Prevalence (%) of obesity in children aged 5–19 years by the WHO European region from 1980 to 2016.
\r\n\t
\r\n\tTherefore, this book will aim to analyze practices, strategies, approaches of biodiversity management and examine factors that affect the effectiveness of managing biodiversity in the parks. In addition, the roles of government and other land management agencies and involvement of indigenous community, landholders and community groups to conserve and improve biodiversity management will also be highlighted.
The advance of cryo-electron microscopy (cryo-EM) and electron tomography (ET) opens a new window to the analysis of large biomolecular assemblies under biologically relevant conditions. Figure 1 illustrates the basic procedure from EM/ET experiment to the understanding of molecular complexes. 2D images of samples are the raw data from EM/ET experiment. A 3D reconstruction is needed to build volume maps, which often needs an initial 3D model to start with. In most cases, the resolution of EM/ET maps are not high enough to determine atom positions; therefore, people rely on known high-resolution structures from X-ray, NMR, or homology modelling to derive structures of molecular assemblies through either rigid fitting or flexible fitting. Because molecular environments are different in X-ray crystal, in NMR solution, and on cryo-EM grids, molecular structures in these samples are not identical, especially in the side chains, in loops, and around hinge regions. When the resolution of EM/ET maps is not high enough to show structure difference from X-ray or NMR structures, rigid fitting is often used to produce complex structures [1-8].
When EM/ET maps have high enough resolution or for systems with flexible components, rigid fitting cannot handle structural variation information in EM/ET maps. In different states, proteins and protein assemblies often adopt different conformations, such as in bound and unbound states. Typically, protein side chains have certain conformational flexibilities and can adapt to different environmental conditions. To accommodate conformational variations, a process called flexible fitting is used to change structures from X-ray or NMR experiments to match EM/ET maps. There are a series of methods available to perform flexible fitting [9-14].
Whether to choose rigid fitting or flexible fitting depends on the resolution of EM/ET maps. There is no absolute resolution boundary for choosing rigid fitting from flexible fitting. The rule of thumb is that when the resolution cannot distinguish structure difference of EM/ET maps from fitting structures, then rigid fitting should be used. Flexible fitting becomes necessary when the resolution is high enough to show significant structural variation between the fitting X-ray/NMR structures and the EM/ET maps. For proteins undergoing domain hinge motion, a map with a resolution as low as 50 Å could show the difference, while for side chain rotations, a map needs a resolution of 10Å or higher to identify an alternate orientation.
Basic procedure from electron microscopy experiment to macromolecular structures.
To illustrate the procedure of atomic structure derivation from EM maps, we describe here the core-weighted grid-threading Monte Carlo (CW-GTMC) rigid fitting method [2] and the map-restrained self-guided Langevin dynamics (MapSGLD) flexible fitting method[14]. Using four examples, we highlight their applications in structural, dynamics, and mechanism studies. The rigid fitting and flexible fitting methods have been implemented in both AMBER [15] and CHARMM [16]. In AMBER, this method has been implemented in Sander, which is part of AmberTools and is freely available at: http://ambermd.org/#AmberTools, as well as in pmemd, which is the main AMBER simulation engine (http://ambermd.org/#Amber14). In CHARMM, it is part of the EMAP module, where a rigid fitting is done through EMAP DOCK command, and a flexible fitting is carried out through DYNA simulation command. Users can refer to the emap test cases in both AMBER and CHARMM as examples of rigid and flexible fitting.
Rigid fitting of atomic structures to electron microscopy images is a common approach to interpret low-resolution maps and to obtain complex structural information. Figure 2 illustrates the procedure of a rigid fitting to obtain a complex structure. Assume EM/ET experiment produced the complex map em0 and the structures of components, a7na and a7nb are available. By rigid fitting a7na and a7nb into em0, one can obtain the complex structure of a7na+a7nb. A typical rigid fitting starts with blurring the molecular structures, a7na and a7nb, to create maps, ema and emb, which is often done by distributing atomic masses into grid points in the space. The component maps, ema and emb, are translated and rotated to fit the EM/ET map em0. After all component maps are fit, component molecules are positioned accordingly to produce the complex structure.
Rigid fitting steps to derive atomic structures of complexes.
A map represents a distribution over a spatial region. Typically, a map is described by quantities, e.g., density, on lattice grid points:
Here, the map grids are defined by grid point positions,
A major application of EM/ET experiment is to determine structures of molecular assemblies. For low resolution of EM/ET maps, electron densities of structure components spread to a certain range beyond atomic boundaries, which causes significant density overlap between neighboring structures. We define the “core” region of a structure as the part whose density distribution is unlikely to overlap with the density distribution of the other maps and to be altered by the presence of adjacent components. The “surface” region is defined as the part that is accessible or can interact with other components. Therefore, the core region is always enclosed by the surface region.
It is then possible to define a core index, which describes the depth of a grid point located within this core as follows:
where,
For a correct fit, a match in the core regions (high core index) corresponds to a high correlation in densities.
For a correct fit, a match in the surface regions (low core index) corresponds to a high correlation in densities.
For a correct fit, a match between the core region of components and the surface region of assemblies must have low correlation in densities.
For a correct fit, a match between a surface (low core index) region and a core region may have low correlation in densities.
For scenarios 1–3, a normal correlation function works fine to distinguish the correct fit from wrong fits. But for scenario 4, the distribution property is altered by the overlap density from neighboring components in a complex map and a regular correlation function is likely to fail. To account for the effect of overlap, and properly recognize the correct fit from misfit, we need to minimize the contribution to correlation function from scenario 4. This can be achieved by “down-weighting” the match between a region with low core index in the map of individual components and a region with high core index in the complex map. We choose the following weighting function to implement this idea:
where
where
Figure 3 illustrates the definition of core indices for the maps of two individual proteins, A and B, and their complex. In each map, the core index is zero outside the density regions, 1 at the outer edge and becomes larger for the grid points that locate more deeply in the core region. Please note that the core region does not necessarily correspond to the region with high density. For internal cavities that are buried well below the surface of a structure (e.g., the cavity in protein B), it is possible that the core index can have high values while densities are low. When proteins A and B form complex, the core indices of their interaction surfaces dramatically increase in regions where the surfaces become deeply buried in the AB complex.
The core index distributions in schematic 2D maps of proteins A and B and their complex. Regions of protein density are colored red and green, respectively, and a region of protein B containing an inaccessible cavity as shown in light green. Regions outside of the protein are colored white. The numerical values of the core index for each grid point are labelled in each map. Bold numbers indicate the core indices of proteins A and B that change upon the formation of the AB complex.
These core-weighted correlation functions are designed to down-weight the regions overlapping with other components, while emphasizing the regions with no overlap. As explained above, the regions with significant overlap have small
To perform rigid fitting, one needs to search a conformational space with three translational and three rotational degrees of freedom. The grid-threading Monte Carlo (GTMC) search is a combination of a grid search and Monte Carlo sampling [17]. The conformational space is split into searching grid points, which is not those defined for maps. Short Monte Carlo searches are performed starting from each of the searching grid points to identify local maxima close to the grid points. After searching out the local maxima, we can identify the global maximum among them. Figure 4 illustrates this procedure for a search in a 2D conformational space. The 2D conformational space is divided into a 3 × 3 grid. Among all the local maxima, the local maximum at (5.3) has the highest correlation and is identified as the global maximum. More details of the core-weighted fitting method can be found elsewhere [2].
Illustration of the grid-threading Monte Carlo (GTMC) search in a 2D conformational space. The conformational space is split into a 3 × 3 grid. From each of the 9 grid points, a short MC search (shown as purple curves) is performed to locate a nearby local maximum. Among these local maxima, the global maximum is identified. Only conformations along the 9 Monte Carlo paths are explored during a GTMC search.
When EM/ET maps have enough resolution to show structural difference from X-ray or NMR structures, flexible fitting should be applied. Flexible fitting allows conformational changes to adapt to the EM/ET maps. Low-resolution EM/ET maps often do not have enough structural information to uniquely define thousands of atomic positions of molecular systems. To make up the informational gap, an atomic force field is used to determine most of the degrees of freedom. An atomic force field defines covalent bonded terms, nonbonded interactions, as well as solvation-free energies. Theoretically, an ideal atomic force field aided with sufficient molecular simulation can determine molecular structures without the need of experimental information. However, current force fields are not accurate enough to determine molecular structures from scratch. In addition, biological systems are often too complicated to be accurately described by overly simplified simulation systems. A middle approach is to utilize an atomic force field to supplement the missing information in low-resolution maps in determining the structure of molecular systems. In other words, low-resolution maps can provide structural information to compensate the inaccuracy in atomic force fields and X-ray or NMR structures provide reasonable initial conformations to simplify the conformational search in molecular simulation.
For a group of N atoms, at the target conformation, these atoms should reproduce the target map at given experimental condition and these atoms must all sit at high-density positions. Because atomic masses are closely correlated to their numbers of electrons, we can define a map-restraint potential as the total products between the atomic mass,
The restraint constant,
It should be noted that this map-restraint potential only captures the low-resolution characteristics of molecular systems and is not designed to reproduce atomic structures by itself. Instead, when aided with an all-atom force field, which contains bonded interactions (bond lengths, bond angles, dihedral angles) and nonbonded interactions (van der Waals, electrostatic interactions, solvation), the map-restraint potential can help to stabilize conformations that agree with the restraint map. It is the combination of a force field and the map restraint that drives an atomic system to the target conformation. This map-restraint potential has an order of O(N) and is very efficient to calculate as compared to other pair-wise nonbonded interactions, especially for large systems.
The map restraints drive atoms in a cooperative way so that atoms interacting through the force field contribute together to match the target map density distribution. The map restraints have the following convenient characteristics for a targeted conformational search:
The map-restraint energy surface is soft, which makes large-scale conformational transition feasible.
The map-restraint is atom-identity-blind, so the restraint energy calculation is of O(N).
The map-restraint energy tolerates noises in target maps.
The map-restraint can be extended to maps of other properties such as partial charges, desolvation energies, and van der Waals interactions [18].
