• Overview
  • Obesity prevalence
  • Trends over time
  • Population breakdowns
  • Drivers
  • Comorbidities
  • Health systems
  • Policies
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Obesity prevalence

Adults, 2019-2020

Survey type:Self-reported
Age:15+
Sample size:22,072
Area covered:National
References:Encuesta Europea de Salud en España (EESE) 2020. Available at: https://www.mscbs.gob.es/estadEstudios/estadisticas/EncuestaEuropea/EncuestaEuropea2020/EESE2020_inf_evol_princip_result.pdf. Last accessed: 27.05.21.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Adults, 2017

Survey type:Self-reported
Age:18+
Sample size:23089
Area covered:National
References:ENES 2017 available at https://www.mscbs.gob.es/estadEstudios/estadisticas/encuestaNacional/encuesta2017.htm (last accessed 03.03.21)
Notes:Sample size is for 15+ Years (only 18+ years included below)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

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, 2014-2015

Survey type:Measured
Age:25-64
Sample size:3966
Area covered:National
References:Aranceta-Bartrina, J. et al. (2016) 'Prevalence of General Obesity and Abdominal Obesity in the Spanish Adult Population (Aged 25-64 Years) 2014-2015: The ENPE Study', Rev Esp Cardiol (Engl Ed), 69(6), pp. 579-87. doi: 10.1016/j.rec.2016.02.009. Epub 2016 Apr 26
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Adults, 2008-2010

Survey type:Measured
Age:18+
Sample size:12036
Area covered:National
References:Gutierrez-Fisac JL, Guallar-Castillion P, Leon-Munoz LM, Graciani A, Banegas JR & Rodriguez-Artalejo F. Prevalence of general and abdominal obesity in the adult population of Spain, 2008-2010. Obesity Reviews early online 12th Dec 2011.
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

Survey type:Measured
Age:20+
Sample size:6569
References:http://www.fnri.dost.gov.ph/files/fnri%20files/nns/factsandfigures2003/anthropometric.pdf last accessed June 14th 2011
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Adults, 1990-2001

Survey type:Measured
Age:20+
Sample size:20589
Area covered:Regional
References:Serra Majem L, Ribas Barba L, Aranceta-Bartrina J, Pérez Rodrigo C, Saavedra Santana P, Peña Quintana L. Obesidad infantil y juvenil en España. Resultados del estudio enKid (1998-2000). Med Clin (Barc). 2003, 121 (19): 725-732. Aranceta-Bartrina J, Serra-Majem L, Foz-sala M, Moreno-Esteban B; Grupo Colaborativo SEEDO. Prevalencia de obesidad en España. Med Clin (Barc). 2005, 125 (12): 460-6. Gutierrez-Fisac JL, López E, Banegas JR, Graciani A, Rodríguez-Artalejo F (2004). Prevalence of overweight and obesity in elderly people in Spain. Obes Res; 12 (4): 710-715.
Notes:Pooled analysis of random regional population samples: 1998 - 2000 1990 - 2000 2001
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Adults, 1990-1994

Survey type:Measured
Age:25-60
Sample size:5388
References:Aranceta J, Perex Rodrigo C, Serra Majem LI et al. Prevalence od Obesity in Spain: SEEDO'97 study. Spanish Collaborative Group for the Study of Obesity. Med Clin (Barc). 1998;117:441-5
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Children, 2019-2020

Survey type:Measured
Age:8-16
Sample size:3724
Area covered:National
References:Gómez SF, Homs C, Wärnberg J, et alStudy protocol of a population-based cohort investigating PhysCIal Activity, Sedentarism, lifestyles and Obesity in Spanish youth: the PASOS studyBMJ Open 2020;10:e036210. doi: 10.1136/bmjopen-2019-036210. Available at: https://bmjopen.bmj.com/content/10/9/e036210. Further data provided by personal communication by Dr. SANTI F. GÓMEZ of the GASOL Foundation.
Cutoffs:IOTF

Children, 2019

Survey type:Measured
Age:6-9
Sample size:16665
Area covered:National
References:Ministerio de Consumo, Agency Espanola de seguirdad alimentaria y nutrction (2020) ALADINO 2019 Informe Breve. ESTUDIO SOBRE LA ALIMENTACIÓN, ACTIVIDAD FÍSICA, DESARROLLO INFANTIL Y OBESIDAD EN ESPAÑA 2019
Cutoffs:WHO

Children, 2015-2016

Survey type:Measured
Age:6-9
Sample size:10,899
Area covered:National
References:Estudio ALADINO Estudio de Vigilancia del Crecimiento, Alimentación,Actividad Física, Desarrollo Infantil y Obesidad en España. 2015. Ministerio de Sanidad, Servicios Sociales e Igualdad Agencia Española de Consumo, Seguridad Alimentaria y Nutrición, 2016. Available from: http://www.aecosan.msssi.gob.es/AECOSAN/docs/documentos/nutricion/observatorio/Estudio_ALADINO_2015.pdf (accesed 9th April 2019) [Article in Spanish].
Notes:IOTF cut-offs used.
Cutoffs:IOTF

