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Childhood Obesity in Cheshire East

Key Points

  • Obesity is more common in older age groups but the growth in the proportion of overweight and obese children is a major concern.
  • Although the national overweight and obese rates have increased between 2006-07 and 2007-08, In Central and Eastern Cheshire Primary Care Trust both the prevalence of overweight and obese children has decreased between 2006-07 and 2007-08 in both Reception Year and Year 6. Nationally the Year 6 prevalence of both overweight and obese has increased. In 2007-08 local prevalence for obesity are significantly ower in for both school years than the England average [1].
  • Tackling obesity requires a coherent multi agency approach [2]. The Primary Care Trust, new Local Authority and partners in the private and third sector need to work closely together to determine a full suite of locally focused interventions targeted at reducing overweight and obesity in maternity and early years and at the factors that promote an ‘obesogenic’ [3] environment.

Introduction

Obesity has been defined as “an excess of body fat frequently resulting in a significant impairment of health and longevity” [4]. Currently, one third of children in Britain are obese [5]. The World Health Organisation describes obesity as an epidemic [6]. It is predicted that if no action is taken nine out of ten adults and two-thirds of children will be obese by 2050 [7]. Overweight and obesity are largely preventable through lifestyle changes.

Childhood obesity has both short and longer-term impacts. Children may develop the symptoms of metabolic syndrome, including hypertension, dyslipidaemia (lipid imbalance) and hyperinsulinaemia (abnormally high levels of insulin in the blood). Obesity may also cause mechanical problems such as back pain and foot strain, exacerbation of asthma, psychological problems, including poor self-esteem, depression and eating disorders, and Type 2 Diabetes [8].

Many obese adolescents become obese adults and are at risk of obesity-related disorders and diseases normally associated with middle age, such as type 2 diabetes and hypertension. Studies have shown that the higher a child’s Body Mass Index (BMI) and the older the child, the more likely they will be obese as an adult. Furthermore, research has demonstrated that the children of obese parents have a greater risk of becoming overweight or obese adults, increasing the likelihood of developing such health problems later in life [9].

National Picture

 [10]
  • The most recent figures (2006) show that, among children aged 2-15, almost one-third – nearly 3 million – are overweight (including obese) (29.7%) and approximately one-sixth – about 1.5 million – are obese (16%).
  • Mean BMI (kg/m2) among children aged 2-15 increased between 1995 and 2006. For boys mean BMI rose from 17.7kg/m2 to 18.2kg/m2 (0.5kg/m2 growth), and for girls mean BMI rose from 18.1kg/m2 to 18.4kg/m2 (0.3kg/m2 growth).
  • Obesity among children aged 2-15 rose from 11.5% in 1995 to 15.9% in 2006 – a relative increase of 38%. A more marked increase was observed in obesity levels among boys (57%) – from 10.9% in 1995 to 17.1% in 2006. Among girls, obesity levels rose from 12% in 1995 to 14.7% in 2006 – an increase of 23%.
  • The proportion of children aged 2-15 who were classified as overweight and obese rose by 20% between 1995 and 2006 (from 24.5% to 29.5% respectively). For boys, there was a 27% increase (from 24% in 1995 to 30.4% in 2006) and for girls, there was a 14% increase (from 25% in 1995 to 28.6% in 2006).
  • For children aged 2-10, obesity rose by 53% from 9.9% in 1995 to 15.1% in 2006. Obesity among boys rose by 75% (from 9.6% in 1995 to 16.8% in 2006) but among girls the growth was noticeably slower at 29% (from 10.3% to 13.3% respectively).
  • Children aged 2-10 classified as overweight and obese increased from 22.7% in 1995 to 27.6% in 2006 – an increase of 22%. Among boys, there was a 30% rise in the prevalence of overweight (including obese) from 22.5% in 1995 to 29.2% in 2006; and among girls there was a 13% increase from 22.9% to 25.9% respectively.
    Among 11-15 year olds, obesity rose by 21% (14.4% in 1995 to 17.4% in 2006). For boys, there was a 30% increase in the levels of obesity
  • 13.5% and 17.6% respectively) and among girls, an 11% increase (15.4% and 17.1% respectively).
    The levels of overweight (including obese) among 11-15 year olds increased from 28.1% in 1995 to 32.9% in 2006 – an increase of 17%. For boys, the prevalence of overweight and obesity rose by 20% (26.9% and 32.4% respectively) and for girls by 14% (29.3% and 33.3% respectively).