In some cases, there are large-scale conformational changes between X-ray/NMR structures and the EM/ET experimental systems. The self-guided Langevin dynamics (SGLD) simulation method [19-22] is a method designed for an efficient search of conformational space. The equation of SGLD motion with map restraints has the following general form:
where
The method combining the map potential and the SGLD method is called MapSGLD [14]. This is a general method for targeted conformational search. Flexible fitting is a direct application of this method to efficiently identify conformations that match EM/ET maps.
Use restraint maps to maintain structures of GB1 substructures during conformational search.
GB1 folding simulation by targeting the map of the folded state. The black line is for an LD simulation without enhanced sampling and the red line is for an SGLD simulation with an enhanced sampling.
Targeted conformational search is a convenient way to study dynamic properties of macromolecular systems. In protein-folding studies, it has been observed that secondary structure elements fold first, followed by their arrangement to form tertiary structures. To study how the secondary structure elements fold into the tertiary structures, it requires these secondary structures to be maintained during simulations. Similarly, for protein assemblies, it is desired to simulate how individual proteins assemble to form the complex structure while these individual proteins remain folded. These are typical examples of targeted conformational search. Figure 5 shows a small protein, the B1 domain of streptococcal protein G, abbreviated here as GB1, in its folded and unfolded states under the map restraints to maintain its secondary structures. GB1 has 56 residues with one α-helix and one β-sheet. The β-sheet is made of two β-hairpins. Three restraint maps for the three secondary structure motifs were generated from the NMR structure: residues 1 to 19 for the N-terminal β-hairpin, residues 22 to 37 for the helix, and residues 42 to 56 for the C-terminal β-hairpin. Figure 6 shows two simulation results, one with TSG = 300 K and one with TSG =500 K. When TSG = 300 K = T, it was a normal conformational search and the SGLD simulation reduced to a regular Langevin dynamics (LD) simulation, where the simulation failed to reach the folded conformation in up to 100 ns. While in the case of TSG = 500 K, conformational motion was accelerated, which prompted the protein to reach the folded state in 9.5 ns. In other words, the map restraint itself is not enough to bring the protein to the folded state in 100 ns, but SGLD can significantly accelerate the search to find a target conformation.
The pyruvate dehydrogenase multienzyme complex couples the activity of three component enzymes (E1, E2, and E3) in the oxidative decarboxylation of pyruvate to generate acetyl-CoA, linking glycolysis and the tricarboxylic acid cycle. The Bacillus stearothermophilus PDH complex is assembled around a core of 60 dihydrolipoyl acetyltransferase (E2) chains arranged with icosahedral symmetry. Each E2 chain consists of three domains: (i) an N-terminal 9 kDa lipoyl domain, which visits the active sites of the pyruvate decarboxylase (E1) component and then those of E2 and dihydrolipoyl dehydrogenase (E3); (ii) a 4 kDa peripheral subunit-binding domain to which E1 and E3 bind tightly and mutually exclusively; and (iii) a C-terminal 28 kDa catalytic (acetyltransferase) domain, 60 copies of which assemble to form the icosahedral inner core. These domains are linked by stretches of extended, conformationally flexible polypeptide chain.
(a) The experimental map (at 14 Å resolution) of the icosahedral complex formed from 60 copies of the E2 catalytic domain of the pyruvate dehydrogenase. (b) The X-ray structure (PDB code: 1B5S) of the same complex. (c) Comparison of the location of the E2 catalytic domain obtained using a CW-GTMC search (green) with that from the X-ray structure (red) (rms = 2.13Å). The experimental EM map to fit is shown as blue wires.
Using the CW-GTMC method, we fit 60 copies of E2 into a 14 Å electron microscopic map of the icosahedral core of pyruvate dehydrogenase (Figure 7a), a 1.8 MDa complex comprised of 60 copies of the E2 catalytic domain, whose structure (Figure 7b) has been determined using X-ray crystallographic methods (PDB code: 1B5S). The CW-GTMC search with 5000 MC steps for each of 729 (3×3×3×3×3×3) grids identified all 60 global maximum positions [2]. Figure 7c compares the CW-GTMC fit and the corresponding X-ray structure position. The atomic structure of the E2 core from our rigid fit agrees well with the X-ray structure, validating the core-weighted GTMC method.
Since atomic coordinates of the B. stearothermophilus E1 enzyme are not available, the coordinates of the closely related E1 α2β2 tetramer from Pseudomonas putida (PDB entry 1QS0) were used. From sequence alignment of the two enzymes, we found the presence of additional amino acid segments 42–51, 178–182, and 375–380 in the P. putida E1 α-subunit and 187–192 in its β-subunit, which are not present in the B. stearothermophilus E1 enzyme. By omitting these residues from the P. putida structure, we obtained a model for the B. stearothermophilus E1 enzyme. Using the core-weighted grid-threading Monte Carlo (CW-GTMC) method, we fit the coordinates to a 28 Å electron cryo-microscopy map [1]. The transformation space was divided into 5 × 5 × 5 grids and orientation space was divided into 3 × 3 × 3 grids. At each grid point, a 1000-step Monte Carlo search was performed with an initial transformational step size of 15 Å and initial rotational step size of 30°.
The E1E2 cryo-EM map at 28 Å resolution and the atomic structure obtained through CW-GTMC fitting. The left panel shows sectioned view of the density for the E1E2 complex with 60 docked copies of the atomic coordinates of the E1 α2β2 tetramer, the E2 catalytic domain, and the E2 peripheral subunit-binding domain. To illustrate the probable location of the linker domain connecting the peripheral subunit-binding and catalytic domains of the E2 chain, 60 radial spokes have been included. Right panels show the views of the docked E1 molecules (in yellow) and E2 peripheral subunit-binding domains (in red) from threefold (A and C) and fivefold (B and D) vertices. The views in (A) and (B) are for the best fit obtained by the CW-GTMC, while the views in (C) and (D) are for the second-best fit.
The automatic rigid fitting procedure identified two types of best-fit conformations into which all starting positions converged. The spatial relationship between these positions is indicated in the plot shown in Figure 8. In the second-best fit identified by the automated procedure, the E1 tetramer is pushed toward the fivefold vertex, covering some regions of the density not sampled by the best fit. In this orientation, the long axis of E1 is still along the surface of the icosahedron, but it is translated toward the fivefold vertex relative to the best fit. Analysis shows that the path from the best to the second-best fit involves a swivelling motion of E1 around an axis perpendicular to the icosahedral surface, with very little movement of the location and orientation of the E1 active site relative to the inner core. It is interesting that, while neither the best nor the second-best fit appears to span the outer density fully, the fits in Figure 8 show that almost all regions of the outer density are included in one or other of the two orientations of E1. Based on these findings our working hypothesis is that the two orientations reflect stable positions for the E1 tetramer in the E1E2 complex. Since each E1 molecule in the complex may sample both orientations over time, the smear of the outer density in our 3D reconstruction probably reflects the averaged contribution to the structure from these two populations.
The advance in electron microscopy experiment technology results in high-resolution maps, to show dynamic details of macromolecular systems, such as domain motion, loop rearrangements, and side chain reorientations. Here, we describe flexible fitting of EM maps through the MapSGLD method to address the dynamics of macromolecular systems [14]. One advantage of using SGLD for the targeted conformational search is to promote large-scale conformational changes necessary for protein functions. We chose the open–close transitions of a group II chaperonin to demonstrate the application of this method. By flexible fitting a group II chaperonin, mn-cpn, using maps from the EM databank: EMD-5138 (close state) and EMD-5140 (open state) [24], we obtained dynamics of the chaperonin-folding chamber opening and closing, as well as the structures in these states.
Opening (top) and closing (bottom) of the chaperonin-folding chamber during the MapSGLD simulations. The last column compares the final conformations with their corresponding PDB entries (in grey). The opening simulation started from the closed state (PDB: 3J03) and was restrained with the map at the open state: EMD-5140. The closing simulation started from the open state structure (PDB: 3IYF) and was restrained with the map at the closed state: EMD-5138.
Zhang and colleagues have modelled the structures of the closed state (PDB:3J03) [25] and the open state (PDB:3IYF) [24]. We used these model structures as starting conformations and use the maps of the opposite states as restraints to perform MapSGLD simulations to examine the capability of MapSGLD to identify target conformations.
Each monomer of the chaperonin assembly contains three domains, the apical domain (residues 205–334), the intermediate domain(residues 136–204, 335–371) and the equatorial domain (residues 1–135, 372–491). We used movable map restraints to maintain the structures of these domains. The movable map restraints were generated from the initial conformation with a resolution of 3 Å and a map-restraint constant of 0.1 kcal/g. The experimental EM maps were applied to the system as fixed map restraints with a restraint constant of 0.05 kcal/g. Figure 9 shows the conformations during the opening and closing of the folding chamber obtained from MapSGLD simulations. We can see the apparent difference in the starting conformation from the EM maps and the agreement of the final conformations with their restraint maps. The root-mean-square-deviation (rmsd) of the final conformation from the closing simulation was within 1.5 Å from the closed structure (PDB:3J03) and the rmsd of the final conformation from the opening simulation was within 2.0 Å from the opened structure (PDB:3IYF), demonstrating the reliability of the flexible fitting method. From the simulation trajectories we can extract atomic details of the folding chamber dynamics during opening and closing.
Figure 10 shows the energies and rmsd during these MapSGLD simulations. From the middle panel of Figure 10, we can see that the closing simulation reached within 1.51 Å from the closed structure in 20 ps and remained there with little change afterward. Also we can see that the opening simulation reached within 2.01 Å from the opened structure in 20 ps and remained there with little change afterward.
Examining the energy profiles shown in the bottom panel of Figure 10, we can see that in order for the closed assembly to open up, it first went through an energy barrier. It reached a peak at about 15ps, and began an energy decrease throughout the rest of the simulation. Throughout the closing simulation, there was no energy barrier. It was the energy barrier overcoming ability of SGLD made it efficient to overcome of the energy barrier during the opening process.
The opening and closing simulation profiles. Bottom panel: the molecular potential energy profiles during the MapSGLD simulations. Middle panel: the rmsd profiles during the MapSGLD simulations. Top panel: the rmsd profiles during the MD simulations continuing from the final conformations of the MapSGLD simulations.
