Breaking the obesity-cancer link: assessing European school-based and complementary obesity-prevention strategies and their implementation obstacles.

Nowadays, obesity among children and adolescents is considered an additional factor in cancer development during adulthood. These facts are supported by current epidemiological studies. To address these challenges, a wide range of obesity prevention programmes have been launched in Europe, promoting actions for personalized healthy dietary behaviors, physical exercise, and combinations of both, often using e-health platforms. Another pillar of interventions is school-based policies, such as limiting access to high-fat and high-sugar foods or providing healthy food vouchers, which represent another pillar of public health action, complemented by actions that cover out-of-school activities, such as family interventions, tax policies, engagement actions, and so on. However, the main limitations of the current intervention policies are their depth of penetration and, consequently, upscaling issues. Furthermore, there is a lack of a concrete approach to assess these policies within a Multi-Actor, Context-Aware framework. This multi-pillar assessment is presented in this paper for evaluating children's/adolescents' obesity programmes across fourteen European countries. The analysis includes the coverage of each programme, its financial limitations, results obtained in terms of obesity reduction and mitigation of cancer risk, along with structural and educational system limitations.