According to the WHO (2019), one in five children in Europe aged 0 to 14 have a body weight above the age- and sex-adjusted mean value.

This also applies to Austria, in particular to children between the ages of four and six years, as the SALTO study showed.[1] 

Severe obesity: adiposity

Obesity, including severe obesity (adiposity), is not a matter of flaws, but rather classified as a nutritional disease, and is usually measured by Body Mass Index.[2] Without action, children who are overweight not only suffer from organic disorders, but also are likely to face discrimination, disadvantage in education and later by reduced chances on the job market.[3]

Childhood obesity starts before birth, and is now not only seen as a calorie input/output problem, but as a multifactorial process.[4] They don’t just "grow out of it". Far from it: without early intervention, 90% of children already overweight at the age of three will remain overweight into adolescence and adulthood.[5] Therefore, prevention is considered the most important strategy for reducing obesity and its accompanying illnesses! 

SALTO: SALzburg Together against Obesity

The aim of the project "SALzburg Together against Obesity”[6]  was to enable children to grow up healthy in preschool. The "Community Oriented Core-Setting (COCS)" approach was developed, with the preschool as a core unit of the community, in order to promote physical fitness (e.g. improving motor skills) and nutrition (e.g. establishing water as a thirst quencher) in the children's everyday life over the long term.[7] 

A bundle of actions was tailored at an interpersonal level for preschool teachers (e.g. nutrition handbooks, parent communication coaching and help & support), parents (parents' evenings, fact sheets, take home activities) and community partners (e.g. stakeholder dialogues).

Taking into account the theory of the diffusion of preventive practices[8] - "one behaviour, many information channels" - six topics were each implemented into the kindergarten´s educational programme over half a preschool year (e.g. preparing child-appropriate food portions, father-child cooking). With the help of the SALTO coordinator, the implementation of the measures was arranged with the kindergarten team.

Research results

Over three years, 700 children, 980 parents and 13 educators were observed for their body weight, food and activity preferences, time spent sitting, motor skills and knowledge by an annual internal and external evaluation. The accompanying research showed that the proportion of severely overweight children remained the same, motor milestones, such as doing a somersault, were now achieved by more children. In addition to this, the corridor and garden of the open-space concept compared to the physical education room offers a valuable space for movement.

Overall, SALTO proved to make a significant contribution in improving knowledge transfer on healthy eating and physical activity within the group of educators and in interaction with parents, as well as providing additional impetus for the establishment of preventive practices in preschool.[9] 


Susanne Ring-Dimitriou is a researcher at the Department of Sport and Exercise Science and heads the University 55-PLUS programme.

Literature on the article is available from the author: susanne.ring-dimitriou(at)sbg.ac.at

[1] Mayer et al., 2014; SALTO 2017 [2] ICD-11, WHO, Version 09/2020 [3] WHO, 2019 [4] Butland et al., 2007 [5] Geserick et al., 2018 [6] SALTO, 2015-2018; gefördert vom Land Salzburg und dem Bundesministerium für Landesverteidigung und Sport [7] Ring-Dimitriou et al., 2019 [8] Rogers, 2002 [9] vgl. Ring-Dimitriou, Aistleitner, & Weghuber, 2018

Translation: Leonie Young


An article for the PGC Campaign WALK THE TALK

 Barrierefreiheit: Kurzbeschreibung des Bildes


Graphic: Kay Müller, PLUS






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