Driven by the map-restraint potential, MapSGLD simulations search for conformations matching the EM maps. It is the map-restraint potential that makes the targeted conformation a global free-energy minimum state. Without the map-restraint potential, experimental structures may not be the global free-energy minimum states at this simplified simulation conditions. There are many factors that affect the global minimum, such as inaccuracies in the force field, overly simplified setup of the simulated system, or inadequate description of the effects of the solvent. To illustrate this point, we performed conventional molecular dynamics simulations without the map restraint from the final conformations of the MapSGLD simulations, and the rmsd profiles are shown in the top panel of Figure 10. We can see that in the MD simulations, the systems slowly drifted away from the corresponding states, which indicates that the simplification in simulation conditions can cause conformational deviations from experimental observations and the map restraint can help overcome the effect of the simplification in simulation conditions.
A milestone in high-resolution structure determination using cryo-electron microscopy (cryo-EM) has been reached recently [26] through the structure of a complex between Escherichia coli β-galactosidase and the cell-permeant inhibitor phenylethyl β-D-thiogalactopyranoside (PETG), determined by cryo-EM at an average resolution of ~2.2 angstroms (Å). Besides the PETG ligand, ~800 water molecules and for magnesium and sodium ions are identified in the map. To achieve resolutions close to 2 Å using single-particle cryo-EM, preparation of specimens of adequate quality and intrinsic protein flexibility, rather than imaging or image-processing technologies, are the major bottlenecks. Figure 11 shows the EM map and the protein structure fit into the map. The right panel shows side chains and their map density. At this resolution, the EM density of heavy atoms is recognizable.
The 2.2Å resolution EM density map of a complex between Escherichia coli β-galactosidase and the cell-permeant inhibitor phenylethyl β-D-thiogalactopyranoside (PETG) and the flexible fit structure of the complex. The left panel shows the whole complex (as ribbon) and the right panel shows residues around residue A355 shown (sticks).
To understand kinesin walking mechanism, it is desirable first to see how kinesin complexes with microtubule. Due to the heterogeneity of the kinesin–microtubule complex, it is difficult to determine the complex structure through X-ray crystallography. Instead, the complex models are often built from low-resolution electron microscopy maps. The kinesin–microtubule complex system was built by fitting the kinesin motor domains (1BG2 or 2NCD) and tubulin (1JFF) into the complex EM map (EMD-5011). Figure 12 illustrates the structure obtained by the CW-GTMC rigid fitting. Rigid fitting provides a reasonable first guess of the complex structure at the limit of the map resolution. Their surface elements, such as loops and side chains, must adjust to suit their environment. Energy minimizations were performed on these fitting results to derive energetically favorable structures.
Fitting X-ray structures of kinesin (PDB: 1BG2 or 2NCD) (yellow) and microtube (PDB: 1JFF) (cyan) into the 8 Å resolution EM map of a kinesin–microtube complex to obtain initial conformations of the complex. (a) The EM map EMD-5011. (b) A cross-section view of the fitting result. (c) An enlarged view of the fitting. (d) The complex structure from the fitting.
Based on the EM fit complex structures, SGLD simulations were performed to study the dynamics of these complexes at different nucleotide states: 1BG2/ADP, 1BG2/ATP, 2NCD/ADP, and 2NCD/ATP. SGLD simulations showed significant conformational change and the final conformations are compared with the initial fit structures in Figure 13. As can be seen clearly, the motor domains rotated certain angles in related to their initial positions. After the SGLD simulations, 1BG2 in the ADP-binding state rotated about -40° and in the ATP-binding state rotated about 30°. 2NCD in the ADP-binding state rotated approximately -20° and in the ATP-binding state rotated approximately -60°. In other words, 1BG2 rotated count clockwise for about 70°, while 2NCD rotated clockwise for about 40°, when changing from the ADP-binding state to the ATP-binding state. This directional difference in rotation clearly corresponds to the directional walking of the two types of kinesin. Because the coiled-coil linker to cargo extends near the C-terminal of the β6 strand, a counter clockwise rotation will result in a plus-end-directed movement of the linker, and a clockwise rotation will result in a minus-end-directed movement of the linker. This kinesin-specific directional rotation provides clues to understanding the mechanism of kinesin walking directions.
These application examples illustrate the atomic structure derivation procedures through rigid fitting and flexible fitting. These derived atomic structures open a gateway for further understanding of dynamics and functions of molecular systems.
The kinesin–microtubule complexes before and after the SGLD simulations. The initial kinesin structures are shown in grey and microtubules are colored cyan. 1BG2/ADP, 1BG2/ATP, 2NCD/ADP, and 2NCD/ATP are colored green, red, blue, and yellow, respectively. The upper row shows their side views and the bottom row shows their top views. Rotation angles are calculated with the β6 strand in the kinesin motor domains against the initial conformation.
This research was supported by the Intramural Research Programs of National Heart, Lung, and Blood Institute (Z01 HL001027-30). Katherine Wu of Massachusetts Institute of Technology performed the kinesin-microtube simulation.
Obesity in children is the most serious public health problem globally [1], as children are more likely to become obese adults in their future lives. Currently, childhood obesity represents a significant public health challenge in both developed and developing countries by increasing the burden of noncommunicable diseases (NCDs) [2]. Recent estimates suggest that over 38 million children younger than 5 years of age were overweight or obese in 2019 [3]. Over 340 million children and adolescents aged 5–19 years were overweight or obese in 2016 [3]. The prevention of diabetes mellitus and obesity in adults and children was one of the goals set by the World Health Assembly in 2013 [4]. The rapid increase worldwide in obesity is also analyzed in association with the economic causes because some differences were observed between high- and low-income settings. In high-income settings, the higher prevalence of obesity is observed in disadvantaged and marginalized communities. In contrast, in low- and middle-income settings, the prevalence of obesity is higher in groups with higher socioeconomic status. This trend can be explained by socioeconomic inequalities, because in the high-income countries, commonly, the socioeconomic disparities improve the consumption by the poor people of inexpensive, energy-dense foods and beverages.
\nFurthermore, the increment of obesity prevalence by 23–33% was recorded for children in low-education, low-income, and higher-unemployment households. The family with low-income demonstrates a lower awareness that their children are overweight and then face a host of barriers to improving the diet, the activity behaviors, and the general health status [5]. Many economic consequences for public health strategies are related to the epidemic trend of childhood obesity.
\nThe problem of childhood obesity has become a global public health concern, and the fight for its prevention is a commitment that involves all institutions. The prevention of obesity requires the implementation of surveys to monitor its evolution over time, the knowledge of its determinants, and the research and implementation of interventions, necessarily in a multisectoral and multidisciplinary context, as well as a continuous evaluation process. These actions are necessary for the implementation of evidence-based interventions, which must be supported by appropriate nutritional policies. Overweight and obesity at a young age are associated with various health or economic consequences, therefore it is important to analyze the causes and risk factors and identify the best prevention and treatment strategies. On the prevention of childhood obesity, the promotion of teamwork and the dissemination of information related to childhood obesity is one of the vital strategies to fight against childhood and adolescent obesity. Therefore, teamwork in health care is a crucial strategy for promoting public health and preventing childhood chronic diseases such as childhood obesity.
\nIn Europe, childhood obesity remains a significant health challenge and is distributed disparately across and between countries and population groups [6]. Approximately, 398, 000 children aged 6–9 years were severely obese in Europe in 2019 [7]. Obesity in children is associated with immediate adverse consequences such as psychological problems [8] and lower educational attainment [9]. Also, it is associated with negative health effects later in life or adulthood, such as type 2 diabetes mellitus, hypertension, obstructive sleep apnea, dyslipidemia, and other noncommunicable diseases [10]. Childhood obesity is the outcome of an interaction between a complex series of factors related to environmental, genetic, and ecological effects [10]. Due to the speedily increasing prevalence of childhood obesity in Europe, various initiatives and actions have been launched in recent years in response to this alarming trend. As a result, the WHO European Childhood Obesity Surveillance Initiative has measured the trends in childhood obesity for over a decade [11]. It provides data to inform policy and practice to respond to the problem of childhood obesity [11, 12]. Also, the EU developed an action plan to tackle childhood obesity (EU Action Plan on Childhood Obesity 2014–2020) on February 24, 2014 [13]. However, the progress on combating obesity in children has been slow and inconsistent across the region. For instance, the latest data have shown that southern European countries such as Greece, Italy, Malta, Cyprus, San Marino, and Spain have the highest rate of childhood obesity (nearly one in five children are obese) [14]. On the other hand, Denmark, France, Ireland, and Norway are among countries with the lowest rates of obesity in children in either sex [14]. Hence, childhood obesity is still a so-called time bomb [15] for future demands for health services and could jeopardize the progress toward achieving the Sustainable Development Goals (SDGs) [16].
\nThe present chapter is aimed at (1) illustrating the prevalence of obesity in children and adolescents aged 5—19 years by the WHO European Region and (2) analyzing the effectiveness of the prevention strategies adopted in EU countries to combat childhood obesity from a social and legal point of view and pointing out the best strategies to reduce the prevalence of obesity in children and adolescents.
\nData on the prevalence of obesity in children and adolescents aged 5—19 years in the WHO European Region were taken from the Global Health Observatory (GHO) data [17]. By geographic area, the highest crude prevalence of childhood obesity was observed in Mediterranean countries in 2016, ranging from 7.6% to 13.8% for either sex. In particular, Greece, Malta, Italy, Cyprus, Andorra, Turkey, and Israel among the Mediterranean countries had the highest prevalence of childhood and adolescent obesity in 2016 (Table 1). In 1980, Oriental European countries had a prevalence of less than 2%, ranging from 0.3 to 1.9%. However, in 2016, it changed completely, and the prevalence was more than 4%, ranging from 4.2 to 11.1% (Table 1). The prevalence in all northern European countries, except Iceland, increased by over 100% between 1980 and 2016, but in Iceland, it increased by 94% in the same period (5.1% in 1980 and 9.9% in 2016). In 2016, among the Western European countries, the United Kingdom (UK) and Germany had the highest childhood obesity. In contrast, Armenia, Azerbaijan, and the Republic of Moldova among Eastern European countries with relatively low prevalence levels (Table 1). The prevalence distribution in Oriental Europe countries showed relatively small when compared to the other areas in Europe in 2016. However, EU member states (Bulgaria, Czechia, Hungary, Lithuania, Poland, Slovakia) among Oriental countries had higher prevalence levels (Table 1).
