What can we do about childhood obesity

Childhood obesity was back in the headlines this week following the publication of two UK child health reports.

The first was a worrying analysis of government public health data from over a million children in England. Not only did this show a significant upward trend in the prevalence of obesity among 10 and 11 year olds over the last six years, but also found evidence of widening health inequalities. In fact, children from deprived areas are almost twice as likely to be obese than those in affluent areas (24.2% versus 12.8% of Year 6 school children).

On the same day, the British Medical Association painted a fairly gloomy picture of child health and well-being in 2013 in their report Growing Up in the UK. The BMA accused the government of “failing children”, and highlighted obesity as one of several public health problems about which little was being done.

The Department of Health aims to achieve “a sustained downward trend in the level of excess weight in children” by 2020. Much of the policy focus is on encouraging people to make healthier lifestyle choices by providing guidance and advice on a healthy diet and physical activity, improving labelling of foods, and encouraging businesses to include calorie information on their menus.

What evidence do we have on the treatment and prevention of childhood obesity? There are almost 200 relevant systematic reviews on DARE. In the last year alone, there have been 25 reviews looking at interventions as diverse as regular breakfast cereal consumption, telemedicine counselling and bariatric surgery.

Several reviews look at efforts to encourage healthier lifestyles and much of the primary research evidence suggests these interventions can be effective. However the evidence itself isn’t always of the best quality, with many studies measuring short term changes in diet or exercise, without assessing the long term impact on weight and obesity. Even where systematic reviews have found statistically significant benefits, some authors have questioned whether these benefits are large enough to truly matter.

What about the issue of socioeconomic inequalities? A recent review of physical activity interventions in economically disadvantaged communities reported positive effects for group-based activities targeting overweight adults, but unfortunately these effects were not apparent in studies of children and adolescents.

So while it seems public health approaches to childhood obesity can work, precisely which techniques work best, for whom and for how long is a far more complex matter.

References

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Page last updated: 2 July, 2014