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EuropeaN Energy balance Research to prevent excessive weight Gain among Youth (ENERGY) project: Design and methodology of the ENERGY cross-sectional survey

Maartje M van Stralen1*, Saskia J te Velde2, Amika S Singh1, Ilse De Bourdeaudhuij3, Marloes K Martens4, Maria van der Sluis4, Yannis Manios5, Evangelia Grammatikaki5, Mai JM Chinapaw¹, Lea Maes6, Elling Bere7, Jorgen Jensen8, Luis Moreno9, Nataša Jan10, Dénes Molnár11, Helen Moore12 and Johannes Brug2

Author Affiliations

1 Department of Public and Occupational Health, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, the Netherlands

2 Department of Epidemiology and Biostatistics, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, the Netherlands

3 Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium

4 ResCon, Amsterdam, the Netherlands

5 Department of Nutrition and Dietetics, Harokopio University, Athens, Greece

6 Department of Public Health, Ghent University, Ghent, Belgium

7 Faculty of Health and Sport, University of Agder, Kristiansand, Norway

8 Institute of Food and Resource Economics, University of Copenhagen, Copenhagen, Denmark

9 GENUD (Growth, Exercise, Nutrition and Development) Research Group. E.U. Ciencias de la Salud, Universidad de Zaragoza, 50009 Zaragoza, Spain

10 Slovenian Heart Foundation, Ljubljana, Slovenia

11 Department of Paediatrics, Pecs University, Pecs, Hungary

12 Obesity Related Behaviours Research Group, Durham University, Durham, UK

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BMC Public Health 2011, 11:65  doi:10.1186/1471-2458-11-65

Published: 31 January 2011



Obesity treatment is by large ineffective long term, and more emphasis on the prevention of excessive weight gain in childhood and adolescence is warranted. To inform energy balance related behaviour (EBRB) change interventions, insight in the potential personal, family and school environmental correlates of these behaviours is needed. Studies on such multilevel correlates of EBRB among schoolchildren in Europe are lacking. The ENERGY survey aims to (1) provide up-to-date prevalence rates of measured overweight, obesity, self-reported engagement in EBRBs, and objective accelerometer-based assessment of physical activity and sedentary behaviour and blood-sample biomarkers of metabolic function in countries in different regions of Europe, (2) to identify personal, family and school environmental correlates of these EBRBs. This paper describes the design, methodology and protocol of the survey.


A school-based cross-sectional survey was carried out in 2010 in seven different European countries; Belgium, Greece, Hungary, the Netherlands, Norway, Slovenia, and Spain. The survey included measurements of anthropometrics, child, parent and school-staff questionnaires, and school observations to measure and assess outcomes (i.e. height, weight, and waist circumference), EBRBs and potential personal, family and school environmental correlates of these behaviours including the social-cultural, physical, political, and economic environmental factors. In addition, a selection of countries conducted accelerometer measurements to objectively assess physical activity and sedentary behaviour, and collected blood samples to assess several biomarkers of metabolic function.


The ENERGY survey is a comprehensive cross-sectional study measuring anthropometrics and biomarkers as well as assessing a range of EBRBs and their potential correlates at the personal, family and school level, among 10-12 year old children in seven European countries. This study will result in a unique dataset, enabling cross country comparisons in overweight, obesity, risk behaviours for these conditions as well as the correlates of engagement in these risk behaviours.