\n\n | 1980 | \n1990 | \n2000 | \n2010 | \n2016 | \n||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
\n | M (%) | \nF (%) | \nT (%) | \nM (%) | \nF (%) | \nT (%) | \nM (%) | \nF (%) | \nT (%) | \nM (%) | \nF (%) | \nT (%) | \nM (%) | \nF (%) | \nT (%) | \n
Mediterran ean Region | \n\n | \n | \n | \n | \n | \n | \n | \n | \n | \n | \n | \n | \n | \n | \n |
Turkey | \n0.7 | \n0.8 | \n0.7 | \n2.3 | \n2.5 | \n2.4 | \n5.2 | \n5.3 | \n5.2 | \n9.3 | \n8.7 | \n9 | \n12.1 | \n10.9 | \n11.5 | \n
Cyprus | \n3.7 | \n1.8 | \n2.7 | \n8.5 | \n4.2 | \n6.4 | \n11.9 | \n6.1 | \n9.1 | \n14.1 | \n7.6 | \n10.9 | \n15.5 | \n8.7 | \n12.2 | \n
Israel | \n7.5 | \n5.9 | \n6.7 | \n9.8 | \n7 | \n8.4 | \n11.8 | \n8.1 | \n10 | \n13.4 | \n9 | \n11.3 | \n14.2 | \n9.5 | \n11.9 | \n
Andorra | \n8.8 | \n7 | \n7.9 | \n11.9 | \n8.6 | \n10.3 | \n13.4 | \n9.3 | \n11.4 | \n14.5 | \n10 | \n12.3 | \n15 | \n10.4 | \n12.8 | \n
Malta | \n8.6 | \n7.2 | \n7.9 | \n11.2 | \n8.2 | \n9.8 | \n13.2 | \n9.4 | \n11.4 | \n14.9 | \n10.5 | \n12.7 | \n15.7 | \n11.1 | \n13.4 | \n
Portugal | \n2 | \n1.7 | \n1.9 | \n4.4 | \n3.5 | \n3.9 | \n7.9 | \n6.4 | \n7.2 | \n10.4 | \n9.2 | \n9.8 | \n10.7 | \n10.2 | \n10.4 | \n
Spain | \n4.7 | \n2.8 | \n3.8 | \n7 | \n3.8 | \n5.4 | \n9.3 | \n5.1 | \n7.3 | \n11.8 | \n7.2 | \n9.5 | \n13.1 | \n8.4 | \n10.8 | \n
Albania | \n0.4 | \n0.2 | \n0.3 | \n1 | \n0.6 | \n0.8 | \n2.6 | \n1.5 | \n2.1 | \n6.1 | \n3.6 | \n4.9 | \n9.5 | \n5.5 | \n7.6 | \n
Croatia | \n1.3 | \n0.7 | \n1 | \n3.1 | \n1.7 | \n2.4 | \n5.9 | \n3.2 | \n4.6 | \n10.3 | \n5.7 | \n8.1 | \n13.8 | \n7.9 | \n10.9 | \n
France | \n3.2 | \n2.9 | \n3 | \n4.5 | \n3.7 | \n4.1 | \n6.2 | \n5 | \n5.6 | \n7.9 | \n6.3 | \n7.1 | \n8.9 | \n7.2 | \n8.1 | \n
Greece | \n5.8 | \n3.6 | \n4.7 | \n8.5 | \n4.9 | \n6.7 | \n11.2 | \n6.6 | \n9 | \n14.8 | \n9.1 | \n12 | \n16.8 | \n10.7 | \n13.8 | \n
Italy | \n6.2 | \n4.2 | \n5.2 | \n8.2 | \n5.1 | \n6.7 | \n12.2 | \n7.2 | \n9.3 | \n13.3 | \n9.3 | \n11.4 | \n14.5 | \n10.4 | \n12.5 | \n
Montenegro | \n0.4 | \n0.2 | \n0.3 | \n1.3 | \n0.7 | \n1 | \n3.7 | \n2 | \n2.9 | \n7.2 | \n3.9 | \n5.6 | \n9.7 | \n5.3 | \n7.6 | \n
Northern Region | \n\n | \n | \n | \n | \n | \n | \n | \n | \n | \n | \n | \n | \n | \n | \n |
Iceland | \n5.8 | \n4.4 | \n5.1 | \n8.2 | \n5.5 | \n6.9 | \n10.2 | \n6.3 | \n8.1 | \n11.5 | \n6.7 | \n9.1 | \n12.5 | \n7.2 | \n9.9 | \n
Ireland | \n1.4 | \n1.5 | \n1.5 | \n3 | \n3.1 | \n3.1 | \n5.3 | \n5.6 | \n5.4 | \n8.5 | \n8 | \n8.3 | \n10.4 | \n9.1 | \n9.8 | \n
Denmark | \n3.7 | \n3.3 | \n3.5 | \n6 | \n4.5 | \n5.3 | \n8.1 | \n5.2 | \n6.7 | \n8.8 | \n4.9 | \n6.9 | \n9.4 | \n4.9 | \n7.2 | \n
Estonia | \n1.7 | \n1.7 | \n1.7 | \n2.6 | \n2.3 | \n2.5 | \n3.6 | \n2.8 | \n3.2 | \n5.6 | \n3.7 | \n4.7 | \n7.8 | \n4.7 | \n6.3 | \n
Finland | \n3.4 | \n1.5 | \n2.5 | \n6.7 | \n3 | \n4.9 | \n9.3 | \n4.2 | \n6.8 | \n11.1 | \n4.9 | \n8.1 | \n12.4 | \n5.6 | \n9.1 | \n
Netherlands | \n1.4 | \n1.2 | \n1.3 | \n2.5 | \n2 | \n2.3 | \n4.5 | \n3.4 | \n3.9 | \n6.9 | \n4.8 | \n5.9 | \n8.4 | \n5.6 | \n7 | \n
Norway | \n2.7 | \n2.5 | \n2.6 | \n4.7 | \n3.9 | \n4.3 | \n7.2 | \n5.6 | \n6.4 | \n9.1 | \n6.8 | \n8 | \n10.4 | \n7.7 | \n9.1 | \n
Sweden | \n3.3 | \n2.5 | \n2.9 | \n4.7 | \n2.9 | \n3.9 | \n6.5 | \n3.6 | \n5 | \n7.4 | \n4 | \n5.7 | \n8.6 | \n4.7 | \n6.7 | \n
Oriental Region | \n\n | \n | \n | \n | \n | \n | \n | \n | \n | \n | \n | \n | \n | \n | \n |
Hungary | \n2 | \n1.4 | \n1.7 | \n3.5 | \n2.3 | \n2.9 | \n5.8 | \n3.7 | \n4.8 | \n9.9 | \n6.2 | \n8.1 | \n13.7 | \n8.4 | \n11.1 | \n
Kazakhstan | \n1.5 | \n0.8 | \n1.2 | \n2.4 | \n1.4 | \n1.9 | \n3.7 | \n2.1 | \n2.9 | \n5.6 | \n3.4 | \n4.6 | \n8.1 | \n4.9 | \n6.5 | \n
Lithuania | \n1.3 | \n1.1 | \n1.2 | \n2.7 | \n2.1 | \n2.4 | \n4.3 | \n2.8 | \n3.6 | \n6.3 | \n3.7 | \n5 | \n8.7 | \n4.8 | \n6.8 | \n
Armenia | \n1.3 | \n1.2 | \n1.3 | \n2.2 | \n1.9 | \n2 | \n2.8 | \n2.3 | \n2.6 | \n3.8 | \n3.2 | \n3.5 | \n5.3 | \n4.2 | \n4.8 | \n
Azerbaijan | \n0.9 | \n0.7 | \n0.8 | \n1.5 | \n1.2 | \n1.3 | \n2.2 | \n1.8 | \n2 | \n3.5 | \n2.9 | \n3.2 | \n5.3 | \n4.4 | \n4.9 | \n
Bosnia and Herzegovina | \n0.3 | \n0.2 | \n0.3 | \n1 | \n0.6 | \n0.8 | \n2.2 | \n1.3 | \n1.8 | \n4.5 | \n2.9 | \n3.7 | \n6.5 | \n4.3 | \n5.4 | \n
Bulgaria | \n1.6 | \n1 | \n1.3 | \n3.4 | \n2 | \n2.7 | \n5.9 | \n3.5 | \n4.7 | \n10.1 | \n5.8 | \n8 | \n13.6 | \n7.8 | \n10.8 | \n
Czech Republic | \n2.3 | \n1.5 | \n1.9 | \n3.7 | \n2.2 | \n3 | \n5.8 | \n3.1 | \n4.5 | \n9.1 | \n4.8 | \n7 | \n12.6 | \n6.6 | \n9.7 | \n
Poland | \n1.4 | \n0.6 | \n1 | \n2.9 | \n1.3 | \n2.1 | \n4.9 | \n2.1 | \n3.6 | \n8.8 | \n3.6 | \n6.3 | \n12.7 | \n5.3 | \n9.1 | \n
Republic of Macedonia | \n1.3 | \n0.7 | \n1 | \n2.8 | \n1.4 | \n2.1 | \n5.3 | \n2.7 | \n4 | \n8.7 | \n4.5 | \n6.7 | \n11.9 | \n6.4 | \n9.3 | \n
Republic of Moldova | \n0.4 | \n0.3 | \n0.4 | \n1.1 | \n0.8 | \n1 | \n2 | \n1.4 | \n1.7 | \n3.2 | \n2.1 | \n2.7 | \n5.1 | \n3.3 | \n4.2 | \n
Romania | \n0.8 | \n0.4 | \n0.6 | \n1.7 | \n1 | \n1.4 | \n3.6 | \n1.9 | \n2.8 | \n7.1 | \n3.7 | \n5.4 | \n10.7 | \n5.4 | \n8.1 | \n
Russian Federation | \n1.7 | \n1.4 | \n1.5 | \n3.1 | \n2.2 | \n2.6 | \n4.1 | \n2.4 | \n3.2 | \n6.6 | \n3.3 | \n5 | \n9.5 | \n4.4 | \n7.1 | \n
Serbia | \n1 | \n0.5 | \n0.8 | \n2.5 | \n1.2 | \n1.9 | \n5.1 | \n2.5 | \n3.8 | \n9.2 | \n4.9 | \n7.1 | \n12.4 | \n7 | \n9.8 | \n
Slovakia | \n0.8 | \n0.4 | \n0.6 | \n1.8 | \n1 | \n1.4 | \n3.5 | \n1.9 | \n2.7 | \n6.8 | \n3.7 | \n5.3 | \n10.4 | \n5.7 | \n8.1 | \n
Occidental Region | \n\n | \n | \n | \n | \n | \n | \n | \n | \n | \n | \n | \n | \n | \n | \n |
Switzerland | \n1.1 | \n0.9 | \n1 | \n3.1 | \n2.1 | \n2.6 | \n5 | \n3.1 | \n4.1 | \n6 | \n3.8 | \n5 | \n6.9 | \n4.6 | \n5.8 | \n
United Kingdom | \n3 | \n3.8 | \n3.4 | \n5.2 | \n6 | \n5.6 | \n8.3 | \n8.6 | \n8.5 | \n10.3 | \n9.6 | \n9.9 | \n10.9 | \n9.4 | \n10.2 | \n
Luxembourg | \n3.6 | \n2.7 | \n3.2 | \n5.7 | \n3.8 | \n4.8 | \n7.8 | \n4.9 | \n6.4 | \n9.5 | \n5.7 | \n7.6 | \n10.4 | \n6.2 | \n8.3 | \n
Belgium | \n4.5 | \n4.6 | \n4.6 | \n6.3 | \n5.2 | \n5.8 | \n7.5 | \n5.6 | \n6.6 | \n7.8 | \n5.5 | \n6.7 | \n8.2 | \n5.8 | \n7 | \n
Austria | \n3.5 | \n1.8 | \n2.6 | \n5.6 | \n2.6 | \n4.1 | \n7.9 | \n3.6 | \n5.8 | \n9.8 | \n4.8 | \n7.4 | \n11.2 | \n6 | \n8.6 | \n
Germany | \n3.8 | \n2.7 | \n3.3 | \n5.9 | \n3.7 | \n4.9 | \n8 | \n4.8 | \n6.4 | \n9.7 | \n5.8 | \n7.8 | \n11 | \n6.8 | \n8.9 | \n
Prevalence (%) of obesity in children aged 5–19 years by the WHO European region from 1980 to 2016.
