• Overview
  • Obesity prevalence
  • Population breakdowns
  • Drivers
  • Comorbidities
  • Health systems
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Obesity prevalence

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.

Adults, 2013

Survey type:Measured
Age:18+
Sample size:4574
References:Magriplis, E., Panagiotakos, D., Kyrou, I., Tsioufis, C., Mitsopoulou, A. V., Karageorgou, D., Dimakopoulos, I., Bakogianni, I., Chourdakis, M., Micha, R., Michas, G., Ntouroupi, T., Tsaniklidou, S. M., Argyri, K., & Zampelas, A. (2020). Presence of Hypertension Is Reduced by Mediterranean Diet Adherence in All Individuals with a More Pronounced Effect in the Obese: The Hellenic National Nutrition and Health Survey (HNNHS). Nutrients, 12(3), 853. https://doi.org/10.3390/nu12030853
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Adults, 2013-2016

Survey type:Measured
Age:18+
Sample size:4822
Area covered:National
References:Touloumi, G., Karakosta, A., Kalpourtzi, N., Gavana, M., Vantarakis, A., Kantzanou, M., Hajichristodoulou, C., Chlouverakis, G., Trypsianis, G., Voulgari, P. V., Alamanos, Y., Makrilakis, K., Liatis, S., Chatzipanagiotou, S., Stergiou, G., & EMENO study group (2020). High prevalence of cardiovascular risk factors in adults living in Greece: the EMENO National Health Examination Survey. BMC public health, 20(1), 1665. https://doi.org/10.1186/s12889-020-09757-4
Notes:Sample size: 2065 men and 2757 women
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Adults, 2001-2003

Survey type:Measured
Age:18-79
Sample size:915
Area covered:Regional
References:Koukoulis GN, Sakka C, Katsaros F,Goutou M, Tsirona S, Tsiapali E, Piterou A, Stefanidis I, Stathakis N. High rates of obesity prevalence in adults living in Central Greece: data from the ARGOS Study. HORMONES 2010, 9(3):253-262
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Adults, 1994-1998

Survey type:Measured
Age:19-64
Sample size:25773
References:Trichopolou A. Data from MONICA correspondence to WHO
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Children, 2015

Survey type:Measured
Age:4-17
Sample size:336,014
Area covered:National
References:Tambalis KD, Psarra G and Sidossis LS. 2018. Current data in Greek children indicate decreasing trends of obesity in the transition from childhood to adolescence; results from the EYZHN (National Action for Children’s Health) program. J PREV MED HYG. 59: E40-E51
Notes:IOTF cut-offs used 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

Children, 2010

Survey type:Measured
Age:10-12
Sample size:1091
Area covered:National
References:Brug J, van Stralen MM, te Velde SJ, Chinapaw MJM, De Bourdeaudhuij I, et al. (2012) Differences in Weight Status and Energy-Balance Related Behaviors among Schoolchildren across Europe: The ENERGY-Project. PLoS ONE 7(4): e34742. doi:10.1371/journal.pone.0034742
Notes:IOTF International Cut Off
Cutoffs:IOTF

Children, 2009-2013

Survey type:Measured
Age:6-9
Sample size:10616
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 II and III (2009- 2013) IOTF cut-offs used.
Cutoffs:IOTF

Children, 2005-2006

Survey type:Measured
Age:10-12
Sample size:481
Area covered:Regional
References:Yannis Manios, Peter D Angelopoulos, Georgia Kourlaba, Maria Kolotourou, Evangelia Grammatikaki etal. 2010. Prevalence of obesity and body mass index correlates in a representative sample of Cretan school children. International Journal of Pediatric Obesity. Early Online, 1 - 7.
Cutoffs:IOTF

Children, 2003

Survey type:Measured
Age:13-17
Sample size:14459
Area covered:National
References:Tzotzas T, Kapantais E, Tziomalos K, Ioannidis I, Mortoglou A, Bakatselos S, Kaklamaanou M, Lanaras L & Kaklamanos I. 2008. Epidemiological survey for the prevelance of overweight and abdominal obesity in Greek adolescents. Obesity, 16, 1718 - 1722.
Notes:IOTF International Cut Off
Cutoffs:IOTF

