Associations between deprivation and rates of childhood overweight and obesity in England, 2007-2010: an ecological study.
ABSTRACT To investigate the associations between deprivation and rates of childhood overweight and obesity in England, from 2007 to 2010.
An ecological study using routine data from the National Child Measurement Programme and Indices of Multiple Deprivation (IMD) 2010 scores.
Local authority districts in England.
Schoolchildren in Reception year (age 4-5 years) and Year 6 (age 10-11 years) attending non-specialist maintained state schools in England. PRIMARY AND SECONDARY OUTCOME MEASURES: Prevalence of overweight in both Reception and Year 6, prevalence of obesity in both Reception and Year 6 and IMD 2010 scores for each local authority.
In 2009-2010, local authority IMD 2010 scores were strongly correlated with obesity rates among schoolchildren in Reception (r=0.625, p<0.001) and Year 6 (r=0.733, p<0.001). There were no statistically significant changes in association between obesity in Reception or Year 6 and IMD from 2007-2008 to 2009-2010. In contrast, the prevalence of overweight was not statistically significantly correlated with local authority IMD scores in Reception (r=0.095, p=0.092) and only weakly correlated in Year 6 (r=0.184, p=0.001). There were no statistically significant changes in association between overweight in Reception or Year 6 and IMD from 2007-2008 to 2009-2010.
Childhood obesity rates in England are strongly associated with deprivation. Given the enormous public health implications of overweight and obesity in the population, these findings suggest that significant effort is required to tackle unhealthy weight in children in all local authorities and that this should be a priority in areas with high levels of deprivation.
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ABSTRACT: To investigate associations between weight status and body size perception in children in the UK. Cross-sectional survey. School-based sample in the UK. 399 children (205 boys, 194 girls) aged 7-9 years. Perceived body size was assessed using a visual method (Children's Body Image Scale, matching to images representing body mass indexes (BMI) from 3rd to 97th percentiles) and verbal descriptors from "too thin" to "too fat". BMI (converted to BMI SD scores using UK data) was assessed and demographic information was recorded. Modest associations between actual and perceived body size were found with visual (r = 0.43, p<0.001) and verbal (r = 0.41, p<0.001) methods, but there was a consistent response bias towards underestimation. Using visual matching, most children (45%) underestimated their body size, with significantly greater underestimation (p<0.001) at higher BMI. A gender-by-weight group interaction (p = 0.001) showed that at lower weights girls were more accurate than boys, but at higher weights girls were less accurate. Using the verbal scale, the majority of children reported their body size as "just right" in all weight groups (52-73%), with no sex differences. Children can estimate their body size using visual or verbal methods with some accuracy, but show greater underestimation at higher weights, especially in girls. These findings suggest that underestimation is more widespread than has been assumed, which has implications for health education among school-aged children.Archives of Disease in Childhood 08/2009; 94(12):944-9. · 3.05 Impact Factor
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ABSTRACT: To review the evidence on the diet and nutrition causes of obesity and to recommend strategies to reduce obesity prevalence. The evidence for potential aetiological factors and strategies to reduce obesity prevalence was reviewed, and recommendations for public health action, population nutrition goals and further research were made. Protective factors against obesity were considered to be: regular physical activity (convincing); a high intake of dietary non-starch polysaccharides (NSP)/fibre (convincing); supportive home and school environments for children (probable); and breastfeeding (probable). Risk factors for obesity were considered to be sedentary lifestyles (convincing); a high intake of energy-dense, micronutrient-poor foods (convincing); heavy marketing of energy-dense foods and fast food outlets (probable); sugar-sweetened soft drinks and fruit juices (probable); adverse social and economic conditions-developed countries, especially in women (probable). A broad range of strategies were recommended to reduce obesity prevalence including: influencing the food supply to make healthy choices easier; reducing the marketing of energy dense foods and beverages to children; influencing urban environments and transport systems to promote physical activity; developing community-wide programmes in multiple settings; increased communications about healthy eating and physical activity; and improved health services to promote breastfeeding and manage currently overweight or obese people. The increasing prevalence of obesity is a major health threat in both low- and high income countries. Comprehensive programmes will be needed to turn the epidemic around.Public Health Nutrition 03/2004; 7(1A):123-46. · 2.25 Impact Factor
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ABSTRACT: The aim of this paper was to investigate variations in childhood obesity globally and spatially at the micro-level across Leeds. Body mass index data from three sources were used. Children were aged 3-13 years. Obesity was defined as above the 98th centile (British reference dataset). The data were analysed by age group and gender, then tested for significant micro-level hot spots of childhood obesity using a spatial scan statistic and a two-level multilevel model. Older children (13 years) were 2.5 times (95% CI 2.1 to 3.1) more likely to be obese than younger children (3 years). Childhood obesity was significantly associated with deprived and affluent areas. 'Blue collar communities,' 'Constrained by circumstances' and 'Multicultural' had significantly higher (relative risk (RR): 1.1, 1.2, 1.2; 95% CI 1.0 to 1.2, 1.1 to 1.2, 1.1 to 1.3, respectively) obesity levels, and 'Typical traits' and 'Prospering suburbs' had significantly lower (RR: 0.9, 0.8; 95% CI 0.8 to 1.0, 0.7 to 0.9, respectively) obesity levels. In the unadjusted model, obesity 'hot spots' were found in deprived (RR 1.5) and affluent (RR 6.1) areas. After adjusting for demographic covariates, hot spots were found only in affluent areas (RR 1.6 to 1.9), and cold spots in affluent (RR 1.3 to 4.4) and deprived (RR up to 1.1) areas. These results suggest there is either a spread of obesity across socio-economic groups and/or something special about the high-/low-prevalence areas that affects the likelihood of obesity. The microlevel spatial analyses displayed the variations in obesity across Leeds thoroughly, identifying high-risk populations.Archives of Disease in Childhood 11/2009; 95(2):94-9. · 3.05 Impact Factor