Data source: Global Health Observatory (GHO) data [17]; M, male; F, female; and T, total.
Obesity in children aged 5–19 years in almost all European regions have increased rapidly from 1980 to 2016. Mainly EU member states have shown increasing trends in the prevalence of obesity in children and adolescents during the study period. Notably, Greece and Croatia have shown secular trends in the prevalence of childhood obesity among EU countries in the Mediterranean Region (Figure 1). Besides, the prevalence in the United Kingdom tripled for either sex from 1980 to 2016, ranging from 3.4 to 10.2%, respectively (Table 1). Similarly, in France and Spain, the prevalence almost tripled from 1980 to 2016: for example, in France, it ranged from 3% in 1980 to 8.1% in 2016 and in Spain, passing from 3.8% in 1980 to 10.8% in 2016 (Table 1). In Slovakia, the prevalence of obesity in children has increased from 0.6% in 1980 to 8.1% in 2016 (Table 1). On the other hand, in Cyprus, Lithuania, Portugal, and the Netherlands, the prevalence has increased more than five times over 36 years in each country (Table 1). In contrast, in Italy, Malta, and Belgium, the magnitude of childhood obesity has doubled from 1980 to 2016. As shown in Table 1, in Poland, the prevalence has increased from 1% in 1980 to 9.1% in 2016, while in Bulgaria, it grew by more than eight times in the same period (1.3% in 1980 and 10.8% in 2016). In Ireland, the prevalence of obesity in children and adolescents has steadily increased over 36 years (1.5% in 1980 and 9.8% in 2016) (Figure 2). Mainly the prevalence level increased from 1.5 and 1.4%, respectively, for girls and boys in 1980 to 9.1 and 10.4% for girls and boys in 2016 (Table 1). Furthermore, the Oriental EU member states except for Lithuania all have shown consistently increased trends in the prevalence over 16 years (from 2000 to 2016) (Figure 3). Trends in the prevalence of obesity in children and adolescents aged 5–19 years have been presented in EU countries by geographic areas (Figures 1–4).
\nTrends in the prevalence of obesity in children and adolescents aged between 5 and 19 years in the Mediterranean region EU countries from 1980 to 2016.
Trends in the prevalence of obesity in children and adolescents aged between 5 and 19 years in the northern EU countries from 1980 to 2016.
Trends in the prevalence of obesity in children and adolescents aged between 5 and 19 years in the oriental EU countries from 1980 to 2016.
Trends in the prevalence of obesity in children and adolescents aged between 5 and 19 years in the occidental EU countries from 1980 to 2016.
The alarming proportions reached by childhood obesity in many countries pose an urgent and serious challenge, also concerning the most serious consequences of obesity on health. Obesity can produce effects immediately on a child’s health, educational performance, and quality of life, or chronic illnesses in adults, which are very likely to remain obese. The policy to tack childhood obesity is slow and inconsistent and then to review and resolve this gap, in 2014, the Commission on Ending Childhood obesity has been established. Moreover, the “Strengthening Nutrition Action of Food and Agriculture Organization of the United Nations and World Health Organization-United Nations decade of Action on Nutrition 2016-2025,” describes that in the same year (2014). The Second International Conference on Nutrition (ICN2) listed obesity and overweight among the malnutrition forms. It focused the attention of 164 member States of FAO and WHO, about the need to change the choices of the food systems for better diets and a healthier planet. The unhealthy diets, maternal and child malnutrition, are considered as the current top risk factors for one-quarter of global deaths.
\nFurthermore, the number of people of all ages who are affected by diet-related noncommunicable diseases (NCDs) has increased. The documents produced by ICN2 make up the roadmap for the governments of the world to eradicate hunger and prevent all forms of malnutrition such as undernutrition, micronutrient deficiency, overweight, and obesity. One year later, has been adopted the 2030 Agenda for Sustainable Development (“2023 Agenda”) and its Sustainable Development Goals (SDGs) at the United Nations (UN) General Assembly. In 2015, the United Nations mentioned the prevention and control of noncommunicable diseases as a top priority in the Sustainable Development Goals, and obesity listed as a risk factor for noncommunicable diseases [18]. The Global Action Plan for the Prevention and Control of Non-communicable Diseases 2013–2020 assess policy options for member states per their legislation for the selection and for undertaking actions from among the policy options about the monitoring, the disease registries, and the surveillance of NCDs.
\nRegarding the surveillance, the WHO indicates the surveillance of the key risk for the NCDs considering behavioral and metabolic risk factors as for example the use of alcohol, the physical inactivity, tobacco use, unhealthy diet, overweight, and obesity, raised blood pressure, raised blood glucose, and hyperlipidemia, and determinants of risk exposure such as marketing of food, tobacco, and alcohol [19]. Moreover, to accelerate the actions on nutrition, the UN General Assembly, in 2016, proposed that the period from 2016 to 2020 should be a UN Decade of Action on Nutrition (Nutrition Decade), providing a clearly defined, time-bound, and cohesive framework for all countries and stakeholders to increase nutrition investments and implement policies and programs to improve food security and nutrition, reach the six global nutrition targets 2025, and the diet-related global noncommunicable disease (NCD) targets. Modifying possible risk factors as the reduction of an unhealthy diet is one of the “best buys” for the prevention and control of noncommunicable diseases (NCDs) proposed by the World Health Organization [20].
\nAll reports proposed by the international organization of public health proposed a no single intervention to resolve childhood obesity and overweight but analyses and interventions about the environmental context and three critical periods in the life-course. The first is the preconception and pregnancy, infancy and early childhood, and finally, older childhood and adolescence. Therefore, the prevention and the treatment of obesity require a whole-of-government approach in which the policies of all sectors are across the same target, which the health, the eradication of harmful health impacts, and thus improve population health and health equity. The Commission on Ending Childhood Obesity collected and an organic package of recommendations to address childhood obesity and achieve strategic objectives. As a result, the first object is tacking the obesogenic environment because the major negative elements are the unhealthy diet and physical activity of children. The second goal is the reduction of the risk to develop the obesity development factors able to change the biology and behavior of children before birth and through infancy. The last is the treatment and cure of children or young people with notified obesity. Consequently, the areas identified by the commission to define the preventive actions are the promotion of healthy foods intake, physical activity, the cure preconception, and pregnancy care, the early childhood diet, and physical activity, the health, nutrition, and physical activity for school-age children and finally the weight management. The first recommendation concerns the promotion of healthy food intake and the reduction of sugar-sweetened beverages by children and adolescents. Among the actions promoted are listed the development and diffusion of appropriate and context-specific nutrition guidelines for adults and children, the implementation of a tax on sugar-sweetened beverages, and the marketing of foods and nonalcoholic beverages to children. Besides, the description of the nutrient-profiles to identify unhealthy foods and beverages associated with a standardized global nutrient labeling system. The Codex Alimentarius Commission proposes a standardized system of food labeling for all packaged foods and beverages, which can support the nutrition and health education [21]. In association with the correct labeling system could be improved, also, the public education of both adults and children about nutrition literacy and the interpretation of front-of-pack. This recommendation is included in the recommendation 14 of United Nations decade of Action on Nutrition 2016–2025, concerning saturated fat, sugars, salt, and trans-fat reduction has been focused on the promotion of a healthy diet to stop the consumption and sale of highly processed foods, growing fastest in lower-middle-income countries. The actions to prevent and control NCDs include the reduction of salt intake, and the setting of target levels for the amount of salt, reformulating food products. Furthermore, the action plan has been indicated the elimination of industrial trans-fats and the reduction of sugar consumption through taxation on sugar-sweetened beverages. The availability, and consequently, the high consumption of these products, is the principal cause of health problems such as obesity and other diet related NCDs. The reduction of sedentary behaviors in children and adolescents, focusing on physical activity programs, is the second recommendation and includes the definition of advice to children, adolescents, parents, caregivers, teachers, and health professionals on healthy body size, physical activity, sleep behaviors and appropriate use of screen-based entertainment. The same recommendation promotes the improvement, during the recreational time, for all children (including the children with disabilities), of physical activity favoring adequate facilities at school or in public areas. Recent epidemiologic data show a decline from the age of school about physical activity. About 81% of adolescents have insufficient physical activity lower than 60 minutes each day. Obesity is more linked with physical activity because it creates a vicious cycle, which increases body fat levels and decreases physical activity. The recommendation about the prevention of childhood overweight and obesity regarding all guidelines promoted introduces the protection of the diet in women during pregnancy, the improvement of child nutrition status and growth, and finally, the promotion of physical activity to address sedentary lifestyle from the early stages of life. The best keys to these recommendations are breastfeeding promotion and protection because they have a crucial role in the reduction of childhood obesity risk. Indeed, the diagnosis and management of hyperglycemia and gestational hypertension, the monitoring of gestational weight gain, the correct diet, and lifestyles during pregnancy are key preventive factors against childhood overweight and obesity. To ensure healthy child development, policies should provide advice not only on healthy eating but also on appropriate sleep time, sedentary or screen time, physical activity, or active play for the age group of 2–5 years. The school is also a fundamental environment to promote the correct lifestyles, especially about the diet. Two aspects can be improved at school, the promotion of standardized meals, in accordance with guidelines, without unhealthy foods with sugar, sweetened beverages or energy-dense, nutrient-poor foods etc. but characterized by the introduction of fresh fruits, vegetables, and safe drinking water. The secondary aspect is the improvement of knowledge’s on children about health education within the core curriculum of schools and practical experiences of food preparation available to children, their parents, and caregivers.