Children, 2015-2016

Survey type:Measured
Age:6-9
Sample size:10899
Area covered:National
References:Ministerio de Consumo, Agency Espanola de seguirdad alimentaria y nutrction (2020) ALADINO 2019 Informe Breve. ESTUDIO SOBRE LA ALIMENTACIÓN, ACTIVIDAD FÍSICA, DESARROLLO INFANTIL Y OBESIDAD EN ESPAÑA 2019
Cutoffs:WHO

Children, 2012

Survey type:Measured
Age:8-17
Sample size:978
Area covered:National
References:Sánchez-Cruz JJ, Jiménez-Moleón JJ, Fernández-Quesada F, Sánchez MJ. Prevalence of Child and Youth Obesity in Spain in 2012.Rev Esp Cardiol. 2013 Jan 31. pii: S0300-8932(12)00640-9. doi: 10.1016/j.recesp.2012.10.016. [Epub ahead of print] In English & Spanish
Notes:International IOTF cut off points
Cutoffs:IOTF

Children, 2010-2011

Survey type:Measured
Age:6-9
Sample size:7659
Area covered:National
References:Napoleón Pérez-Farinós, Ana M. López-Sobaler, M. Ángeles Dal Re, Carmen Villar, Estefanía Labrado, Teresa Robledo, Rosa M. Ortega, "The ALADINO Study: A National Study of Prevalence of Overweight and Obesity in Spanish Children in 2011", BioMed Research International, vol. 2013, Article ID 163687, 7 pages, 2013. https://doi.org/10.1155/2013/163687
Cutoffs:IOTF

Children, 2010

Survey type:Measured
Age:10-12
Sample size:1008
Area covered:Regional
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, 2010-2011

Survey type:Measured
Age:6-9
Sample size:7659
Area covered:National
References:Ministerio de Consumo, Agency Espanola de seguirdad alimentaria y nutrction (2020) ALADINO 2019 Informe Breve. ESTUDIO SOBRE LA ALIMENTACIÓN, ACTIVIDAD FÍSICA, DESARROLLO INFANTIL Y OBESIDAD EN ESPAÑA 2019
Cutoffs:WHO

Children, 2009-2013

Survey type:Measured
Age:7-8
Sample size:7747
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, 2000-2002

Survey type:Measured
Age:13-14
Area covered:National
References:Personal communication from LA Moreno
Notes:Large National Survey but sample size not specified 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, 1998-2000

Survey type:Measured
Age:5-17
Sample size:2057
Area covered:National
References:Serra Majem L, Ribas Barba L, Aranceta Bartrina J, Pérez Rodrigo C, Saavedra Santana P, Peña Quintana L. (2003). Obesidad infantil y juvenil en España. Resultados del estudio enKid (1998-2000). Medicina Clinica (Barc). 121 (19): 725 - 732
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, 1995-1996

Survey type:Measured
Age:13-14
Area covered:National
References:Personal communication from LA Moreno
Notes:Large National Survey but sample size not specified 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, 1985-1986

Survey type:Measured
Age:13-14
Area covered:National
References:Personal communication from LA Moreno
Notes:Large National Survey but sample size not specified 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, 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.

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.

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.

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.

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) Translated graphics for obesity by educational level are also available for 2011-12 & 1990-94 (on request).
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) Translated graphics for obesity by educational level are also available for 2011-12 & 1990-94 (on request).
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Men, 2011-2012

Survey type:Self-reported
Age:25-64
Sample size:34784
Area covered:National
References:National Health Survey Spain. Ministry of Health. Social Services and Equality and INE. http://www.ine.es (last accessed 20.5.15)
Notes:Education definitions: 1. Cannot read or write, or incomplete primary education 2. Complete primary education 3. Secondary education, 1st stage 4. Secondary education, 2nd stage 5. Advanced professional training or the equivalent 6. University 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, 2011-2012

Survey type:Self-reported
Age:25-64
Sample size:34784
Area covered:National
References:National Health Survey Spain. Ministry of Health. Social Services and Equality and INE. http://www.ine.es (last accessed 20.5.15)
Notes:Education definitions: 1. Cannot read or write, or incomplete primary education 2. Complete primary education 3. Secondary education, 1st stage 4. Secondary education, 2nd stage 5. Advanced professional training or the equivalent 6. University education
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.

Men, 1990-1994

Survey type:Measured
Age:25-60
Sample size:5388
Area covered:Four Spanish regions (Catalunya, Basque Country, Madrid and Valencia)
References:Aranceta J, Perez Rodrigo C, Serra Majem L et al. Influence of sociodemographic factors in the prevalence of obesity in Spain. The SEEDO '97 Study. European Journal of Clinical Nutrition (2001); 55: 430-435. http://www.nature.com/ejcn/journal/v55/n6/pdf/1601189a.pdf (last accessed 29.4.15)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 1990-1994

Survey type:Measured
Age:25-60
Sample size:5388
Area covered:Four Spanish regions (Catalunya, Basque Country, Madrid and Valencia)
References:Aranceta J, Perez Rodrigo C, Serra Majem L et al. Influence of sociodemographic factors in the prevalence of obesity in Spain. The SEEDO '97 Study. European Journal of Clinical Nutrition (2001); 55: 430-435. http://www.nature.com/ejcn/journal/v55/n6/pdf/1601189a.pdf (last accessed 29.4.15)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Children, 2019-2020

