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Childhood obesity has been a local priority for a number of years. In May 2015 the Health Secretary announced that childhood obesity was a national priority and that work was underway to develop a new national childhood obesity strategy.
Figures for 2014/15 show that in England by age 4-5 (Reception Year) over one in five children are either overweight or obese (21.9%). By age 10-11 (Year 6) that rises to one in three children overweight or obese, and of those one in three, two thirds are classified as obese.
Weight gain is due to an imbalance in the energy that you take in (i.e. food and drinks you consume) and the energy that you expend e.g. through being active. Therefore, households where children are sedentary, tend to have longer screen times, watching television and computer games and eating/snacking while watching TV are at greater risk of childhood obesity.
Though factors in older children are well-known to be associated with weight gain, many children entering Reception year are already overweight. This highlights the importance of taking a “lifecourse” approach to obesity and looking at early life factors such as breastfeeding as protecting against childhood overweight and even prenatal factors such as smoking during pregnancy as a risk factor for childhood obesity.
Children who are overweight or obese are at greater risk of developing health problems in childhood including type 2 diabetes, problems with breathing including obstructive sleep apnoea (OSA) and problems with joints and bones including joint pain and slipped upper fermoral epiphysis (SUFE). Due to this greater risk of illness, children who are obese are more likely to be absent from school due to illness.
Childhood obesity is also associated with longer term health problems. Overweight and obese children are more likely to become obese adults, and are more likely to develop related diseases such as type 2 diabetes and heart disease.
The resulting NHS costs attributable to overweight and obesity (in adults and children) are projected to reach £9.7 billion by 2050, with wider costs to society estimated to reach £49.9 billion per year (Foresight 2007). These factors combine to make the prevention of obesity a major public health challenge.
The proportion of 4 and 5 year olds in Slough who are overweight (including those who are obese) has come down slightly from 20.2% in 2013/14 to 19.9% in 2014/15. This is measured according to the postcode of the primary school. When measured according to child’s postcode the figure is 19.6%. In this age group, Slough children are less overweight than the England average (Figure 1).
Source: National Child Measurement Programme
In terms of those aged 10 and 11 years in Slough, however, the proportion overweight has increased from 36.5% in 2013/14 to 38% in 2014/15 so that now it is significantly higher than the average for England (Figure 2). Again, these figures are according to Slough school postcode; the corresponding figure according to the child’s postcode is 38.8%.
While for the younger age group, there was also a reduction in the proportion of overweight children that were obese, in those in Year 6 (aged 10 and 11), the proportion of obese children increased over the same period.
(Source: HSCIC National Child Measurement Programme)
We can also look at the rates of overweight children according to the ward they live in (Figure 3). While there is some variation across the borough, in fact levels of child obesity in 10 and 11 year olds is similarly high in all wards. The highest levels of obesity in children of this age are seen in Colnbrook with Poyle and Wexham Lea.
(highest rates of obesity shaded dark red)
Source: National Child Measurement Programme
The school food survey for Slough 2014/15 visited all but two primary schools in Slough and found positive results in that the uptake of school meals had risen to 49% from 32% in the previous year (though the national target is for 70% of children to be eating school meals).
The survey also found that 86% of school meals provided were balanced and complied with guidelines while only 39% of packed lunches were healthy and balanced. This finding is consistent with national evidence on packed lunches and reflects the governments aim to encourage more pupils to eat school meals.
A new National Childhood Obesity strategy is expected to be published by the government in early 2016. Existing strategies and policy papers are described below.
‘Healthy Lives, Healthy People: A call to action on obesity in England’ outlines the main components of the governments new approach to obesity as including:
In the paper ‘2010 to 2015 government policy: obesity and healthy eating’, the government sets out its actions on obesity as:
Change4life is a public health campaign that aims to use marketing techniques to encourage people to adopt healthy behaviours. The 'sugar smart' campaign is the current focus of C4L activity.
The Public Health Responsibility Deal
The responsibility deal was launched in 2011 and aimed to get businesses and other influential organisations to create healthier environments by offering healthier food and opportunities for more physical activity through signing voluntary pledges.
Recommendations for physical activity for children and young people can be found at NHS Choices. Guidelines for a balanced diet are represented using the ‘eatwell plate’ while more specific and detailed advice on weaning and infant feeding can be found at NHS choices pregnancy and babies pages
Slough Youth Offer
Slough’s youth offer includes offers to provide support for young people to make informed choices about any aspect of their lives and to support young people in leading healthy lifestyles.
Get Active Slough: a leisure strategy
This strategy outlines the plans for encouraging physical activity is adopted as a habit for life for all making ”more people, more active, more often”.
There have been improvements in obesity rates for younger children (aged 4 and 5), reflecting good work in promoting breastfeeding and good infant feeding practice locally, however, the rates of obesity for older children (aged 10 and 11) continues to rise.
School meal uptake is improving though is still not achieving the national target, and while school meals in Slough are providing healthy and balanced options for children, the quality of packed lunches remains poor.
Socioeconomically deprived areas Levels of childhood obesity are, on average, higher in deprived areas than they are in less deprived areas. The obesity prevalence among reception year children attending schools in areas in the most deprived decile is double that of the least deprived decile (NCMP 2013/2014). Similarly, levels of childhood obesity are associated with the proportion of children eligible for free school meals.
Children with disabilities
Though there is limited data available on children with disabilities specifically, we do know that adults with disabilities are more likely to be obese and to be less physically active than the general population (National Obesity Observatory).
Black and Minority Ethnic Groups
Child obesity prevalence varies significantly between ethnic groups. Children from Asian and Black Groups are more likely to be obese than white ethnic groups (National Obesity Observatory), though there is limited data exploring these associations in any depth and methods of measuring obesity are unhelpfully based only on Caucasian population.