Global Epidemiology · Nov 2026
Rationale and methodology of an ongoing Maltese longitudinal cohort study focusing on obesity: a decade of population health surveillance
By Grech E, Calleja N, Calleja K et al.
Background/objective Obesity prevalence in Malta is among the highest in Europe and continues to rise. Population metabolic health is dynamic and longitudinal evidence is required to understand temporal changes in adiposity and their determinants within the Maltese population. This study aims to investigate 10-year longitudinal changes in adiposity and examine associations between socio-demographic, socio-economic, lifestyle, clinical, and biological factors and overweight/obesity outcomes among adults in Malta. Methods SAHHTEK 2.0 is a 10-year longitudinal follow-up of the 2016 SAHHTEK cohort. Of 1861 original participants, 455 were systematically selected for invitation to reassessment in 2026. Questionnaire, anthropometric, blood pressure, fasting glucose, and lipid measurements will be repeated. Prespecified multivariable regression models will examine longitudinal associations between baseline exposures and adiposity outcomes in 2026, with BMI as the primary outcome and adjustment for baseline adiposity and prespecified covariates. Results At the time of writing, 268 of the targeted 455 participants have been recruited. Data collection is ongoing, and analyses will quantify changes in adiposity over a 10-year period and identify key determinants of overweight and obesity. Conclusions Findings of this study will provide essential evidence on obesity trajectories and modifiable risk factors, supporting targeted prevention strategies and informing national public health policy.