Child obesity a national plan for action Eustace de Sousa Interim Deputy Director for Health & Wellbeing and National Lead - Children, Young People and Families National Children and Adult Services Conference 2016. WP1 2 November 2016
Why is childhood obesity an issue?
Why we all need to work together to reduce Childhood Obesity: Loretta Sollars Public Health England
BMI status of children by age National Child Measurement Programme 2014/15 Underweight 1.0% Underweight 1.4% Overweight 12.8% Obese 9.1% Reception (aged 4-5 years) Overweight 14.2% Obese 19.1% Year 6 (aged 10-11 years) Healthy weight 77.2% Healthy weight 65.3% This analysis uses the 2 nd,85 th and 95 th centiles of the British 1990 growth reference (UK90) for BMI to classify children as underweight, healthy weight, overweight and obese. These thresholds are the most frequently used for population monitoring within England. 4 National Children and Adult Services Conference 2016
Prevalence of excess weight among children National Child Measurement Programme 2014/15 One in five children in Reception is overweight or obese (boys 22.6%, girls 21.2%) One in three children in Year 6 is overweight or obese (boys 34.9%, girls 31.5%) Child overweight (including obesity)/ excess weight: BMI 85 th centile of the UK90 growth reference 5 Weblink to Annual Report 2015/16 in a Slide Style Presentation Format: http://digital.nhs.uk/pubs/ncmpeng1516
Inequalities
Obesity prevalence by deprivation decile National Child Measurement Programme 2014/15 30% Year 6 Obesity prevalence 25% 20% 15% 10% 5% 25.0% 12.0% 24.2% 11.2% 22.7% 10.3% 21.2% 9.7% 19.3% 9.0% 17.8% 8.3% 16.0% 7.6% Reception 15.0% 13.7% 11.5% 7.0% 6.8% 5.7% 0% Most deprived Index of Multiple Deprivation 2010 decile Least deprived Child obesity: BMI 95 th centile of the UK90 growth reference 7 National Children and Adult Services Conference 2016
Obesity prevalence by ethnic group National Child Measurement Programme 2014/15 Children in Reception (aged 4-5 years) Children in Year 6 (aged 10-11 years) White British 8.5% White British 17.5% White Irish 7.8% White Irish 18.0% White other 8.8% White other 20.7% Mixed: White and Black Caribbean 11.8% Mixed: White and Black Caribbean 24.0% Mixed: White and Black African 14.2% Mixed: White and Black African 24.3% Mixed: White and Asian 6.1% Mixed: White and Asian 16.7% Mixed other 9.3% Mixed other 20.6% Indian 7.8% Indian 20.7% Pakistani 10.7% Pakistani 25.1% Bangladeshi 12.5% Bangladeshi 27.3% Asian other 9.5% Asian other 23.4% Black Caribbean 11.4% Black Caribbean 27.9% Black African 15.7% Black African 28.2% Black other 14.5% Black other 27.1% Chinese 7.6% Chinese 18.1% Any other ethnic group 11.0% Any other ethnic group 24.4% Not stated 8.7% Not stated 18.3% 0% 5% 10% 15% 20% Obesity prevalence 0% 5% 10% 15% 20% 25% 30% Obesity prevalence 8 National Children and Adult Services Conference 2016 Child obesity: BMI 95 th centile of the UK90 growth reference
Key Findings from Tracking Study in South Gloucester Changes in objectively measured BMI in children aged 4 11 years: data from the National Child Measurement Programme (2006/7-2012/13) Matthew Pearce, Sarah Webb-Phillips, Isabelle Bray Journal of Public Health Advance Access published May 6, 2015
Key results: Transitions between weight status WEIGHT STATUS RECEPTION YEAR 6 UNDERWEIGHT 0% HEALTHY WEIGHT 15.7% OVERWEIGHT 16.3% OBESE 68% ~ 2 / 3 children who are obese at R remain obese at Y6 Gurnam Johal, Children Young People and Families Team, PHE 10. National Children and Adult Services Conference 2016
Key results: Transitions between weight status WEIGHT STATUS RECEPTION YEAR 6 UNDERWEIGHT 0% HEALTHY WEIGHT 42.7% OVERWEIGHT 27% OBESE 30.3% ~ 1 / 3 children who are overweight at R remain so at Y6 ~ 1 / 3 children who are overweight at R become obese at Y6 Gurnam Johal, Children Young People and Families Team, PHE Gurnam Johal, Children Young People 11. National Children and Adult Services Conference and Families 2016 Team, PHE
Prevalence of overweight and obesity Children aged 2-10 and 11-15 years; Health Survey for England 2012-2014 40% 35% Obese Overweight 34.6% 36.2% 30% 25% 26.9% 20.4% 25.2% 18.9% 20% 13.5% 12.1% 15% 10% 5% 13.4% 14.2% 13.1% 17.3% 0% 2-10 11-15 2-10 11-15 Boys Girls Child overweight BMI between 85 th centile and <95 th centile, child obesity BMI 95 th centile of the UK90 growth reference. 12 National Children and Adult Services Conference 2016
The Childhood Obesity Plan Published August 2016
HM Government Childhood Obesity A Plan for Action Over the coming year, we will monitor action and assess progress and take further action where it is needed. 14 specific actions focusing on: food composition early years schools support for health professionals improving technology 14 Childhood Obesity Plan for Action: www.gov.uk/government/publications/childhood-obesity-a-plan-for-action
Soft Drinks Industry Levy HM Treasury Lead Consultation ended mid-october 2016 Legislation in Finance Bill 2017 Producers and importers have 2 years to act Revenue will be invested in programmes for schools to encourage physical activity and healthy diets This Includes: Doubling Primary PE and Sport Premium 10m for Healthy Breakfast clubs 15 Childhood Obesity Plan for Action: www.gov.uk/government/publications/childhood-obesity-a-plan-for-action
