Nutrition Action (GINA): https://extranet.who.int/nutrition/gina/en

Joint Action on Nutrition and Physical Activity (JANPA)

The overall aim of the project is to contribute to halting the rise of overweight and obesity in children and adolescents by 2020.

Categories (partial):Evidence of Nutritional or Health Strategy/ Guidelines/Policy/Action plan
Evidence of Physical Activity Guidelines/Policy
Year(s):2015-2017
Target age group:Children
Organisation:European Commission
Find out more:www.janpa.eu
Linked document:Download linked document
References:Overview of the Joint Action JANPA HLG/EU Platform DG Santé Luxembourg [Internet]. 2017. Available from: https://ec.europa.eu/health/sites/health/files/nutrition_physical_activity/docs/ev_20171130_co05_en.pdf ‌

National Health Strategy 2015-2020

The strategy contains priorities and policies for overcoming the growing health challenges of Bulgarian citizens. The ways of linking health policies with measures ensuring equal treatment, the necessary impacts on the social determinants of health and the basic prerequisites for the functioning of the health system are presented.

Categories:Evidence of Nutritional or Health Strategy/ Guidelines/Policy/Action plan
Year(s):2015-2020
Target age group:Adults and children
Organisation:Ministry of Health
Find out more:extranet.who.int
Linked document:Download linked document
References:Policy - Национална Здравна Стратегия 2020 [National Health Strategy 2020] | Global database on the Implementation of Nutrition Action (GINA) [Internet]. extranet.who.int. [cited 2020g Jul 21]. Available from: https://extranet.who.int/nutrition/gina/en/node/24691. ‌

National program for prevention of chronic non-communicable diseases 2014-2020

The main objective of the program is to improve public health and enhance the quality of life by reducing premature mortality, morbidity and disability.

Categories:Evidence of NCD strategy
Year(s):2014-2020
Target age group:Adults and children
Organisation:Ministry of Health
Find out more:janpa-toolbox.eu
Linked document:Download linked document
References:NATIONAL PROGRAMME FOR PREVENTION OF NON-COMMUNICABLE DISEASES 2014-2020 [Internet]. Available from: https://janpa-toolbox.eu/files/Bulgaria-NATIONAL%20PROGRAMME%20FOR%20PREVENTION%20OF%20NON-COMMUNICABLE%20DISEASES%202014-2020.pdf ‌

NCD targets for Bulgaria

Bulgaria released their National Program for Prevention of Chronic Noncommunicable Diseases 2014-2020. NCD targets include: 'by 2020, halt the trend of increasing incidence of obesity in adults and children' & '20% reduction in premature mortality (death before 65 years) from cardiovascular disease by 2020'.

Categories:Evidence of NCD strategy
Year(s):2014-2020
Target age group:Adults and children
Find out more:srzi.bg
References:https://extranet.who.int/ncdccs/Data/BGR_Bulgaria_NCD_targets.pdf

Physical activity strategy

Bulgaria have published their own national recommendations on physical activity, as well as the National strategy for physical education and sports development 2012–2022 which aims "to highlight the social function of physical education (PE) and sports in Bulgaria, and the need for political, economic and social changes to improve the uptake of physical activity"

Categories:Evidence of Physical Activity Guidelines/Policy
Year(s):2012-2022
Target age group:Adults and children
References:https://www.euro.who.int/__data/assets/pdf_file/0010/288091/BULGARIA-Physical-Activity-Factsheet.pdf

EU Regulation 1169/2011

Passed in 2011, EU Regulation 1169/2011 on the Provision of Food Information to Consumers requires a list of the nutrient content of most pre-packaged food to be provided on the back of the pack from October 2011.

Categories:Labelling Regulation/Guidelines
Year(s):2011 (ongoing)
Target age group:Adults and children
Organisation:European Parliament and the Council of the European Union
Find out more:eur-lex.europa.eu
References:Information provided with kind permission of WHO Global database on the Implementation of Nutrition Action (GINA): https://extranet.who.int/nutrition/gina/en/node/22917 (last accessed 28.06.22)

Evaluation of the EU school milk and fruit scheme

European Court of Auditors (2011) Are the school milk and school fruit schemes effective? Special Report No 10. Publications Office of the European Union, Luxembourg.