\nFinally, the six recommendations of the commission are the correct weight management in children and young people suffering from obesity and overweight, developing multicomponent services concerning physical activity, nutrition, and psychological support. These supports are delivered by professional and treated teams, as part of Universal health coverage. The responsibilities of these actions are divided by different structures at different levels. The first is the WHO and concerns the institutionalization of each measure across all technical areas of WHO, and regional and country offices. Furthermore, it provides the consultation and technical support for action at global, regional, and national levels, with international agencies, and the governments of each Member States. Each Member States are supported by International organizations, and define political commitment against childhood obesity, coordinate all sectors and institutions engaged for policies about nutrition, food, agriculture, sport and recreation, urban planning etc. Collect and record all data on BMI-for-age of children and define the national targets for childhood obesity. The other structures are represented by nongovernmental organizations (NGOs), the private sector, the philanthropic foundations, and academic institutions [22].
\nIn Europe, the EU Action Plan on Childhood Obesity 2014–2020 translates the international guidelines with the purpose of demonstrating the shared of EU Member States to addressing childhood obesity; set out priority areas for action and a possible toolbox of measures for consideration and finally propose ways of collectively keeping track of progress. The EU Action Plan considers the presence of three types of stakeholders which are: the 28 EU Member States, the European Commission, and international organizations such as the WHO and finally civil society (e.g., nongovernmental organizations (NGOs), industry, research institutes, and associations). The national, regional, and local level was represented by the specific authorities. Each area defined in the EU action plan is in agreement with the areas proposed by the Global Action Plan, and to evaluate the efficacy of the intervention for each region were defined as specific indicators. Regarding the area for action 1: Support a healthy start in life the first operational objective is, for example, increase the prevalence of children that are breastfed, the indicator is the % of children breastfed and the final target the achievement of 20% in 2020 of children with adequate periods of exclusive breastfeeding according to national recommendations. The area of action 2 is about the promotion of healthier environments, especially at schools and preschools, and the main priority is the establishment of children’s health as a priority at schools, and for example, the first operational objective is to “provide the healthy option and increase daily consumption of fresh fruit and vegetables, healthy food and water intake in schools (with a targeted focus on schools in underprivileged districts).” The action is the development of preschool and school meals with fruits, vegetables, and drinking milk following the existing EU guidelines. The indicators are, for example, the number of member states implementing frameworks on preschool and school meals, and the target to achieve in 2020 is 90% of the member states participating in the program. The other areas are the improvement of healthy options regarding the availability of healthy food choices to children and the target of restriction related to vending machines. Area number 4 has the goal to limit the exposure of children to advertisements for food/drinks high in fat, sugars, and salt. The improvement of family knowledge and information’s on the daily food and health choices of children of action number 5. The last two areas of action are number 6 to encourage physical activity, and number 7 is related to the monitoring and evaluation of children’s nutritional status and behaviors. At this moment, the assessment of the effectiveness of the Action Plan that can be analyzed is referred to in 2018, because the final assessment will be defined at the end of 2020. The initial results compare the activities improved before 2014 with the activities promoted with the EU Action Plan in each action area [23]. The results show an improvement of actions relatively the guidance around the pregnancy, the policies on vending machines, energy drinks, and reformulation of food and especially the concentration of salt.
\nDespite the important engagement of the European countries in reversing the progress of obesity, the incidence of overweight subjects remains alarming, particularly if considering the young population. Childhood weight gain has, in fact, a severe impact on health and psychosocial outcomes, deeply affecting individual and family’s quality of life. Research shows that overweight children are more likely if compared to normal weight ones, to become obese adults and so to develop chronic conditions. The recent increment of hours dedicated to “screen time” and the associated damaging effects on eating habits, together with little safe spaces to be active in, are essential factors influencing the level of physical activity and health among young. Also, cheaper and larger-portioned fast food, as well as the massive consumption of high-sugar products, must be taken into consideration. In 2014, in EU, the 7% of yearly national health budgets were spent on diseases correlated to obesity, and investigations showed how policies addressed to children obesity control would repay on investment of 6–10%.
\nFor these reasons, in 2007, after analyzing the report by the WHO European Childhood Obesity Surveillance Initiative (COSI), the European Commission adopted the White Paper on a Strategy for Europe on Nutrition, Overweight and Obesity-related Health issues, composed of six major goals: better-informed subjects, physical activity, and healthier options promotion, supporting low socioeconomic groups and developing evidence and monitoring systems to support the program. The High-Level Group on Nutrition and Physical Activity and the EU Platform for Action on Diet, Physical Activity, and Health are the main instruments set up for implementation of the strategy. The first one enables governments to share health and economic analysis and enhances contact between governments and the EU platform for action on a diet, physical activity, and health. It also works on some priorities such as reducing children’s exposure to marketing of foods high in fat, salt and sugars, physical activity, labeling, and public procurement of food, reducing health inequalities. The EU Platform is a forum for European level organizations, including Food business and consumer organizations, scientific associations, and NGOs. The high-level group can also be asked by the commission to prepare the groundwork for relevant prevention and promotion initiatives agreed by the steering group on promotion and prevention.
\nIn 2013 the strategy went through an external evaluation to test its efficiency: the results were positive. However, they suggested a greater commitment to promoting physical activity. Besides, an Action Plan on Childhood Obesity addressed to a Europe-wide context was redacted, to lower young overweight by 2020. One of its main goals is to support a healthy start in life, encouraging breastfeeding and promoting the adoption of a healthy lifestyle both during the early stage of life and preconception period. Developing healthier school environments is the sequel, providing wholesome meals, with the proper nutritional intake, and also allowing adequate time to consume it. Making the healthy option more available in addition, both in schools and in the working environment, would encourage good eating behavior to be part of the routine. The fourth point is about making families informed in order to empower parents in planning a correct meal plan and schedule regular active leisure activities, which is also linked to the significant focus on the promotion of the physical activity. Last, the increase in monitoring and research, would, in the end, test the nutritional quality of food, health status, and habits of children, together with the collection of systematic data.
\nThe main actors of the plan are 28 EU Member States, the European Commission, and a variety of civil society stakeholders such as NGOs, industry and agricultural sectors, University and research institutes. Another project, the Joint Action on Nutrition and Physical Activity (JANPA), was proposed as a contribution to the EU action plan on childhood obesity 2014–2020, focusing on specific outcomes that can effectively contribute to nutritional and physical activity policies during childhood. It has the following objectives: economic evaluation of the cost of overweight and obesity in children with the aim to encourage public actions, promoting healthy nutrition and physical activity to pregnant women and families with young children, promoting healthier environments in schools and preschools, efforts at a local or at a national level regarding nutrition and physical activities, promoting healthy eating and drinking practices, and improving the information addressed to the consumer at the national level [13]. At the national level, many policies and programs have been adopted in recent years in Europe, aiming to prevent child obesity and improve its treatment and management.
\nData from the Childhood Obesity Surveillance Initiative (2015 – 17) show that Italy is ranked first in Europe for child obesity, with 21% of children obese or overweight: taking into account this evidence, Italy has turned its attention not only to monitoring, but also to the population approach, using media, brochures, and education in schools and health-care facilities. These actions are part of the Italian Health Plan on Prevention. One of the objectives of this program is to reduce the preventable and avoidable burden of morbidity, mortality, and disability of noncommunicable diseases. Another initiative adopted in Italy is the program named “OKKIO all Salute,” launched in 2007 as a part of the COSI initiative, to monitor children’s weight, eating behaviors, physical activity habits, and their related risk factors among children of 6–10 years. From 2008, around 45.000 families took part in this project. Italy is also part of the international program HBSC (Health Behavior in School-aged Children), showing commitment to understanding factors influencing children’s eating behaviors [24].
\nThe increasing prevalence of overweight and obesity, especially among children, is a significant public health problem in Malta, as it has been estimated that 40% of school-aged children are overweight or obese. Different actions have been put in place to tackle this problem since the Maltese Presidency of the Council of the EU selected childhood obesity as one of its priority areas during its European Presidency in the first half of 2017. Considering the fact that children spend much time in school, particular attention was put to the school environment. In 2016, the government of Malta enacted the “Healthy Lifestyle Promotion and Care of Non-Communicable Diseases Act,” which aimed to promote physical activity and balanced diets to achieve healthy lifestyles and reduce the noncommunicable diseases in all age groups. An intersectoral Advisory Council was set up, and one of its major initiatives was outlining a legislative tool for schools: there was a clear need for improving the school environment to help the whole school community to adopt healthier dietary patterns and lifestyle. The consumption of healthy foods and restrictions on products high in salt, sugar, and fats were encouraged, following nutritional criteria based on the WHO nutrient profiling model and carrying random inspections by specifically trained health practitioners.