Local Data

Since 2006-07, the National Child Measurement Programme (NCMP) has weighed and measured sufficient numbers of children to give robust data. Children in Reception year and Year 6 are weighed and measured during the school year as part of this programme. The primary purpose of the National Child Measurement Programme is to help local areas to understand the prevalence of child obesity in their area, and help inform local planning and delivery of services for children [11].

Table 1 presents Childhood Obesity Data (PDF, 30KB) shows that:

  • In 2006-07 and 2007-08 Central and Eastern Cheshire Primary Care Trust, more than one in five of the children measured in reception year (aged 4-5 years), were either overweight or obese (22% & 20.4% respectively). In Year 6 children (aged 10-11 years); this rate was nearly one in three (31.5% & 29.5% respectively).
  • The prevalence of obesity was significantly higher in Year 6 than in reception – 16.7% & 16.1% compared to 8.6% & 8.4% respectively.
  • The percentage of children who were overweight was higher in Year 6 than in reception (14.8% & 13.4% and 13.4% & 13. 0% respectively).
  • The overall overweight and obesity rates reduced between 2006-07 and 2007-08 (22% to 20.4% and 31.5% to 29.5% respectively).

Rates of childhood overweight and obesity in the Local Authorities which comprise Cheshire East are comparable with rates across the North West. However, in 2006/07 Crewe and Nantwich had the highest percentage – 39.6% - of Year 6 boys who were overweight or obese [12].  This analysis has not yet been calculated for 2007-08 data.

As data coverage increases it was anticipated that overweight and obese prevalence rates would increase, this is not the case in the Primary Care Trust. Caution must be exercised with this data as the year on year decreases are not significant.

Further Information and Evidence of Effective Intervention

Tackling obesity requires a coherent multi agency approach [13]. The Primary Care Trust, new Local Authority and partners in the private and third sector need to work closely together to put in place a full suite of locally focused interventions targeted at reducing overweight and obesity in maternity and early years and at the factors that promote an ‘obesogenic’ environment. Table 2 outlines the key interventions for local delivery (PDF, 27KB) to ensure local people are given the best opportunity to achieve and maintain a healthy weight.

Reccomendations

The National Child Measurement Programme results are further analysed into town and borough council areas and between the two years to explain the variation across the towns, the two years and with national data.
The Primary Care Trust and Local Strategic Partnership partners agree the Obesity Strategy currently being developed by the Cheshire East Children and Family Healthy Weight Steering Group.
The range of interventions to prevent and manage excess weight as outlined in Table 2 need to be commissioned.

Downloads


[1] National Child Measurement Programme 2006/07 & 2007/08

[2] Cross Cutting Obesity Unit, Department of Health and Department for Children, Schools and Families (2008). Healthy Weight, Healthy Lives; Guidance for Local Areas, March 2008

[3] An obesogenic environment – this is a term commonly used to explain how it has become normal for people to eat lots of high-fat/ high sugar food, spend hours in sedentary activities such as watching TV and use the car instead of walking even short distances

[4] House of Commons Health Committee 2004

[5] NHS Information Centre (2006) Health Survey for England 2005 Latest Trends. NHS Information Centre.

[6] World Health Organisation Information on Obesity

[7] Foresight 2007. Tackling Obesities: Future Choices

[8] Healthy Weight, Healthy Lives: A Toolkit for Developing Local Strategies. National Heart Forum, Cross-Government Obesity Unit, Faculty of Public Health, p.22

[9] Healthy Weight, Healthy Lives: A Toolkit for Developing Local Strategies. National Heart Forum, Cross-Government Obesity Unit, Faculty of Public Health, p.22

[10] Craig, R, Mindell, J. (Eds). Health Survey for England 2006. Volume 2: Obesity and Other Risk Factors in Children. London. The Information Centre for Health and Social Care. 2008, cited in Healthy Weight, Healthy Lives: A Toolkit for Developing Local Strategies, p.15-19

[11] National Child Measurement Programme 2006/07

[12] Healthy Weight in the North West Population. North West Public Health Observatory. 2008, p.24

[13] Cross Cutting Obesity Unit, Department of Health and Department for Children, Schools and Families (2008). Healthy Weight, Healthy Lives; Guidance for Local Areas, March 2008

Cheshire East Council  Telephone: 0300 123 55 00
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