[Childhood obesity in Spain: Fifteen years of monitoring and action through the WHO European Childhood Obesity Surveillance Initiative (COSI) and the ALADINO study].

Abstract

Childhood obesity is a global Public Health issue with long-term effects on quality of life and high prevalence in Spain, particularly among minors from lower socioeconomic backgrounds. This situation requires intersectoral public policies focused on promoting physical activity and reducing sedentary behaviour through strategies such as physical activity prescription and the recommendation of health assets. This study analyses Spanish policies aimed at promoting and prescribing physical activity within the healthcare system, with an emphasis on the child population and in alignment with the World Health Organization Global Action Plan on Physical Activity 2018-2030. Key policies include the National Strategic Plan for the Reduction of Childhood Obesity, the 2025-2027 Primary and Community Care Action Plan, and the Physical Activity Prescription Plan, which incorporate actions related to awareness-raising, the creation of active environments, and the training of professionals and citizens. These policies have promoted physical activity across educational, healthcare, and community settings, expanding access to safe environments and sports programmes. The development of healthy urban environments, the implementation of physical activity prescription, and the identification and recommendation of health assets have shown progress in recent years, although challenges remain, such as ensuring equitable access to resources and the long-term sustainability of public health interventions. Under the Health in All Policies approach, intersectoral and equitable action is needed, supported by community initiatives that foster cultural change towards healthier lifestyles. Consolidating physical activity prescription and the recommendation of health assets as integral elements of the system is essential to reduce obesity and promote the health of children and adolescents, with benefits extending across the life course.