Survey type:Measured
Age:8-16
Sample size:3724
Area covered:National
References:Gómez SF, Homs C, Wärnberg J, et alStudy protocol of a population-based cohort investigating PhysCIal Activity, Sedentarism, lifestyles and Obesity in Spanish youth: the PASOS studyBMJ Open 2020;10:e036210. doi: 10.1136/bmjopen-2019-036210. Available at: https://bmjopen.bmj.com/content/10/9/e036210. Further data provided by personal communication by Dr. SANTI F. GÓMEZ of the GASOL Foundation.
Cutoffs:IOTF

Children, 2012

Survey type:Measured
Age:8-17
Sample size:978
Area covered:National
References:Sánchez-Cruz J-J, et al. Prevalencia de obesidad infantil y juvenil en España en 2012. Rev Esp Cardiol. 2013. http://dx.doi.org/10.1016/j.recesp.2012.10.016 (last accessed 20.5.15)
Notes:Prevalence of overweight and obesity of children based on educational level of person responsible for diet.
Cutoffs:Other

Children, 2010

Survey type:Measured
Age:10-12
Sample size:1008
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

Overweight/obesity by age

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.

Adults, 2008-2010

Survey type:Measured
Sample size:12036
Area covered:National
References:Gutiérrez-Fisac, J. L., Guallar-Castillón, P., León-Muñoz, L. M., Graciani, A., Banegas, J. R. and Rodríguez-Artalejo, F. (2012). Prevalence of general and abdominal obesity in the adult population of Spain, 2008–2010: the ENRICA study. Obesity Reviews; 13: 388–392. doi: 10.1111/j.1467-789X.2011.00964.x
Notes:Data on waist circumference and prevalence of abdominal obesity also available.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Children, 2019-2020

Survey type:Measured
Sample size:3724
Area covered:National
References:Gómez SF, Homs C, Wärnberg J, et alStudy protocol of a population-based cohort investigating PhysCIal Activity, Sedentarism, lifestyles and Obesity in Spanish youth: the PASOS studyBMJ Open 2020;10:e036210. doi: 10.1136/bmjopen-2019-036210. Available at: https://bmjopen.bmj.com/content/10/9/e036210. Further data provided by personal communication by Dr. SANTI F. GÓMEZ of the GASOL Foundation.
Cutoffs:IOTF

Children, 2019

Survey type:Measured
Sample size:16665
Area covered:National
References:Ministerio de Consumo, Agency Espanola de seguirdad alimentaria y nutrction (2020) ALADINO 2019 Informe Breve. ESTUDIO SOBRE LA ALIMENTACIÓN, ACTIVIDAD FÍSICA, DESARROLLO INFANTIL Y OBESIDAD EN ESPAÑA 2019
Cutoffs:WHO

Children, 2015-2016

Survey type:Measured
Sample size:10,899
Area covered:National
References:Available from: http://www.aecosan.msssi.gob.es/AECOSAN/docs/documentos/nutricion/observatorio/Estudio_ALADINO_2015.pdf (accesed 9th April 2019) [Article in Spanish].
Notes:IOTF cut-offs used. Translated graphics for data by age category are also available from 2011-12 and 2010-11 (on request).
Cutoffs:IOTF

Children, 2012

Survey type:Measured
Sample size:978
Area covered:National
References:Sánchez-Cruz J-J, et al. Prevalencia de obesidad infantil y juvenil en España en 2012. Rev Esp Cardiol. 2013. http://dx.doi.org/10.1016/j.recesp.2012.10.16 (last accessed 20.5.15)
Cutoffs:IOTF

Children, 2012-2013

Survey type:Measured
Sample size:7yrs 1820 8yrs 1606 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, 2011-2012

Survey type:Self-reported
Sample size:6051
Area covered:National
References:National Health Survey: http://www.ine.es/jaxi/tabla.do (last accessed 20.5.15)
Notes:Self Report
Cutoffs:IOTF

Children, 2010-2011

Survey type:Measured
Sample size:7659
Area covered:National
References:Pérez-Farinós N, López-Sobaler AM, Dal Re MÁ, Villar C, Labrado E, Robledo T, Ortega RM. The ALADINO study: a national study of prevalence of overweight and obesity in Spanish children in 2011. Biomed Res Int. 2013;2013:163687. doi: 10.1155/2013/163687. Epub 2013 Sep 8
Cutoffs:IOTF

Overweight/obesity by region

Adults, 2017

Survey type:Self-reported
Age:18+
Sample size:23089
Area covered:National
References:ENES 2017 available at https://www.mscbs.gob.es/estadEstudios/estadisticas/encuestaNacional/encuesta2017.htm (last accessed 03.03.21)
Notes:Sample size for 15+ years only 18+ included
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Men, 1990-1994

