The Role of Energy Balance-Related Behaviors (EBRBs) and their Determinants on the Prevalence of Overweight and Obesity in Children in Need, in Greece: A Scoping Review

Background/aim: There is scarce literature concerning 'children in need' at a European level (including Greece), particularly regarding energy balance-related behaviors (EBRBs) associated with overweight and obesity. This scoping review aimed to synthesize evidence on the EBRBs associated with overweight and obesity among 'children in need' in Greece and their key determinants.

Methods: Inclusion criteria included children (0-18 years) who were 'in need', living with overweight or obesity, residing in Greece, and which included data on EBRBs and their potential determinants. APA PsychInfo, CINAHL, Cochrane CENTRAL, EMBASE, MEDLINE, as well as grey literature (in Greek/English), were searched (without publication date limitations). Data was extracted using an adapted Joanna Briggs Institute tool.

Results: Seven studies were identified (n = 141-7,283 participants), highlighting prevalent EBRBs, categorized into groups; nutrition (lower diet quality, poor dietary habits, higher intake of carbohydrates, sugar sweetened beverage consumption, low adherence to the Mediterranean diet pattern, lack of daily breakfast consumption), sleep (low sleep duration), and sedentary behaviors / physical activity (television in children's bedrooms, high screen time, low physical activity, high sedentary time). Key determinants included low parental education, food culture, food preparation by grandmothers, the home environment, parental dietary choices, and lower socioeconomic status, etc. CONCLUSION: This review identified specific EBRBs associated with overweight and obesity affecting children in need in Greece and their determining factors. These findings should guide future research, tailored intervention programs, and public health policies (i.e. the European Child Guarantee Strategy) targeted at this understudied priority population of children in need, in Greece. Review registration number: Open Science Framework: https://osf.io/w7qdu.