Taking out 20% of sugar in products The food industry have been asked to reduce the amount of sugar in every day products consumed by children by 20% by 2020 (5% reduction in year 1) against a 2015 baseline PHE will support this by setting clear targets, close monitoring and the publication of transparent and comparable data at 6 monthly intervals Initial focus will be on top 9 categories of foods providing sugar to children (drinks covered by HMT) Applies to retailers, manufacturers and eating out of home sectors (e.g. restaurants, pubs, cinemas and coffee shops) including contract caterers and suppliers Businesses have three options: reduce sugar per 100g, reduce portion size and/or shift purchasing patterns The reductions should be accompanied by reductions in calories, where possible, no increases in saturated fat and achieving current salt targets Category specific sales weighted average targets/100g of product will be set for achievement by 2020 Calorie caps for single serve products will be set e.g. chocolate bar 16 Childhood Obesity Plan for Action: www.gov.uk/government/publications/childhood-obesity-a-plan-for-action
Which products? Contributors to sugar intake in the UK (children aged 4-18 years) other* breakfast cereals yoghurt, fromage frais, ice cream biscuits, buns, cakes, table sugar soft drinks fruit juice preserves and sweet spreads sugar and chocolate confectionery This programme is about foods consumed by all children under 18 years including the very young- it encompasses family foods and those foods specifically marketed at these age groups 17 Childhood Obesity Plan for Action: www.gov.uk/government/publications/childhood-obesity-a-plan-for-action
Public Health England Key Actions continued Action: Enabling health professionals to support families Resources to build the understanding and increase the effectiveness of the wider Public Health Workforce resources to influence behaviour change and initiate difficult conversations about health and wellbeing targeted training for Health Visitors and School Nurses given their unique positioning which enables them to identify weight issues in children early on A tool to support DPHs to make the case for LAs to take a corporate approach to investing in reducing childhood obesity Advocacy materials Guides to the evidence base Commissioning support 18 Childhood Obesity Plan for Action: www.gov.uk/government/publications/childhood-obesity-a-plan-for-action
Resources
Key Resources Our Healthy Year: To engage with parents, teachers and school nurses Classroom activities Information for head teachers and governors Provide practical tips to parents Educational tools Why invest slides? PowerPoint slides illustrating the facts and figures about obesity, the costs, the benefits of investing and the potential routes to action. 20. National Children and Adult Services Conference 2016
Key Resources: Physical Activity Influencing the physical environment through work with the RTPI and planners Partnership with Sport England to encourage inactive people to meet the CMO s recommendations for physical activity Overview from the evidence about what works in schools and colleges to increase levels of physical activity among children and young people. 21 National Children and Adult Services Conference 2016
Key Resources: Scientific Advisory Committee on Nutrition The Dietary Reference Value for free sugars should not exceed 5% of total dietary energy for age groups from 2 years upwards Consumption of sugar-sweetened beverages, by children and adults, should be minimised. It is unlikely that a single action alone would be effective in reducing sugar intakes. Implementing a broad structured programme of parallel measures would be likely to achieve this, including action to tackle promotions/marketing; encourage reformulation; and consider fiscal measures. 22 National Children and Adult Services Conference 2016
Change4Life sugar resources Clear messages about sugary drinks: (i) Sugary drinks have no place in a child's daily diet (ii) Swap to water, lower fat milks, sugar free, diet and no added sugar drinks instead (iii) A typical 8 year old shouldn t have more than 6 sugar cubes a day Maximum sugar intakes for different ages Illustrates sugar content in drinks, snacks & puddings Lots of suggestions for cutting back on sugar 23. National Children and Adult Services Conference 2016
Change4Life 24 National Children and Adult Services Conference 2016
Why we have to act now International and national evidence shows obesity rates are only going upwards Significant impact on rates of adults with diabetes consequence to the NHS Social inequalities Evidence tells us this requires a whole system approach there isn t a silver bullet 25 National Children and Adult Services Conference 2016
For more information Eustace de Sousa Email: eustace.desousa@phe.gov.uk Twitter: @EustacedeSousa Web: www.gov.uk/phe NCMP Email: ncmp@phe.gov.uk Twitter: @PHE_Obesity Web: www.noo.org.uk 26 National Children and Adult Services Conference 2016