Survey type:Measured
Age:25-60
Sample size:5388
Area covered:Four Spanish regions: Catalunya, Basque Country, Madrid and Valenci
References:Aranceta J, Perez Rodrigo C, Serra Majem L et al. Influence of sociodemographic factors in the prevalence of obesity in Spain. The SEEDO '97 Study. European Journal of Clinical Nutrition (2001); 55: 430-435
Notes:Obesity defined as BMI => 30 kg/m2
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 1990-1994

Survey type:Measured
Age:25-60
Sample size:5388
Area covered:Four Spanish regions: Catalunya, Basque Country, Madrid and Valenci
References:Aranceta J, Perez Rodrigo C, Serra Majem L et al. Influence of sociodemographic factors in the prevalence of obesity in Spain. The SEEDO '97 Study. European Journal of Clinical Nutrition (2001); 55: 430-435
Notes:Obesity defined as BMI => 30 kg/m2
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Men, 1990-1994

Survey type:Measured
Age:25-60
Sample size:5388
Area covered:Four Spanish regions: Catalunya, Basque Country, Madrid and Valenci
References:Aranceta J, Perez Rodrigo C, Serra Majem L et al. Influence of sociodemographic factors in the prevalence of obesity in Spain. The SEEDO '97 Study. European Journal of Clinical Nutrition (2001); 55: 430-435
Notes:Data is age-adjusted prevalence. Obesity defined as BMI => 30 kg/m2 Note that odds ratio for obesity by socio-demographic factors also available.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 1990-1994

Survey type:Measured
Age:25-60
Sample size:5388
Area covered:Four Spanish regions: Catalunya, Basque Country, Madrid and Valenci
References:Aranceta J, Perez Rodrigo C, Serra Majem L et al. Influence of sociodemographic factors in the prevalence of obesity in Spain. The SEEDO '97 Study. European Journal of Clinical Nutrition (2001); 55: 430-435
Notes:Data is age-adjusted prevalence. Obesity defined as BMI => 30 kg/m2 Note that odds ratio for obesity by socio-demographic factors also available.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Children, 2017

Survey type:Self-reported
Age:2-17
Sample size:6106
Area covered:National
References:Informe Anual del Sistema Nacional de Salud 2019, Available at: https://www.mscbs.gob.es/estadEstudios/estadisticas/sisInfSanSNS/tablasEstadisticas/InfAnualSNS2019/Informe_SNS_2019.pdf. Data from Spanish National Health Survey 2017. Available at: https://www.mscbs.gob.es/estadEstudios/estadisticas/encuestaNacional/encuestaNac2017/ENSE17_Metodologia.pdf. Both last accessed: 06.05.21.
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, 2017

Survey type:Self-reported
Age:18+
Sample size:23,089
Area covered:National
References:Spanish National Health Survey 2017 (Encuesta Nacional de Salud 2017). Available at: https://www.mscbs.gob.es/estadEstudios/estadisticas/encuestaNacional/encuesta2017.htm. Last accessed: 11.05.21.
Definitions:Social class based on the occupation of the reference person.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 2017

Survey type:Self-reported
Age:18+
Sample size:23,089
Area covered:National
References:Spanish National Health Survey 2017 (Encuesta Nacional de Salud 2017). Available at: https://www.mscbs.gob.es/estadEstudios/estadisticas/encuestaNacional/encuesta2017.htm. Last accessed: 11.05.21.
Definitions:Social class based on the occupation of the reference person.
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
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, 2011-2012

Survey type:Self-reported
Age:18+
Sample size:34784
Area covered:National
References:National Health Survey: http://www.ine.es/jaxi/tabla.do (last accessed 20.5.15)
Notes:Definitions: I. Directors and managers of establishments with 10 or more wage earners and professionals traditionally associated with university degrees II. Directors and managers of establishments with 10 or more wage earners, professionals traditionally associated with university degrees and other technical support professionals III. Intermediate occupations and self-employed workers IV. Supervisors and workers in skilled technical occupations V. Skilled primary sector workers and other semi-skilled workers VI. Non-skilled workers
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 2011-2012

Survey type:Self-reported
Age:18+
Sample size:34784
Area covered:National
References:National Health Survey: http://www.ine.es/jaxi/tabla.do (last accessed 20.5.15)
Notes:Definitions: I. Directors and managers of establishments with 10 or more wage earners and professionals traditionally associated with university degrees II. Directors and managers of establishments with 10 or more wage earners, professionals traditionally associated with university degrees and other technical support professionals III. Intermediate occupations and self-employed workers IV. Supervisors and workers in skilled technical occupations V. Skilled primary sector workers and other semi-skilled workers VI. Non-skilled workers
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.