Children, 2003-2004

Survey type:Measured
Age:6-11
Sample size:4131
Area covered:Regional
References:Papadimitriou A, Kounadi D, Konstantinidou M, Xepapadaki P and Nicolaidou P. Prevalence of Obesity in Elementary Schoolchildren Living in Northeast Attica, Greece. Obesity 2006;7:1113-1117
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

Children, 1994

Survey type:Measured
Age:6-11
Sample size:2298
Area covered:Regional
References:Papadimitriou A, Kounadi D, Konstantinidou M, Xepapadaki P and Nicolaidou P. Prevalence of Obesity in Elementary Schoolchildren Living in Northeast Attica, Greece. Obesity 2006;7:1113-1117
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

Overweight/obesity by age and education

Men, 2014

Survey type:Self-reported
Area covered:National
References:Eurostat 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.

Women, 2014

Survey type:Self-reported
Area covered:National
References:Eurostat 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.

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.

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.

Men, 2008

Survey type:Self-reported
Age:18+
Area covered:National
References:EUROSTAT Database http://ec.europa.eu/eurostat/web/health/health-status-determinants/data/database# (last accessed 17th July 2015)
Notes:Definitions are: levels 0-2 = pre-primary, primary and lower secondary education levels 3-4 = upper secondary and post-secondary non-tertiary education levels 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.

Women, 2008

Survey type:Self-reported
Age:18+
Area covered:National
References:EUROSTAT Database http://ec.europa.eu/eurostat/web/health/health-status-determinants/data/database# (last accessed 17th July 2015)
Notes:Definitions are: levels 0-2 = pre-primary, primary and lower secondary education levels 3-4 = upper secondary and post-secondary non-tertiary education levels 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.

Children, 2012

Survey type:Measured
Age:3-6
Sample size:1229
Area covered:Subnational- Athens
References:Manios, Y. et al. (2018). Prevalence and sociodemographic correlates of overweight and obesity in a large Pan-European cohort of preschool children and their families: The ToyBox-study. Nutrition. 55-56, pp.1-7.
Notes:IOTF International cut-offs used. Low Maternal education classed as <14 y of education. Medium/high Maternal education classed as >14 y of education.
Cutoffs:IOTF

Children, 2010

Survey type:Measured
Age:10-12
Sample size:1091
Area covered:National
References:Brug J, van Stralen MM, te Velde SJ et al. Differences in Weight Status and Energy-Balance Related Behaviors among Schoolchildren across Europe: The ENERGY-Project. PLoS ONE 2012;7 (4) e34742
Cutoffs:IOTF

Children, 2007

Survey type:Measured
Age:9-13
Sample size:n=729
Area covered:Urban region of Athens
References:Moschonis, G., Tanagra, S., Vandorou, A., Kyriakou, A., Dede, V., Siatitsa, P.,... Manios, Y. (2010). Social, economic and demographic correlates of overweight and obesity in primary-school children: Preliminary data from the Healthy Growth Study. <i>Public Health Nutrition,</i> <i>13</i>(10A), 1693-1700. doi:10.1017/S1368980010002247
Notes:Prevalence of overweight and obesity by Paternal Education Level. Low (≤9 years of education), Medium (>9 and ≤14 years of education) and High (>14 years of education). IOTF BMI cut-offs used. Note small sample size.
Cutoffs:IOTF

Children, 2007

Survey type:Measured
Age:9-13
Sample size:n=729
Area covered:Urban region of Athens
References:Moschonis, G., Tanagra, S., Vandorou, A., Kyriakou, A., Dede, V., Siatitsa, P.,... Manios, Y. (2010). Social, economic and demographic correlates of overweight and obesity in primary-school children: Preliminary data from the Healthy Growth Study. <i>Public Health Nutrition,</i> <i>13</i>(10A), 1693-1700. doi:10.1017/S1368980010002247
Notes:Prevalence of overweight and obesity by Maternal Education Level. Low (≤9 years of education), Medium (>9 and ≤14 years of education) and High (>14 years of education). IOTF BMI cut-offs used. Note small sample size.
Cutoffs:IOTF

