Childhood obesity

Question 1

Prevalence and trends in obesity in the UK

Answer 1

• Obesity has risen since the 1980s, 27% of adults are obese
• rates are highest in those of the lowest socioeconomic class, in children all other socioeconomic classes are decreasing rates of obesity

Question 2

Centile charts for measurements of children’s weight

Answer 2

• At a population level, BMI of <2nd centile is underweight, healthy is 2-85, overweight is 85-95, obese is 95+ and extremely obese is >99.6
• At a clinical (individual) level, BMI of <0.4 is clinically extremely underweight, <2 underweight, 2-91 is healthy, 91-98 is overweight, >98 is obese, and >99.6 is extremely obese

Question 3

Obesity interventions: support for adults

Answer 3

• BetterHealth program: quitting smoking, PA, eating better app
• NHS 12 week weight loss tool
• Incentives for GPs to undergo weight management referral

Question 4

Support for weight management in children: national child measuring program

Answer 4

• children are weighed and measured in schools and a letter is sent to parents outlining any cause for concern
• 62.4% of parents do not recognise when their child is overweight or obese
• Parents are generally positive about the feedback, and children generally do not mind their measurements being taken (although overweight girls are more likely to be be uncomfortable)
• Common reasons why parents do not accept the feedback: it being normal in their culture to be overweight, children being perceived as eating healthy foods and being physically active, it being just ‘puppy fat’, blaming genetics

Question 5

Support for weight management in children: Change 4 life program

Answer 5

• encouraging a healthy lifestyle
• a study where parents were randomised to receive C4L starter packs or not was found to increase awareness of C4L campaign. Conversely, it seemed to have little or a negative impact on health behaviours (especially in the university-educated). Parents found this starter pack to be condescending

Question 6

Nutritional interventions: sugar reduction program, sugar tax, calorie reduction program

Answer 6

• Sugar reduction: aiming for a 20% reduction in sugar in foods commonly eaten by children by 2020
• The sugar tax: incentivising reformulation and consumer to choose cheaper, healthier choices. 18p tax for 5-8g sugar/100mL, 24p for >8g/100mL. Exempt drinks are 100% fruit juice and milk-based drinks which are a high source of calcium
• the calorie reduction program: covers food not covered by the sugar reduction program. Aim to reduce 20% of kcals in commonly consumed savoury foods by 2024

Question 7

Nutritional interventions: front-of-pack labelling, TV advertising, food promotion restrictions

Answer 7

• FOPL: Cochrane review suggests that is increases consumer awareness and nutritional knowledge, but limited evidence to suggest is decreases purchasing (~1% reduction in kcals and ~6.7% reduction in sugar consumption)
• TV advertising: TV viewing has been found to increase obesity rates in children due to junk food adverts by ~60 kcals. A modelling study found that a ban on advertising up to 9pm would lead to a 4.6% reduction in the prevalence of obesity (-1.5 adverts).
• Food promotion restrictions: UK government will stop BOGOF promotion on fast food items and legislate the location of junk foods (i.e. stopping end-of-aisle promotions), along with sweets at the checkout