Men, 1990-1994

Survey type:Measured
Age:25-60
Sample size:5388
Area covered:Four Spanish regions (Catalunya, Basque Country, Madrid and Valencia)
References:Aranceta J, Perez Rodrigo C, Serra Majem L et al. Influence of sociodemographic factors in the prevalence of obesity in Spain. The SEEDO '97 Study. European Journal of Clinical Nutrition (2001); 55: 430-435
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 1990-1994

Survey type:Measured
Age:25-60
Sample size:5388
Area covered:Four Spanish regions (Catalunya, Basque Country, Madrid and Valencia)
References:Aranceta J, Perez Rodrigo C, Serra Majem L et al. Influence of sociodemographic factors in the prevalence of obesity in Spain. The SEEDO '97 Study. European Journal of Clinical Nutrition (2001); 55: 430-435
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Children, 2019-2020

Survey type:Measured
Age:8-16
Sample size:3724
Area covered:National
References:Gómez SF, Homs C, Wärnberg J, et alStudy protocol of a population-based cohort investigating PhysCIal Activity, Sedentarism, lifestyles and Obesity in Spanish youth: the PASOS studyBMJ Open 2020;10:e036210. doi: 10.1136/bmjopen-2019-036210. Available at: https://bmjopen.bmj.com/content/10/9/e036210. Further data provided by personal communication by Dr. SANTI F. GÓMEZ of the GASOL Foundation.
Cutoffs:IOTF

Children, 2019

Survey type:Measured
Age:6-9
Sample size:16665
Area covered:National
References:Ministerio de Consumo, Agency Espanola de seguirdad alimentaria y nutrction (2020) ALADINO 2019 Informe Breve. ESTUDIO SOBRE LA ALIMENTACIÓN, ACTIVIDAD FÍSICA, DESARROLLO INFANTIL Y OBESIDAD EN ESPAÑA 2019
Definitions:Parental annual incomec
Cutoffs:WHO

Boys, 2017

Survey type:Self-reported
Age:2-17
Sample size:6106
Area covered:National
References:ENES 2017 available at https://www.mscbs.gob.es/estadEstudios/estadisticas/encuestaNacional/encuesta2017.htm (last accessed 03.03.21)
Cutoffs:IOTF

Girls, 2017

Survey type:Self-reported
Age:2-17
Sample size:6106
Area covered:National
References:ENES 2017 available at https://www.mscbs.gob.es/estadEstudios/estadisticas/encuestaNacional/encuesta2017.htm (last accessed 03.03.21)
Cutoffs:IOTF

Children, 2012

Survey type:Measured
Age:8-17
Sample size:978
Area covered:National
References:Sánchez-Cruz J-J, et al. Prevalencia de obesidad infantil y juvenil en España en 2012. Rev Esp Cardiol. 2013. http://dx.doi.org/10.1016/j.recesp.2012.10.016 (last accessed 20.5.15)
Cutoffs:IOTF

Children, 2007-2008

Survey type:Measured
Age:2-9
Sample size:1824
Area covered:National
References:Ahrens W, Pigeot I, Pohlabeln H et al. Prevalence of overweight and obesity in European children below the age of 10. IJO 2014;38:S99-S107
Notes:Lowest income groups sample size too small so excluded
Cutoffs:IOTF

Overweight/obesity by ethnicity

Ethnic groups are as defined by publication of origin and are not as defined by WOF. In some instances ethnicity is conflated with nationality and/or race.

Men, 2017

Survey type:Self-reported
Age:18+
Sample size:23,089
Area covered:National
References:Spanish National Health Survey 2017 (Encuesta Nacional de Salud 2017). Available at: https://www.mscbs.gob.es/estadEstudios/estadisticas/encuestaNacional/encuesta2017.htm. Last accessed: 11.05.21.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 2017

Survey type:Self-reported
Age:18+
Sample size:23,089
Area covered:National
References:Spanish National Health Survey 2017 (Encuesta Nacional de Salud 2017). Available at: https://www.mscbs.gob.es/estadEstudios/estadisticas/encuestaNacional/encuesta2017.htm. Last accessed: 11.05.21.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Boys, 2017

Survey type:Self-reported
Age:2-17
Sample size:6106
Area covered:National
References:Spanish National Health Survey 2017 (Encuesta Nacional de Salud 2017). Available at: https://www.mscbs.gob.es/estadEstudios/estadisticas/encuestaNacional/encuesta2017.htm. Last accessed: 11.05.21.
Cutoffs:IOTF

Girls, 2017

Survey type:Self-reported
Age:2-17
Sample size:6106
Area covered:National
References:Spanish National Health Survey 2017 (Encuesta Nacional de Salud 2017). Available at: https://www.mscbs.gob.es/estadEstudios/estadisticas/encuestaNacional/encuesta2017.htm. Last accessed: 11.05.21.
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, 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)

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)

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)

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, 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 (%).

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

Spain has a universal healthcare system that is consistently ranked among the best in the world. The national system (Sistema Nacional de Salud) is primary funded by taxation and is mostly free at point of service. In addition to the national health service, there are other statutory provisions for civil servants, the armed forces and the judiciary. Public sector workers, for example, are eligible to opt out of the public system if they sign up to the government-subsidised health insurance called MUFACE. Despite the comprehensive health coverage in Spain, out of pocket (OOP) payments make up 23.9% of total health expenditure (greater than the European Union average). Most OOP payments are for pharmaceuticals and medical devices.

Spain has the highest life expectancy in the European Union and has relatively low mortality rates from preventable and treatable causes. Obesity, however, has been increasing in recent years.