Categories:Health Effectiveness Reviews (obesity related)
Year(s):2011 (ongoing)
Target age group:Children
Organisation:EUROPEAN COURT OF AUDITORS
Linked document:Download linked document
References:Information provided with kind permission of World Cancer Research Fund International from their NOURISHING framework www.wcrf.org/NOURISHING

Salt content regulations

Between 2011-12, legislation was introduced in Bulgaria which set mandatory limits on the maximum salt content of certain products: bread, cheese, meat and poultry products, and lutenica.

Categories:Evidence of Nutritional or Health Strategy/ Guidelines/Policy/Action plan
Year(s):2011 (ongoing)
References:https://ec.europa.eu/health/sites/default/files/nutrition_physical_activity/docs/salt_report1_en.pdf

The Toy Box Study

The Toy Box intervention is a multicomponent, kindergarten-based, family-involved intervention, focusing on the promotion of water consumption, healthy snacking, physical activity and the reduction/ breaking up of sedentary time in preschool children and their families.

Categories:Evidence of Community Interventions/Campaign
Year(s):2010-2014
Target age group:Adults and children
Organisation:EU funded multidisciplinary team project
Find out more:www.toybox-study.eu

School food ordinances

Ordinances in Bulgaria were mandated in the years of 2009, 2011, and 2013 which set restrictions for the standards (and nutrient content) of foods. The ordinances had a specific goal of reducing the levels of salt, fat, and sugar available in school food and also restricted the sale of certain items.

Categories:Evidence of Nutritional or Health Strategy/ Guidelines/Policy/Action plan
Evidence of School Food Regulations
Year(s):2009 (ongoing)
Target age group:Children
References:https://ec.europa.eu/jrc/sites/default/files/jrc-school-food-policy-factsheet-bulgaria_en.pdf

Food based dietary guidelines for adults in Bulgaria

While the main focus of this guideline is on diet and nutrition, it also contains guidelines on physical activity to maintain a healthy weight, suggesting to be physically active at least 60 minutes a day. The dietary guidelines were developed by an expert group from the National Center of Public Health Protection from the Ministry of Health, with support from the WHO Regional Office for Europe. The group also received input from consultative meetings with representatives from other relevant ministries, academia, associations of food producers and regional bodies for public health protection

Categories:Evidence of Nutritional or Health Strategy/ Guidelines/Policy/Action plan
Evidence of Physical Activity Guidelines/Policy
Year(s):2006 (ongoing)
Target age group:Adults
Organisation:Ministry of Health
Find out more:www.fao.org
Linked document:Download linked document
References:Bulgarie [Internet]. Food and Agriculture Organization of the United Nations. [cited 2020 Jul 21]. Available from: http://www.fao.org/nutrition/education-nutritionnelle/food-dietary-guidelines/regions/bulgaria/fr/ ‌

FOOD BASED DIETARY GUIDELINES FOR ADULTS IN BULGARIA

National food guidelines for Bulgaria

Categories:Evidence of Nutritional or Health Strategy/ Guidelines/Policy/Action plan
Year(s):2006 (ongoing)
Target age group:Adults
Linked document:Download linked document

Executive committee (Program council) of Food and Nutrition Action Plan 2005-2010

National Multisectoral stakeholder mechanism in place (such as Coalition, Taskforce, Committee) for Obesity or Nutrition (including obesity)

Categories:Evidence of a multi-sectoral national coordination mechanism for obesity or nutrition (including obesity)
Year(s):2005-2010
Target age group:Adults and children
Organisation:Ministry of Health
Linked document:Download linked document

Food And Nutrition Action Plan 2005 - 2010

The plan calls for legislative measures on the marketing of unhealthy foods for children (TBI, MH 2005-2006) and new standards for nutritional content, food labelling, and food marketing to reduce the risk for obesity and its complications. The NFNAP was launched in December 2004 and adopted by the Council of Ministers in August 2005. The strategic goal is to improve the health of the Bulgarian population by improving nutrition and the reducing the risk of foodborne and diet-related chronic diseases. The Action Plan covers the three strategic areas of nutrition, food safety and food security