\nIn August 2018, the Maltese government issued subsidiary legislation to regulate the food being sold and provided by schools, implement programs for healthy eating, ban advertising or sponsorship of unhealthy foods, and ensure the provision of drinking water in schools. One of the divergences identified across EU states was in planning food procurement tenders for schools that promoted healthy eating and to allow their smooth implementation. It has been important to set clear specifications, with support from the Joint Research Centre and experts [24].
\nIn Poland, a 2016 Regulation by the Minister of Health addressed groups of food intended for sale to children and adolescents in the education system. Besides, the School Program Strategy 2017/18 – 2022/23 has, as one of its goals, the promotion of a healthy, balanced diet among children and parents. In particular, it aims to change the eating habits of children by increasing the share of fruit and vegetables and the intake of milk. In Poland, the food industry is one of the most influential lobby groups, with well-organized representation and significant financial resources. Poland is also one of the participating countries in the Choices Program, an initiative introduced in the Netherlands in 2006 in response to WHO’s call for the food industry to take an active voluntary role in tackling obesity. To reduce the consumption of salt, there has been an important consumer awareness initiative through media, schools, and health-care facilities, as well as 16% of salt reduction in bread by 2012. Concerning physical activity, it is mandatory in primary and secondary schools, and it is included in general teaching training [25].
\nIn some countries, reducing childhood obesity is a task shared by the Ministry of Health with the Ministry of Finance (responsible for taxes on food high in saturated fat and sugary soft drinks), the Ministry of Education (for school curricula, healthy nutrition education, and physical activity), and the Ministry of Agriculture and Food Industry (for free school fruit and vegetable schemes and sustainable healthy food supplies) [24]. This is the case of England, opposed to the approach of the Republic of Moldova, where a lack of multisectoral collaboration has been found. The UK Childhood Obesity Plan introduces for the first time a soft drink industry levy and the revenue will be invested in programs to reduce obesity and encourage physical activity, in addition to substantial restrictions for sailing and promoting high sugars and fat drinks or snacks, after the introduction of a tax on sugary drinks was announced in March 2016 and came into force in April 2018.
\nIn some countries, television (TV), radio, and Internet services are regulated with some set standards for advertising to protect children from the overconsumption of unhealthy foods, and this is the case of England, where, the National Office of Communications since 2006, does not allow TV advertisements for such foods to be shown during or close to children TV programs. They also launched a sugar reduction program intending to remove sugar from the food’s children frequently eat, paying attention that it is followed by a calorie restriction and not by compensation with extra fats. Also, supporting agricultural innovation by bringing together food business and researchers is part of the project. Support is also given to disadvantaged families, with the distribution of 60 million worth of vouchers that can be exchanged for fresh fruit and vegetables or vitamins. Of course, also physical activity is considered, and it is included in each day at school for at least 30 minutes. It should also be taken into consideration the GREAT commitment of the UK Government in enabling health professionals to support families’ diet, as well as training them to face eating behaviors changes and promoting wellbeing [26].
\nConcerning Moldova, concrete actions to face childhood obesity were only undertaken in 2012. The National Health Policy (2007–2021) was the first policy document that addressed obesity as a priority, involving the society and government, but it was in 2014 when the Moldovan government endorsed the first National Food and Nutrition Program for 2014–2020 and the Action Plan for 2014–2016, with the specific objective to halt the rise of obesity prevalence among children and adults. The 31 July 2007, the Ministry of Health Decision forbids the marketing of energy-dense food with high-fat content and reduced nutritional value in institutions for children. In 2009, new laws prohibited marketing pressure on children to consume healthy drinks. After the Food Law was amended, selling and distribution of unhealthy food within 100 m by schools were banned. The Republic of Moldova became part of COSI from 2013 and participated in the third and fourth rounds of this initiative. Further in 2014, the government adopted the first National Food and Nutrition Programmed for 2014 – 2020 (NFNP) and its Action Plan with the aim of zero increase in obesity prevalence, employing compulsory nutritional labeling, limitations on advertising, together with the elimination of trans-fats and reduction of sugar and salt [24].
\nEPODE, or Ensemble, Prévenons L’Obésité Des Enfants (Together, Let us Prevent Childhood Obesity) was established in January 2004, based on the guidelines from the National Health Program recommendations. This program was developed based on the effectiveness observed from the Fleurbaix-Laventie Ville Santé Study, which started in 1992 and continuing, which showed a decrease in childhood obesity rate after the nutritional and physical activity initiatives were implemented in the two towns. The project is supported by the French Ministry of Health, in collaboration with more than five other Ministry, the French National Academy of Medicine, together with some partners like Nestle and Ferrero, financing half of the costs of the program. EPODE now extends to nearly 1.8 million inhabitants in 167 French cities, 20 cities in Spain, and eight cities in Belgium. The project aims to reduce BMI in overweight or obese children promoting physical activity and a healthy diet through three major steps: (1) informing community and families about the obesity problem, using meetings and brochures; (2) Training participants (teachers and professionals); (3) starting the action in schools, distributing educational materials, improving school catering, and hosting food workshop [27].
\nUnderstanding the importance of obesity as a health issue, and recognizing the worrying increase of overweight adolescences, a range of federal policies were established in Germany to face the issue since, public health services in Germany have played a great role in putting obesity on the political agenda, and they focused on dealing with obesity from child and adolescent health services perspective. The Robert Koch Institute has launched the German Health Interview and Examination Survey for Children and Adolescents (KiGGS-Study), with a baseline study in 2003–2006 and a follow-up study in 2014–2017. The results of the second study were published in March 2018. They pointed to a strong social gradient, with the prevalence of overweight reaching 27.0% and 24.2% in girls and boys respectively, aged 3–17 years with low socioeconomic status compared to 6.5% in girls and 8.9% in boys with high socioeconomic status.
\nSome of the other vital initiatives in response to the Survey are the National Cycling Plan 2020, which promotes cycling, walking, and the use of public transport and the two programs of the Federal Centre for Health Education (FCHE): Gut Drauf (Feeling Well), which aims to improve the health of children and adolescents aged 12–18 years, and Tutmirgut (Good For Me), aimed at children aged 5-11 years. In 2007, there were 708 programs for overweight or obese children and adolescents in Germany, reaching approximately 44,000 persons [24]. In Germany, policies are implementing a salt reduction in bread and many consumer awareness initiatives regarding a healthy lifestyle, promoted in schools, and via media and Internet [28].
\nThe Danish National Action Plan against Obesity was written to improve awareness in the Danish population and generally reduce high BMI. Children and adolescents are one of their main targets. Concerning nutrition, the aim concerning children’s diet is to reduce the number of subjects who consume more energy from fat and sugar and, at the same time, pay attention to the correct fiber intake. Also, life outside the home was provided with healthy food, and parents were supported in taking proper diet choices. Of course, also physical activity is considered, and new guidelines were established, increasing the hours to it dedicated to schools and strengthening the competences of teachers. Suitable playground and outdoor areas were provided, as well as car-free areas near schools and safe foot and cycle paths [29].
\nHandling childhood obesity is undoubtedly challenging despite the substantial progress made concerning healthy nutrition, early life, and increased physical activity. It has also been essential to restrict advertising on TV actively. Still, it should also be taken into consideration to control video games, mobile phones, tablets, and social media since, nowadays, there is no more efficient way to address kids than getting in touch with them through the Internet. Monitoring childhood obesity is, for sure, more rewarding if compared to adults but, initially, for the complexity of relating to young subjects, it can be very onerous.
\nConsequently and taking into account the role played by multinational food industries in supporting French policies should be considered to further involve in obesity control plans, food, and sports industries. Doing so will make it possible to boost the research resources and, at the same time, allow the markets’ sectors, that would possibly be affected by the latest policies and guidelines, to adapt their selling to the new consumer type. It should also be mentioned that some European countries are still not facing the childhood obesity problem, primarily due to inadequate resources and a lack of interface between the health institutions and industries.
\nIn Malta, for example, the requirement of precise definitions for food procurement that tenders on how to set a healthy meal plan in schools was given by the Advisory Council with the support from the EU Joint Research Centre, a proper example of a strategy controlling balance and micronutrient intake of at least one meal per day of all school kids. This strategy, together with the Healthy Weight for Life strategy for 2012–2020 and the Food and Nutrition Policy and Action Plan for Malta 2015–2020, makes Malta one of the most committed European countries in the battle against childhood obesity. The Maltese case is one of the first to be taken into consideration when evaluating the situation.
\nThe authors declare no conflict of interest.
The Internet has irrevocably changed the dynamics of scholarly communication and publishing. Consequently, we find it necessary to indicate, unambiguously, our definition of what we consider to be a published scientific work.
",metaTitle:"Prior Publication Policy",metaDescription:"Prior Publication Policy",metaKeywords:null,canonicalURL:"/page/prior-publication-policy",contentRaw:'[{"type":"htmlEditorComponent","content":"A significant number of working papers, early drafts, and similar work in progress are openly shared online between members of the scientific community. It has become common to announce one’s own research on a personal website or a blog to gather comments and suggestions from other researchers. Such works and online postings are, indeed, published in the sense that they are made publicly available. However, this does not mean that if submitted for publication by IntechOpen they are not original works. We differentiate between reviewed and non-reviewed works when determining whether a work is original and has been published in a scholarly sense or not.
\\n\\nThe significance of Peer Review cannot be overstated when it comes to defining, in our terms, what constitutes a published scientific work. Peer Review is widely considered to be the cornerstone of modern publishing processes and the key value-adding contribution to a scholarly manuscript that a publisher can make.
\\n\\nOther than the issue of originality, research misconduct is another major issue that all publishers have to address. IntechOpen’s Retraction & Correction Policy and various publication ethics guidelines identify both redundant publication and (self)plagiarism to fall within the definition of research misconduct, thus constituting grounds for rejection or the issue of a Retraction if the work has already been published.