Indicators

Where is the country’s government in the journey towards defining ‘Obesity as a disease’?Some progress
Where is the country’s healthcare provider in the journey towards defining ‘Obesity as a disease’?Some progress
Is there specialist training available dedicated to the training of health professionals to prevent, diagnose, treat and manage obesity?Yes
Have any taxes or subsidies been put in place to protect/assist/inform the population around obesity?Yes
Are there adequate numbers of trained health professionals in specialties relevant to obesity in urban areas?No
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?Yes
Are there any obesity-specific recommendations or guidelines published for children?Some progress
In practice, how is obesity treatment largely funded?Not known

Perceived barriers to treatment

  • Lack of political will, interest and action
  • Economic crisis
  • Stigma
  • Poor health literacy and behaviour
  • Cultural norms and traditions

Summary of stakeholder feedback

While seemingly not yet considered to be a disease by the government and healthcare providers, Spain has several prevention policies in place related to obesity. These include school-level interventions around physical activity and diet, and a sugar tax in the Catalonia region. Stakeholders and patients felt that obesity could be better prevented by the provision of cheaper fruit and vegetables, perhaps through subsidies.

Overall, the health system is generally not thought to be working in terms of obesity treatment. Having said that, one stakeholder felt that primary care centres were becoming better at addressing obesity, with several new and effective programmes being implemented. Generally, though, it appears that a high BMI is required before treatment if offered, and even then, there are long waiting lists. Long waiting lists are said to be one of the reasons individuals leave the health system without treatment.

There are insufficient numbers of obesity professionals in both urban and rural areas but in rural areas, there is said to be no possibility of receiving specialised treatment. There is no specialised obesity training available, except for training for bariatric surgeons.

Based on interviews/survey returns from 3 stakeholders

Last updated: June 2020

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Policies, Interventions and Actions

Trans-fat policy

The content of trans fat, other than trans fat naturally occurring in fat of animal origin, in food intended for the final consumer and food intended for supply to retail, shall not exceed 2 grams per 100 grams of fat.

Categories:Evidence of Nutritional or Health Strategy/ Guidelines/Policy/Action plan
Year(s):2021 (ongoing)
Target age group:Adults and children
Organisation:The content of trans fat, other than trans fat naturally occurring in fat of animal origin, in food intended for the final consumer and food intended for supply to retail, shall not exceed 2 grams per 100 grams of fat.
Find out more:extranet.who.int
References:Countdown to 2023: WHO report on global trans-fat elimination 2020. Geneva: World Health Organization; 2020. Licence: CC BY-NC-SA 3.0 IGO

Value Added Tax on Sugary Drinks

In 2021, the Spanish government increased the Value Added Tax (VAT) for sugary drinks as part of efforts to address rising overweight and obesity. The new tax rate is set a 21% (an increase from 10%). This increase was approved through Law 11/2020 of 30th December on the 2021 General State Budget (LGPE) (article 69).

Categories:Taxation/Subsidies on Food or Beverages or law relating to public health
Year(s):2021 (ongoing)
Target age group:Adults and children
Organisation:Government
Find out more:policydatabase.wcrf.org
References:https://policydatabase.wcrf.org/level_one?page=nourishing-level-one#step2=2#step3=315

Nutri-score Labelling

The Minister for Consumer Affairs, Alberto Garzón, has announced that the front-of-pack nutritional labelling system Nutri-score would enter into force in the first four months of 2021.

Categories:Labelling Regulation/Guidelines
Year(s):2020 (ongoing)
Target age group:Adults and children
Organisation:Government
Find out more:www.lamoncloa.gob.es
References:https://www.lamoncloa.gob.es/lang/en/gobierno/news/Paginas/2020/20200626food-labelling.aspx

Maximum limit for salt in bread

In April 2019, a maximum mandatory limit for the salt content in bread was set, through Royal Decree 308/2019. It restricts the classifications of ‘wholemeal’, ‘sourdough’, ‘artisanal’ and ‘multicereal’ bread and sets the maximum allowable salt in the ordinary bread as a finished product must be 1.66 grams of salt per 100 grams of bread, when analysed by determination of total sodium (Article 11. 2c).

Categories:Evidence of Nutritional or Health Strategy/ Guidelines/Policy/Action plan
Year(s):2019 (ongoing)
Target age group:Adults and children
Organisation:Government
Find out more:boe.es

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

Sugar sweetened beverage tax (Catalonia)

Two-tier sugar sweetened beverage tax in Catalonia.

Categories:Taxation/Subsidies on Food or Beverages or law relating to public health
Year(s):2017 (ongoing)
Target age group:Adults and children
Organisation:Gobierno de Espana
Find out more:www.hacienda.gob.es
Linked document:Download linked document
References:Gobierno de España. Impuesto bebidas azucaradas envasadas CATALUÑA. Available from: http://www.hacienda.gob.es/Documentacion/Publico/PortalVarios/FinanciacionTerritorial/Autonomica/TributosPropios/Normativa/2017/14.%20Impuesto%20bebidas%20azucaradas%20envasadas%20CATALU%C3%91A%202017.pdf. [Accessed 13 December 2018].

EU nutrient content lists

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 13 December 2016.