Girls, 2007

Survey type:Measured
Age:9-13
Sample size:n=729
Area covered:Urban region of Athens
References:Moschonis, G., Tanagra, S., Vandorou, A., Kyriakou, A., Dede, V., Siatitsa, P.,... Manios, Y. (2010). Social, economic and demographic correlates of overweight and obesity in primary-school children: Preliminary data from the Healthy Growth Study. <i>Public Health Nutrition,</i> <i>13</i>(10A), 1693-1700. doi:10.1017/S1368980010002247
Notes:Prevalence of overweight and obesity by Maternal Education Level. Low (≤9 years of education), Medium (>9 and ≤14 years of education) and High (>14 years of education). IOTF BMI cut-offs used. Note small sample size.
Cutoffs:IOTF

Children, 2003-2004

Survey type:Measured
Sample size:2374
Area covered:National
References:Manios et al. (2007) 'Prevalence of obesity in preschool Greek children, in relation to parental characteristics and region of residence', BMC Public Health, 7;178
Notes:Prevalence of overweight by educational level of the mother (years) IOTF BMI cut-offs used
Cutoffs:IOTF

Overweight/obesity by age

Adults, 2003

Survey type:Self-reported
Sample size:17341
Area covered:National
References:Kapantais E, Tzotzas T, Ioannidis I, Mortoglou A, Bakatselos S, Kaklamanou M, Lanaras L, Kaklamanos I. First National Epidemiological Survey on the Prevalence of Obesity and Abdominal Fat Distribution in Greek Adults. Annals of Nutrition & Metabolism 2006;50:330-338
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Adults, 2001-2002

Survey type:Measured
Sample size:3042
Area covered:Regional: Attica region
References:Panagiotakos DB, Pitsavos C, Chrysohoou C et al. Epidemiology of overweight and obesity in a Greek adult population: the ATTICA Study. Obes Res. 2004 Dec;12(12):1914-20.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Children, 2015

Survey type:Measured
Sample size:336,014
Area covered:Subnational
References:Tambalis KD, Psarra G and Sidossis LS. 2018. Current data in Greek children indicate decreasing trends of obesity in the transition from childhood to adolescence; results from the EYZHN (National Action for Children’s Health) program. J PREV MED HYG. 59: E40-E51
Notes:IOTF cut-offs used.
Cutoffs:IOTF

Children, 2012-2013

Survey type:Measured
Sample size:7yrs 2725 9yrs 2642 Both Genders
Area covered:National
References:WORLD HEALTH ORGANIZATION. (2018). WHO European Childhood Obesity Surveillance Initiative: overweight and obesity among 6–9-year-old children. Available: http://www.euro.who.int/__data/assets/pdf_file/0010/378865/COSI-3.pdf?ua=1. Last accessed [Accessed 28th Aug 2018].
Notes:WHO cut-offs used.
Cutoffs:WHO

Children, 2010-2012

Survey type:Measured
Sample size:37344 (in total of 12-19yr olds)
Area covered:National
References:Grammatikopoulou MG, Poulimeneas D, Gounitsioti IS, Gerothanasi K, Tsigga M, Kiranas E; ADONUT Study Group.Prevalence of simple and abdominal obesity in Greek adolescents: the ADONUT studyIOTF. Clin Obes. 2014 Dec;4(6):303-8. doi: 10.1111/cob.12070. Epub 2014
Cutoffs:IOTF

Children, 2003

Survey type:Measured
Sample size:14456
Area covered:National
References:Tzotzas T, Kapantais E, Tziomalos K et al. Epidemiological Survey for the Prevalence of Overweigth and Abdomonial Obesity in Greek Adolescents. Obesity 2008;16:1718-1722
Cutoffs:IOTF

Children, 1990-1991

Survey type:Measured
Sample size:6448
Area covered:National
References:Georgiadis G, Nassis GP. Prevalence of overweight and obesity in a national representative sample of Greek children and adolescents. EJCN 2007;61:1072-1074 (individual year data provided via personal communication)
Cutoffs:IOTF