Categories (partial):Evidence of Nutritional or Health Strategy/ Guidelines/Policy/Action plan
Year(s):2005-2010
Target age group:Adults and children
Organisation:Council of Ministers
Find out more:extranet.who.int
Linked document:Download linked document
References:Policy - Food and Nutrition Action Plan 2005-2010 | Global database on the Implementation of Nutrition Action (GINA) [Internet]. extranet.who.int. [cited 2020 Jul 21]. Available from: https://extranet.who.int/nutrition/gina/en/node/8062 ‌

Framework for Responsible Commercial Communication of Food and Drinks

Self-regulatory policy introduced in Bulgaria by: the Bulgarian Association of Advertisers (BAA), the Association of the Advertising Agencies - Bulgaria (ARA) and the Association of the Bulgarian Radio- and TV operators (ABBRO). Aims to achieve responsible marketing of food and drinks towards children.

Categories:Evidence of Marketing Guidelines/Policy
Target age group:Children
Find out more:www.nss-bg.org

GNPR 2016-17 (q7) Breastfeeeding promotion and/or counselling

WHO Global Nutrition Policy Review 2016-2017 reported the evidence of breastfeeding promotion and/or counselling (q7)

Categories:Evidence of Breastfeeding promotion or related activity
Target age group:Adults
Organisation:Ministry of Health (information provided by the GINA progam)
Find out more:extranet.who.int
References:Information provided with kind permission of WHO Global database on the Implementation of Nutrition Action (GINA): https://extranet.who.int/nutrition/gina/en

No actions could be found for the above criteria.

Contextual factors

Disclaimer: These contextual factors should be interpreted with care. Results are updated as regularly as possible and use very specific criteria. The criteria used and full definitions are available for download at the bottom of this page.

Tap on a tick to find out more about policies influencing this factor.

Labelling

Is there mandatory nutrition labelling?Present
Front-of-package labelling?Absent
Back-of-pack nutrition declaration?Present
Color coding?Absent
Warning label?Absent

Regulation and marketing

Are there fiscal policies on unhealthy products?Absent
Tax on unhealthy foods?Absent
Tax on unhealthy drinks?Absent
Are there fiscal policies on healthy products?Absent
Subsidy on fruits?Absent
Subsidy on vegetables?Absent
Subsidy on other healthy products?Absent
Mandatory limit or ban of trans fat (all settings)?Present
Mandatory limit of trans fats in place (all settings)? Present
Ban on trans-fats or phos in place (all settings)? Absent
Are there any mandatory policies/marketing restrictions on the promotion of unhealthy food/drinks to children?Present
Mandatory restriction on broadcast media?Present
Mandatory restriction on non-broadcast media?Absent
Voluntary policies/marketing restrictions on the promotion of unhealthy food/drinks to children?Absent
Are there mandatory standards for food in schools?Present
Are there any mandatory nutrient limits in any manufactured food products?Present
Nutrition standards for public sector procurement?Absent

Political will and support

National obesity strategy or nutrition and physical activity national strategy?Present
National obesity strategy?Present
National childhood obesity strategy?Absent
Comprehensive nutrition strategy?Present
Comprehensive physical activity strategy?Present
Evidence-based dietary guidelines and/or RDAs?Present
National target(s) on reducing obesity?Present
Guidelines/policy on obesity treatment?Absent
Promotion of breastfeeding?Present

Monitoring and surveillance

Monitoring of the prevalence and incidence for the main obesity-related NCDs and risk factors?Present
Within 5 years?Present

Governance and resource

Multi-sectoral national co-ordination mechanism for obesity or nutrition (including obesity)?Absent

Key

Present
Present (voluntary)
Incoming
Absent
Unknown

Last updated September 13, 2022

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Download contextual factors as a PDF Contextual factors definitions

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