Abstract
<title>Abstract</title> <p> <bold>Purpose</bold> The natural and built environment influences children’s physical activity and weight status. Εvidence on specific recreational facility types remains limited. This study investigated relationships between neighborhood recreational area availability and school children’s weight status using harmonized national and regional Greek data to inform community-tailored interventions. <bold>Methods</bold> Cross-sectional analysis of harmonized data (N=632) from the Hellenic National Nutrition and Health Survey (HNNHS) (HNNHS, 2013–2015; n=313) and Health4EUkids program (2023–2025; n=313), including children aged 7–13 years. Recreational area availability was assessed via parental report (HNNHS) and objective cartographic mapping (Health4EUkids). Areas were categorized by total count (0–1, 2, ≥3) and type (parks, sports centers). Multinomial logistic regression estimated probabilities of overweight and obesity, adjusting for age and sex. <bold>Results</bold> Combined overweight and obesity prevalence was 40.5% (25.2% and 15.3%, respectively), with obesity slightly higher in the regional versus national sample (17.6% vs. 13.1%). Recreational area distribution differed markedly across studies. Access to ≥2 recreational areas was associated with lower overweight/obesity prevalence (38.3% vs. 56.5% for 0–1 areas, p=0.030). Sports center availability was associated with 7% reduced obesity probability (95% CI: 1.2–12.8%), while park presence showed no significant independent effect. <bold>Conclusion</bold> Greater neighborhood recreational area availability, particularly sports centers, was associated with lower obesity risk among Greek children. Substantial regional differences in infrastructure distribution highlight the need for localized assessment and community-tailored interventions. Future research should incorporate physical activity measurement, obesogenic environment features, and larger regionally stratified samples. </p>