Categories:Labelling Regulation/Guidelines
Year(s):2016 (ongoing)
Target age group:Adults and children
Organisation:European Commission
Find out more:eur-lex.europa.eu
Linked document:Download linked document

Recommendations for the population on physical activity and reduced sedentary lifestyle

These recommendations aim to raise awareness of the population which is the amount, intensity, frequency and duration of physical activity that benefits health. They are based on existing international recommendations and on scientific evidence, with the ultimate goal that all people should be more active physically.

Categories:Evidence of Physical Activity Guidelines/Policy
Year(s):2015 (ongoing)
Target age group:Adults and children
Organisation:Ministry of Health, Social Services and Equality
Linked document:Download linked document
References:Ministerio de Sanidad, Servicios Sociales e Igualdad. Actividad Física para la Salud y Reducción del Sedentarismo. Recomendaciones para la población. Estrategia de Promoción de la Salud y Prevención en el SNS. Madrid, 2015

Take action, advise health

Take action, advise health (Acta­vate, aconseja salud) is a free online course for health professionals, that enables them to prescribe physical activity through the institutions of the Spanish National Health System.

Categories:Training
Year(s):2015 (ongoing)
Target age group:Adults and children
Organisation:The Ministry of Education, Culture and Sports
Linked document:Download linked document

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 ‌

Som la pera

'Som la pera' is one of the European Youth Tackling Obesity (EYTO) campaigns and is a school-based intervention using events and activities to encourage healthy living. It involves challenges designed by young people to increase physical activity and consumption of fruits and vegetables.

Categories:Evidence of Community Interventions/Campaign
Year(s):2013 (ongoing)
Target age group:Children
Organisation:European Youth Tackling Obesity (EYTO) project
Find out more:www.eyto.org.uk
References:European Youth Tackling Obesity (EYTO) project. http://www.eyto.org.uk/about/the-campaigns/home (last accessed 10 Feb 2016)

White Paper on Nutrition in Spain

This white paper seeks to be a pioneering tool in Spain and to be both a nutritional resource for academia, scientis and policy makers.

Categories:Evidence of Nutritional or Health Strategy/ Guidelines/Policy/Action plan
Year(s):2013 (ongoing)
Target age group:Adults and children
Organisation:Government
Find out more:www.aecosan.msssi.gob.es
Linked document:Download linked document
References:Agencia Española de Seguridad Alimentaria y Nutrición y el Instituto Nacional de Consumo

FESNAD and SEESO recommendations for prevention and treatment for overweight and obesity in adults

Evidence based Nutritional recommendations for preventing and treating overweight and obesity (developed by two Spanish scientific associations, FESNAD (Spanish Federation of Nutrition, Food and Dietetic Associations) and SEEDO (Spanish Association for the Study of Obesity)).

Categories:Evidence of Management/treatment guidelines
Year(s):2012 (ongoing)
Target age group:Adults and children
Organisation:FESNAD (Spanish Federation of Nutrition, Food and Dietetic Associations) and SEEDO (Spanish Association for the Study of Obesity)
Find out more:www.ncbi.nlm.nih.gov
Linked document:Download linked document
References:Fernández Manuel M. G, Lesmes I.B, Marset J.B, Izquierdo J.Q, Sala X.F, Salas-Salvadó J; FESNAD-SEEDO consensus group (2012). Evidence-based nutritional recommendations for the prevention and treatment of overweight and obesity in adults (FESNAD-SEEDO consensus document). The role of diet in obesity treatment (III/III). Nutrición Hospitalaria. 27(3). pp. 833-64.

Law on Nutrition and Food Safety (Ley 17/2011)

Law on Nutrition and Food Safety (Ley 17/2011) prevents kindergartens and schools from selling food and beverages high in saturated fat, trans fat, salt and sugar. The law also state kindergartens and schools should be free from advertising.

Categories:Evidence of Marketing Guidelines/Policy
Evidence of Nutritional or Health Strategy/ Guidelines/Policy/Action plan
Year(s):2011 (ongoing)
Target age group:Children
Organisation:Government
Find out more:policydatabase.wcrf.org
References:https://policydatabase.wcrf.org/level_one?page=nourishing-level-one#step2=1#step3=337

Integral Plan for Physical Activity and Sport Promotion (Plan Integral de Actividad Fisica y el Deporte)

The Comprehensive Plan for Physical Activity and Sport is a program that aims to promote universal access to quality sport for the whole population.

Categories:Evidence of Physical Activity Guidelines/Policy
Year(s):2010-2020
Target age group:Adults and children
Organisation:High Council for Sport
Find out more:repositori.uji.es
Linked document:Download linked document

Clinical Practice Guideline for the Prevention and Treatment of Childhood and Juvenile Obesity

A set of clinical practice guidelines for the prevention and treatment of obesity in children and juveniles in Spain.

Categories:Evidence of Management/treatment guidelines
Year(s):2009 (ongoing)
Target age group:Children
Organisation:Ministry for Health and Social Policy
Linked document:Download linked document
References:Working Group of the Guideline for the Prevention and Treatment of Childhood and Juvenile Obesity; Iberoamerican Cochrane Centre, coordinator; Clinical Practice Guideline for the Prevention and Treatment of Childhood and Juvenile Obesity; CPGs: Quality Plan for the Spanish National Healthcare System of the Spanish Ministry for Health and Social Policy; Catalan Agency for Health Technology Assessment, 2009; Clinical Practice Guideline: CAHTA no. 2007/25.