Overweight/obesity by region

Men, 2001-2003

Survey type:Measured
Age:18-70
Sample size:852
Area covered:4 Provinces of Central Greece
References:Koukoulis GN, Sakka C, Katsaros F et al. High rates of obesity prevalence in adults living in Central Greece: Data from the ARGOS Study. Hormones 2010;9(3):253-262
Notes:Please note small sample size - less than 1000
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 2001-2003

Survey type:Measured
Age:18-70
Sample size:852
Area covered:4 Provinces of Central Greece
References:Koukoulis GN, Sakka C, Katsaros F et al. High rates of obesity prevalence in adults living in Central Greece: Data from the ARGOS Study. Hormones 2010;9(3):253-262
Notes:Please note small sample size - less than 1000
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Boys, 2010-2012

Survey type:Measured
Age:13
Sample size:4833
Area covered:National
References:Poulimeneas D, Grammatikopoulou MG, Dimitrakopoulos L, Kotsias E, Gerothanasi D, Kiranas ER, Tsigga M (2016) Regional differences in the prevalence of underweight, overweight and obesity among 13-year-old adolescents in Greece. Int J Pediatr Adolesc Med. 2016 Dec;3(4):153-161. doi: 10.1016/j.ijpam.2016.06.002. Epub 2016 Sep 6
Notes:International IOTF Cut off points
Cutoffs:IOTF

Girls, 2010-2012

Survey type:Measured
Age:13
Sample size:4833
Area covered:National
References:Poulimeneas D, Grammatikopoulou MG, Dimitrakopoulos L, Kotsias E, Gerothanasi D, Kiranas ER, Tsigga M (2016) Regional differences in the prevalence of underweight, overweight and obesity among 13-year-old adolescents in Greece. Int J Pediatr Adolesc Med. 2016 Dec;3(4):153-161. doi: 10.1016/j.ijpam.2016.06.002. Epub 2016 Sep 6
Notes:International IOTF Cut off points
Cutoffs:IOTF

Overweight/obesity by age and region

Men, 2014

Survey type:Self-reported
Area covered:National
References:Eurostat 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.

Women, 2014

Survey type:Self-reported
Area covered:National
References:Eurostat 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.

Overweight/obesity by age and socio-economic group

Adults, 2014

Survey type:Self-reported
Area covered:National
References:Eurostat 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.

Men, 2014

Survey type:Self-reported
Area covered:National
References:Eurostat 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.

Women, 2014

Survey type:Self-reported
Area covered:National
References:Eurostat 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.

Overweight/obesity by socio-economic group

Men, 2014

Survey type:Self-reported
Age:18+
Sample size:Total sample number in EU: 35100 (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: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.

Women, 2014

Survey type:Self-reported
Age:18+
Sample size:Total sample number in EU: 35100 (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: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.

Men, 2008

Survey type:Self-reported
Age:18+
Area covered:National
References:EUROSTAT Database http://ec.europa.eu/eurostat/web/health/health-status-determinants/data/database# (last accessed 17th July 2015)
Notes:SES assessed by 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.

Women, 2008

Survey type:Self-reported
Age:18+
Area covered:National
References:EUROSTAT Database http://ec.europa.eu/eurostat/web/health/health-status-determinants/data/database# (last accessed 17th July 2015)
Notes:SES assessed by 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.

Adults, 2001-2002

Survey type:Measured
Age:20-89
Sample size:3042
Area covered:Regional - Attica region
References:Panagiotakos DB, Pitsavos C, Chrysohoou C, Vlismas K, Skoumas Y, Palliou K, Stefanadis C. Dietary habits mediate the relationship between socio-economic status and CVD factors among healthy adults: the ATTICA study. Public Health Nutr. 2008 Dec;11(12):1342-9.
Notes:3 income groups available for each education level
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Children, 2007

