Adolescents' obesity is a major concern in our modern life that could lead to significant increase in the rate of obese future generations and consequently in the health budget. The ASSO (Adolescence Surveillance System for Obesity prevention) project in Italy is tackling this new pandemic using the new e-technology through a multi facets monitoring system on life style including food consumptions, meal patterns and habits, alcohol, smoking, physical activity, fitness and sedentariness, and biological/genetic, and socio-cultural/environmental characteristics of adolescents. The project has been recently piloted in the South of the country. This chapter summarizes the design and structure of the ASSO system, its implementation and the results of an evaluation process for its possible extension to the whole Italian territory and to other European realities as a national surveillance system.
Top1. Introduction
The world's population is facing an unprecedented obesity pandemic (Gortmaker, 2011; Swinburn, 2011; WHO, 2006; WHO 2014). Not only are the rich and occidental countries struggling with alarming numbers of obese people but also poorer countries are also reporting an increasing number of deaths directly or indirectly related to obesity (Bhurosy & Jeewon, 2014; Popkin, 2012). The World Health Organization (WHO) showed that the main cause for mortality is cardiovascular disease (WHO 2014), with obesity one of the major determinants.
Longitudinal studies in all countries since the early 2000s have found increasing rates of overweight specifically in children and adolescents (UNICEF-WHO-World Bank, 2015). Recent data show that in Europe 8-29% of adolescents are overweight/obese, with a growing gradient from Northern to Southern countries (HBSC, 2016a). The HBSC study in Italy (HBSC, 2016b) shows that the prevalence of overweight/obesity in adolescents is on average around 19%.
It is well known that obesity and its associated non communicable diseases are common illnesses of childhood and adolescence representing an emergent public health issue (Ng, 2014; WHO, 2014). There is at least a moderate correlation between weight in childhood and adulthood, as well as obesity in childhood and later health problems (Freedman, 2005; Hills, 2007).
Collecting data on adolescents’ health and behaviours through a standardized surveillance system is essential to understand diet- and physical activity-related health problems, in order to implement appropriate, effective and sustainable action plans. Data collected through a public health surveillance system represents a source that can be used for action, planning, evaluation, and formulating research hypotheses (German, 2001).
Few national surveillance systems have been established worldwide in the field of adolescents’ obesity and lifestyles, such as the Youth Risk Behavior Surveillance System (YRBSS) in the USA (Brener, 2013) and the Health Behavior in School-aged Children Study in Europe (Currie, 2009). In Italy, the paper-based HBSC system is currently being up-taken every two years to collect health behavior information in adolescents, but the need for a web-based, user-friendly, low cost, valid and obesity/fitness-focused instrument has been highlighted recently (Tabacchi, 2014).