Healthy eating as a family

Aims to promote healthy eating as a family by educating teachers and parents.

Categories:Evidence of Community Interventions/Campaign
Year(s):2009 (ongoing)
Target age group:Adults and children
Organisation:Hispacoop, the Spanish Confederation on Consumers and Users' Cooperatives
Find out more:www.menjasaenfamilia.org

NAOS Strategy Working Group- AECOSAN - Health Councils of the Autonomous Communities

Since 2008, the NAOS Strategy has worked in coordination with the Autonomous Communities' Health Departments (CCAA) through a technical working group. In this group, joint initiatives are developed on issues derived from Law 17/2011 on Food Safety and Nutrition, on programmes to promote healthy eating, nutrition, or physical activity for the prevention of obesity and / or the promotion of healthy habits.

Categories:Evidence of Nutritional or Health Strategy/ Guidelines/Policy/Action plan
Year(s):2008 (ongoing)
Target age group:Adults and children
Organisation:Ministry of Health
References:https://extranet.who.int/nutrition/gina/en/node/27123

Actividad física y salud en la infancia y la adolescencia Guía para todas las personas que participan en su educación

Guide for all educations on Physical Activity and Health in Children and Adolescents Guide

Categories:Evidence of Physical Activity Guidelines/Policy
Year(s):2006 (ongoing)
Target age group:Adults and children
Organisation:Ministry of Health
Linked document:Download linked document

EU health and nutrient claims regulation

Regulation nº 1924/2006 establishes EU-wide rules on the use of specified health and nutrient claims. The European Commission approves claims provided they are based on scientific evidence and accessible consumers. The European Food Safety Authority is responsible for evaluating the scientific evidence supporting health claims. Nutrition claims may only be used on food defined as "healthy" by a nutrient profile.

Categories:Labelling Regulation/Guidelines
Year(s):2006 (ongoing)
Target age group:Adults and children
Organisation:European Commission
Linked document:Download linked document
References:https://eur-lex.europa.eu/legal-content/en/ALL/?uri=CELEX%3A32006R1924

Food-based dietary guidelines: Eat healthy and move: 12 healthy decisions (Come sano y muévete: 12 decisiones saludables)

Spain published the dietary guidelines for children and adolescents in 2005. The guidelines for the general population were launched in 2008. The guidelines were developed as part of the Strategy for Nutrition, Physical Activity and the Prevention of Obesity (NAOS Strategy) of the Spanish Agency for Consumer Affairs, Food Safety and Nutrition of the Spanish Ministry of Health, Social Services and Equality.

Categories:Evidence of Nutritional or Health Strategy/ Guidelines/Policy/Action plan
Year(s):2005 (ongoing)
Target age group:Adults and children
Organisation:Ministry of Health
Linked document:Download linked document
References:http://www.fao.org/nutrition/education/food-dietary-guidelines/regions/countries/spain/en/

Self-Regulatory Code on Food Advertising to Children (CODIGO PAOS)

This is a multi-stakeholder initiative developed by the food industry in consultation with the government and the advertising industry. It includes a copy advice procedure for pre-vetting advertisements, and enforcement and monitoring bodies.

Categories:Industry/Government regulations - voluntary /pledges
Categories (partial):Evidence of Marketing Guidelines/Policy
Year(s):2005 (ongoing)
Target age group:Children
Organisation:The Spanish Federation of Food and Drink Industries (FIAB) issued the CODIGO PAOS, with support by the Ministry of Health & Consumer Affairs, and the advertising self-regulatory organisation.
Find out more:estaticos.cocacola.es
Linked document:Download linked document

IMED Multi-disciplinary unit for Obesity treatment

IMED Hospitales has set up the Multidisciplinary Unit for the Treatment of Obesity, a complete unit to solve the problems of obesity and overweight. A team of surgeons, endoscopists, psychologists, psychiatrists, endocrinologists, nutritionists, anesthesiologists, aesthetic doctors and plastic surgeons who work together to provide customized and effective solutions.

Categories:Evidence of Multidisciplinary Intervention
Target age group:Adults and children
Organisation:IMED Elche
Find out more:www.imedelche.com
Linked document:Download linked document
References:Available from: http://www.imedelche.com/fr/pagina/unidad-de-tratamiento-integral-de-la-obesidad/ [accessed August 2019].

NAOS strategy Nutrition, Physical Activity and Obesity Prevention

Aims to promote a healthy diet and increase physical activity.

Categories:Evidence of National Obesity Strategy/Policy or Action plan
Evidence of Nutritional or Health Strategy/ Guidelines/Policy/Action plan
Evidence of Physical Activity Guidelines/Policy
Target age group:Adults and children
Organisation:The Ministry of Health and Consumer Affairs, the Ministry of Education and Science, the Ministry of Agriculture, Fisheries and Food, the Autonomous Communities, Town Councils, foundations, professionals, businesses, NGO’s and consumer associations.
Linked document:Download linked document

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