Survey type:Measured
Age:9-13
Sample size:n=729
Area covered:Urban region of Athens
References:Moschonis, G., Tanagra, S., Vandorou, A., Kyriakou, A., Dede, V., Siatitsa, P.,... Manios, Y. (2010). Social, economic and demographic correlates of overweight and obesity in primary-school children: Preliminary data from the Healthy Growth Study. <i>Public Health Nutrition,</i> <i>13</i>(10A), 1693-1700. doi:10.1017/S1368980010002247
Notes:Prevalence of overweight and obesity by annual family income in €/year IOTF BMI cut-offs used Note small sample size
Cutoffs:IOTF

Children, 2007

Survey type:Measured
Age:9-13
Sample size:n=729
Area covered:Urban region of Athens
References:Moschonis, G., Tanagra, S., Vandorou, A., Kyriakou, A., Dede, V., Siatitsa, P.,... Manios, Y. (2010). Social, economic and demographic correlates of overweight and obesity in primary-school children: Preliminary data from the Healthy Growth Study. <i>Public Health Nutrition,</i> <i>13</i>(10A), 1693-1700. doi:10.1017/S1368980010002247
Notes:Prevalence of overweight and obesity by SES of residence region IOTF BMI cut-offs used Note small sample size
Cutoffs:IOTF

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

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

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

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)

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)

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)

Sugar consumption

Adults, 2016

References:Source: Euromonitor International
Definitions:Sugar consumption (Number of 500g sugar portions/person/month)

Estimated per-capita sugar sweetened beverages intake

Adults, 2016

References:Source: Euromonitor International

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)

Prevalence of confectionery consumption

Adults, 2016

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

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)

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)

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)

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)

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)

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)

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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).

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).

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).

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).

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).

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).

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).

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).

Diabetes prevalence

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 (%).

Health systems

Economic classification: High Income

Health systems summary

Greece has a mixed public/private system made up of a National Health System funded primarily by taxes and a social health insurance system that is funded by insurance premiums from employers and employees. Greece’s economic crisis has had a major impact on its public health system, with large-scale austerity measures reducing spending. As a result, the quality of care in the public sector has decreased, leading many to seek out private care instead. A recent assessment by Amnesty International concluded that the austerity measures has resulted in reductions in the accessibility and the affordability of care.

As public health spending has fallen, private health spending has increased. This has result in reduced financial protection for the majority. Out of pocket expense (OOP) is among the highest in the EU at 35% of total health expenditure in 2017 and informal payments are reportedly rife. The majority of OOP expenses are thought to be due to pharmaceutical costs, costs borne from private care and recently introduced user fees.

Indicators

Where is the country’s government in the journey towards defining ‘Obesity as a disease’?No
Where is the country’s healthcare provider in the journey towards defining ‘Obesity as a disease’?No
Is there specialist training available dedicated to the training of health professionals to prevent, diagnose, treat and manage obesity?No
Have any taxes or subsidies been put in place to protect/assist/inform the population around obesity?No
Are there adequate numbers of trained health professionals in specialties relevant to obesity in urban areas?Some progress
Are there adequate numbers of trained health professionals in specialties relevant to obesity in rural areas?No
Are there any obesity-specific recommendations or guidelines published for adults?No
Are there any obesity-specific recommendations or guidelines published for children?No
In practice, how is obesity treatment largely funded?Out of pocket

Perceived barriers to treatment

  • Lack of political will, interest and action
  • High cost of out of pocket payments
  • Economic crisis
  • Lack of training for healthcare professionals
  • Poor health literacy and behaviour
  • Cultural norms and traditions
  • Food cost and availability
  • Obesity not recognised as a disease
  • Poor availability of pharmaceutical options
  • Use of inappropriate ‘treatments’

Summary of stakeholder feedback

The situation in Greece is dominated by the ongoing financial crisis. Physicians can identify their patient as living with overweight or obesity but due to a diminished health system, there are limited options to be referred onto. The Government has insufficient finance to support treatment and so stakeholders agreed that treatment is usually an 'out of pocket expense’ typically provided via private dieticians or clinics. Concern was expressed that this leaves individuals exposed to the unregulated slimming business. The situation is worse in rural areas where communities have very limited treatment options in both the private and public sector.

