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The overall aim of CO-CREATE is to reduce the prevalence of obesity among adolescents in the European Union through policy actions to promote a healthier food and physical activity environment.

CO-CREATE will contribute to the evidence and infrastructure for local and national policy changes to make healthy choices the easiest, most appealing, and preferred choices for adolescents across Europe, thus reducing the burden of obesity and related non-communicable diseases, both now and in the future.

The initiative involves young people as a key component throughout the project, designing policies and advocating practices they believe will help improve adolescent health. Supported by the European Commission, the budget will provide a program of activities for a five-year period 2018-2023.

The Backdrop

Childhood obesity is on the rise across Europe. By 2025, overweight and obesity is expected to affect one in every five children, to more than 16 million children across Europe. Being overweight or obese in youth, and in particular in adolescence (13-18 year age group), is a strong predictor of remaining so into adulthood, with an increased risk for a wide range of diseases as a consequence, including type-2 diabetes, hypertension, heart disease, psychosocial morbidity and certain types of cancers.

Individual level treatment of overweight and obesity, such as bariatric surgery and weight loss programs, have proven to be either hard to tolerate or ineffective in sustaining weight loss in a large proportion of people undertaking such efforts. Prevention should therefore be the prioritized strategy to support the European population in maintaining a healthy weight over the long term, including a strong focus on the adolescent age group.

Changing the Context

What we eat and how much we move are direct results of the many individual choices we make each day. Obesity prevention efforts have often focused on trying to influence such individual choices as if they were conscious and rational. However, these choices are strongly influenced by the social, physical and economic environments in which we live. This is especially relevant for children and adolescents, who have lower levels of behavioral autonomy than adults do.

In our present-day environment of ever-presence and easy access to cheap, palatable high-calorie foods appealing to preferences for fat, sugar and salt, our sedentary work and leisure environments, as well as a lack of opportunities for daily physical activity, unhealthy choices are often the easiest, default choices. A large and growing body of research shows that people’s nutrition and physical activity behaviors are influenced by complex sets of contextual elements, including unhealthy and unsupportive physical, social, cultural, economic, and political environments.

To be successful in reducing the prevalence of overweight and obesity, we need to move towards comprehensive policies addressing the food and physical activity systems and environments surrounding us, reshaping the context to make healthy choices the easiest and most widely preferred.

Center Participation

Dr. Deanna Hoelscher is the U.S. investigator on this project and will share data and provide insights from the Texas-based School Physical Activity and Nutrition (SPAN) study, which monitors the prevalence of overweight/obesity in school-aged children in Texas. Hoelscher also serves as a member of the Scientific Advisory Committee and will work on various aspects of the project, including policy analysis tools and development of the evaluation framework. 


Read more about project organization here.