\\n\\nIn order to facilitate the tracking of a manuscript’s publishing history and its development from its earliest draft to the manuscript submitted, we encourage Authors to disclose any instances of a manuscript’s prior publication, whether it be through a conference presentation, a newspaper article, a working paper publicly available in a repository or a blog post.
\\n\\nA note to the Academic Editor containing detailed information about a submitted manuscript’s previous public availability is the preferred means of reporting prior publication. This helps us determine if there are any earlier versions of a manuscript that should be disclosed to our readers or if any of those earlier versions should be cited and listed in a manuscript’s references.
\\n\\nSome basic information about the editorial treatment of different varieties of prior publication is laid out below:
\\n\\n1. CONFERENCE PAPERS & PRESENTATIONS
\\n\\nGiven that conference papers and presentations generally pass through some sort of peer or editorial review, we consider them to be published in the accepted scholarly sense, particularly if they are published as a part of conference proceedings.
\\n\\nAll submitted manuscripts originating from a previously published conference paper must contain at least 50% of new original content to be accepted for review and considered for publication.
\\n\\nAuthors are required to report any links their manuscript might have with their earlier conference papers and presentations in a note to the Academic Editor, as well as in the manuscript itself. Additionally, Authors should obtain any necessary permissions from the publisher of their conference paper if copyright transfer occurred during the publishing process. Failure to do so may prevent Us from publishing an otherwise worthy work.
\\n\\n2. NEWSPAPER & MAGAZINE ARTICLES
\\n\\nNewspaper and magazine articles usually do not pass through any extensive peer or editorial review and we do not consider them to be published in the scholarly sense. Articles appearing in newspapers and magazines rarely possess the depth and structure characteristic of scholarly articles.
\\n\\nSubmitted manuscripts stemming from a previous newspaper or magazine article will be accepted for review and considered for publication. However, Authors are strongly advised to report any such publication in an accompanying note to the External Editor.
\\n\\nAs with the conference papers and presentations, Authors should obtain any necessary permissions from the newspaper or magazine that published the work, and indicate that they have done so in a note to the External Editor.
\\n\\n3. GREY LITERATURE
\\n\\nWhite papers, working papers, technical reports and all other forms of papers which fall within the scope of the ‘Luxembourg definition’ of grey literature do not pass through any extensive peer or editorial review and we do not consider them to be published in the scholarly sense.
\\n\\nAlthough such papers are regularly made publicly available via personal websites and institutional repositories, their general purpose is to gather comments and feedback from Authors’ colleagues in order to further improve a manuscript intended for future publication.
\\n\\nWhen submitting their work, Authors are required to disclose the existence of any publicly available earlier drafts in a note to the Academic Editor. In cases where earlier drafts of the submitted version of the manuscript are publicly available, any overlap between the versions will generally not be considered an instance of self-plagiarism.
\\n\\n4. SOCIAL MEDIA, BLOG & MESSAGE BOARD POSTINGS
\\n\\nWe feel that social media, blogs and message boards are generally used with the same intention as grey literature, to formulate ideas for a manuscript and gather early feedback from like-minded researchers in order to improve a particular piece of work before submitting it for publication. Therefore, we do not consider such internet postings to be publication in the scholarly sense.
\\n\\nNevertheless, Authors are encouraged to disclose the existence of any internet postings in which they outline and describe their research or posted passages of their manuscripts in a note to the Academic Editor. Please note that we will not strictly enforce this request in the same way that we would instructions we consider to be part of our conditions of acceptance for publication. We understand that it may be difficult to keep track of all one’s internet postings in which the researcher´s current work might be mentioned.
\\n\\nIn cases where there is any overlap between the Author´s submitted manuscript and related internet postings, we will generally not consider it to be an instance of self-plagiarism. This also holds true for any co-Author as well.
\\n\\nFor more information on this policy please contact permissions@intechopen.com.
\\n\\nPolicy last updated: 2017-03-20
\\n"}]'},components:[{type:"htmlEditorComponent",content:'A significant number of working papers, early drafts, and similar work in progress are openly shared online between members of the scientific community. It has become common to announce one’s own research on a personal website or a blog to gather comments and suggestions from other researchers. Such works and online postings are, indeed, published in the sense that they are made publicly available. However, this does not mean that if submitted for publication by IntechOpen they are not original works. We differentiate between reviewed and non-reviewed works when determining whether a work is original and has been published in a scholarly sense or not.
\n\nThe significance of Peer Review cannot be overstated when it comes to defining, in our terms, what constitutes a published scientific work. Peer Review is widely considered to be the cornerstone of modern publishing processes and the key value-adding contribution to a scholarly manuscript that a publisher can make.
\n\nOther than the issue of originality, research misconduct is another major issue that all publishers have to address. IntechOpen’s Retraction & Correction Policy and various publication ethics guidelines identify both redundant publication and (self)plagiarism to fall within the definition of research misconduct, thus constituting grounds for rejection or the issue of a Retraction if the work has already been published.
\n\nIn order to facilitate the tracking of a manuscript’s publishing history and its development from its earliest draft to the manuscript submitted, we encourage Authors to disclose any instances of a manuscript’s prior publication, whether it be through a conference presentation, a newspaper article, a working paper publicly available in a repository or a blog post.
\n\nA note to the Academic Editor containing detailed information about a submitted manuscript’s previous public availability is the preferred means of reporting prior publication. This helps us determine if there are any earlier versions of a manuscript that should be disclosed to our readers or if any of those earlier versions should be cited and listed in a manuscript’s references.
\n\nSome basic information about the editorial treatment of different varieties of prior publication is laid out below:
\n\n1. CONFERENCE PAPERS & PRESENTATIONS
\n\nGiven that conference papers and presentations generally pass through some sort of peer or editorial review, we consider them to be published in the accepted scholarly sense, particularly if they are published as a part of conference proceedings.
\n\nAll submitted manuscripts originating from a previously published conference paper must contain at least 50% of new original content to be accepted for review and considered for publication.
\n\nAuthors are required to report any links their manuscript might have with their earlier conference papers and presentations in a note to the Academic Editor, as well as in the manuscript itself. Additionally, Authors should obtain any necessary permissions from the publisher of their conference paper if copyright transfer occurred during the publishing process. Failure to do so may prevent Us from publishing an otherwise worthy work.
\n\n2. NEWSPAPER & MAGAZINE ARTICLES
\n\nNewspaper and magazine articles usually do not pass through any extensive peer or editorial review and we do not consider them to be published in the scholarly sense. Articles appearing in newspapers and magazines rarely possess the depth and structure characteristic of scholarly articles.
\n\nSubmitted manuscripts stemming from a previous newspaper or magazine article will be accepted for review and considered for publication. However, Authors are strongly advised to report any such publication in an accompanying note to the External Editor.
\n\nAs with the conference papers and presentations, Authors should obtain any necessary permissions from the newspaper or magazine that published the work, and indicate that they have done so in a note to the External Editor.
\n\n3. GREY LITERATURE
\n\nWhite papers, working papers, technical reports and all other forms of papers which fall within the scope of the ‘Luxembourg definition’ of grey literature do not pass through any extensive peer or editorial review and we do not consider them to be published in the scholarly sense.
\n\nAlthough such papers are regularly made publicly available via personal websites and institutional repositories, their general purpose is to gather comments and feedback from Authors’ colleagues in order to further improve a manuscript intended for future publication.
\n\nWhen submitting their work, Authors are required to disclose the existence of any publicly available earlier drafts in a note to the Academic Editor. In cases where earlier drafts of the submitted version of the manuscript are publicly available, any overlap between the versions will generally not be considered an instance of self-plagiarism.
\n\n4. SOCIAL MEDIA, BLOG & MESSAGE BOARD POSTINGS
\n\nWe feel that social media, blogs and message boards are generally used with the same intention as grey literature, to formulate ideas for a manuscript and gather early feedback from like-minded researchers in order to improve a particular piece of work before submitting it for publication. Therefore, we do not consider such internet postings to be publication in the scholarly sense.
\n\nNevertheless, Authors are encouraged to disclose the existence of any internet postings in which they outline and describe their research or posted passages of their manuscripts in a note to the Academic Editor. Please note that we will not strictly enforce this request in the same way that we would instructions we consider to be part of our conditions of acceptance for publication. We understand that it may be difficult to keep track of all one’s internet postings in which the researcher´s current work might be mentioned.
\n\nIn cases where there is any overlap between the Author´s submitted manuscript and related internet postings, we will generally not consider it to be an instance of self-plagiarism. This also holds true for any co-Author as well.
\n\nFor more information on this policy please contact permissions@intechopen.com.
\n\nPolicy last updated: 2017-03-20
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Today his focus is on defining the growth and development strategy for the company.",institutionString:null,institution:{name:"TU Wien",country:{name:"Austria"}}},{id:"19816",title:"Prof.",name:"Alexander",middleName:null,surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/19816/images/1607_n.jpg",biography:"Alexander I. Kokorin: born: 1947, Moscow; DSc., PhD; Principal Research Fellow (Research Professor) of Department of Kinetics and Catalysis, N. Semenov Institute of Chemical Physics, Russian Academy of Sciences, Moscow.\r\nArea of research interests: physical chemistry of complex-organized molecular and nanosized systems, including polymer-metal complexes; the surface of doped oxide semiconductors. He is an expert in structural, absorptive, catalytic and photocatalytic properties, in structural organization and dynamic features of ionic liquids, in magnetic interactions between paramagnetic centers. The author or co-author of 3 books, over 200 articles and reviews in scientific journals and books. He is an actual member of the International EPR/ESR Society, European Society on Quantum Solar Energy Conversion, Moscow House of Scientists, of the Board of Moscow Physical Society.",institutionString:null,institution:{name:"Semenov Institute of Chemical Physics",country:{name:"Russia"}}},{id:"62389",title:"PhD.",name:"Ali Demir",middleName:null,surname:"Sezer",slug:"ali-demir-sezer",fullName:"Ali Demir Sezer",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/62389/images/3413_n.jpg",biography:"Dr. Ali Demir Sezer has a Ph.D. from Pharmaceutical Biotechnology at the Faculty of Pharmacy, University of Marmara (Turkey). 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