Stakeholders suggest that nearly all appropriately qualified health care practitioners (HCPs) work in the big cities, so there are inadequate numbers in rural areas. However, limited specialist training and the fact you have to self-fund means that few have an adequate level of obesity training. Fortunately, obesity-related associations are known to work with each other to arrange training courses that pool knowledge and resources. It seems that HCPs are keen to equip themselves to treat but have few facilities or resources to do so.

Due to limited finances, there are limited to no prevention efforts in Greece. Stakeholders reported that there are no campaigns or initiatives of note, and there are no fiscal measures in place.

Based on interviews/survey returns from 4 stakeholders

Last updated: June 2020

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Nutrition circular on Kindergartens

Nutrition in Nurseries and Kindergartens. No further details as article in Greek

Categories:Evidence of Nutritional or Health Strategy/ Guidelines/Policy/Action plan
Year(s):2020 (ongoing)
Target age group:Children
Organisation:Ministry of Health
Linked document:Download linked document

2019-2022 National strategic plan for the Public Health

National strategy for improving health of the population [Article in greek].

Categories:Evidence of Nutritional or Health Strategy/ Guidelines/Policy/Action plan
Year(s):2019-2022
Target age group:Adults and children
Find out more:www.moh.gov.gr
Linked document:Download linked document
References:Available from: www.moh.gov.gr/articles/health/domes-kai-draseis-gia-thn-ygeia/ethnika-sxedia-drashs/6237-ethniko-sxedio-drashs-gia-thn-dhmosia-ygeia%3Ffdl%3D14940+&cd=1&hl=en&ct=clnk&gl=uk [accessed 03.09.20].

European Union (EU) Action Plan on Childhood Obesity 2014-2020

EU Action plan. To contribute to halting the rise in overweight and obesity in children and young people (0-18 years) by 2020

Categories:Transnational Obesity Strategies/Policy or Action Plan
Year(s):2014-2020
Target age group:Children
Organisation:Ministry of Health
Find out more:ec.europa.eu
Linked document:Download linked document
References:EU Action Plan on Childhood Table of contents [Internet]. Available from: https://ec.europa.eu/health/sites/health/files/nutrition_physical_activity/docs/childhoodobesity_actionplan_2014_2020_en.pdf &amp;amp;amp;amp;amp;amp;amp;amp;zwnj;

Legislation on food offered in School Canteens

Legislation on food sold in school canteens

Categories:Evidence of Nutritional or Health Strategy/ Guidelines/Policy/Action plan
Taxation/Subsidies on Food or Beverages or law relating to public health
Year(s):2013 (ongoing)
Target age group:Children
Organisation:Ministry of Health
Find out more:www.moh.gov.gr

Regulations for Hygiene and Types of Foods available in Schools and Educational Institutions

Regulations on the type of food available in schools. Appears to provide legislation and regulations. Measures to ban or virtually eliminate industrially-produced trans fatty acids

Categories:Taxation/Subsidies on Food or Beverages or law relating to public health
Year(s):2013 (ongoing)
Target age group:Children
Organisation:Government of Greece
Linked document:Download linked document
References:Information provided with kind permission of GINA (Global database on the Implementation of Nutrition Action) https://extranet.who.int/nutrition/gina/en/node/24687.

The Toy Box Intervention

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

Paideiatrofi

The Paideiatrofi-programme aims to educate the population on a healthy and balanced diet to reduce the childhood obesity rates in Greece. It helps children and their whole family to change their lifestyle in a radical and sustainable way.

Categories (partial):Evidence of Community Interventions/Campaign
Year(s):2008-2013
Target age group:Adults and children
Organisation:Ministry of Health, Nutrition and Sport
References:The EPHE (EPODE for the Promotion of Health Equity) project. http://www.ephestory.eu/project-greece.php (last accessed 10 Feb 2016)

Nutrition Guidelines

Nutrition guidelines available for many groups including adults, children, infants, teens and over 65's

Categories:Evidence of Nutritional or Health Strategy/ Guidelines/Policy/Action plan
Target age group:Adults
Organisation:Ministry of Health
Find out more:www.moh.gov.gr

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