Blog: Taking action on childhood obesity
Tackling obesity is a priority to address health inequalities and reduce risk for a range of diseases. Empowering individuals by supporting them to change their behaviours can have long term benefits. Obesity is a growing problem in the UK, affecting around a quarter of all adults and with estimated costs of over £5 billion a year spent on obesity-related illnesses, according to a UK Government policy paper.
The 2020-2021 National Child Measurement Programme in England found almost 28% of reception children are either overweight or obese, and this increases to over 40% by the final year of primary school. The National Institute for Health and Care Research (NIHR) wants to boost research into prevention of ill health and has identified improving maternal and child health as a key goal for the next decade.
Systemic change
There is increasing evidence that early identification and intervention is important in preventing obesity in young people. Studies have also shown that efforts that include diet or physical activity can reduce the risk of obesity in children aged 0-12 years.
Yet an NIHR review of the research evidence warns that childhood obesity is not being addressed in the most effective way. As well as targeting lifestyle factors through primary care and schools, other drivers of obesity need to be addressed, such as the environments we live in, media, advertising, government policies and the state of the economy.
With this in mind, the NIHR is working with researchers to consider how findings on obesity can be translated into future health policy options, and to consider effective real-world implementation. At the same time, research continues into which interventions (actions taken to improve conditions) are most effective and into the different stages of life that should be targeted to support individuals with their weight loss.
Maternity interventions
Carrying excess weight in pregnancy is associated with complications and poorer health outcomes for both mothers and their babies. There is some evidence that excess weight gain in pregnancy increases the likelihood of long-term obesity in women after birth, as well as in their offspring.
In Northern Ireland and the Republic of Ireland, researchers are testing an intervention to encourage healthy habits in pregnancy and beyond that is integrated with routine antenatal care. Women who are overweight when they arrive for their first antenatal check are recruited and encouraged to develop ten healthy habits around diet, physical activity and weight management; their engagement with the programme as well as long term success will be compared with other overweight women who receive routine antenatal care without the intervention.
The trial began as a pilot with researchers assessing how many women are eligible at each of the four recruitment sites, how willing healthcare staff are to deliver the intervention, and to assess whether a larger trial is feasible and could be effective at supporting women during and after pregnancy.
School-based interventions
With one in three children leaving primary school overweight or obese, interventions that target them before 11 are vital. An NIHR funded pilot, MapMe, supported parents after their child’s National Child Measurement Programme result. As well as receiving the measurements, the parents of 300 overweight children in reception or year six were also sent guidance images of children ranging from underweight to obese and information on healthy eating, physical activity and the consequences of children being overweight. They also received links to online information and support. A year later, those children had achieved a healthier weight than their overweight peers whose parents had not been sent the MapMe information.
The team is extending the trial to roll it out across nine local authorities to over 55,000 families. They have worked with parents and health professionals to improve the intervention and are testing the effect of including a ‘booster’ letter six months after the initial support pack.
The Walking in Schools (WISH) study is another cross-border initiative, aimed at improving physical activity levels amongst adolescent girls (aged 12-14). This is a crucial stage in life where youth physical activity levels have been shown to decline, particularly within girls. Evidence has shown that physical activity behaviour established during childhood is likely to continue into adulthood. Indeed, low levels of physical activity throughout the life course is associated with an increased risk of disease and lower life expectancy in adulthood. Therefore, it is vitally important to promote and establish good physical activity behaviours from a young age.
Evidence from an earlier phase (pilot study) of the WISH study demonstrated that it is potentially beneficial for improving physical activity levels, and various other physical and psychological well-being measures amongst adolescent girls. Now researchers from Ulster University, Professor Marie Murphy and Professor Alison Gallagher are in the process of rolling the intervention out on a larger-scale (cluster-randomised controlled trial). The WISH study team have recruited 18 secondary schools and a total of 591 students across both Northern Ireland and the Border region of the Republic of Ireland to take part in the peer-led walking programme, to be delivered during the school day within the school grounds. Older students (aged 15-18) within each school were also recruited as walk leaders and their role involved the promotion and facilitation of the daily walks for the younger participants. As the study approaches its final stages of data collection towards the end of the year, the team are excited to see the impact the intervention has had towards improving the health and well-being of the student participants. If deemed effective, WISH could be adopted in schools and benefit children across the whole island of Ireland.
This work was supported by the Health and Social Care Research & Development Division. The Cross-border Healthcare Intervention Trials in Ireland Network (CHITIN) programme is funded by the European Union’s INTERREG VA Programme, managed by the Special EU Programmes Body (SEUPB).
The NIHR is also supporting research into interventions and support for adults who are overweight or obese.
How you can get involved with research
To find out more about research trials that are happening now and in the future you can look at our Be Part of Research website, which has a full list of studies. Perhaps one is right for you?
Our what happens in a study page provides more information on how trials work. And if taking part in a study doesn’t feel right at the moment there are other ways to get involved in research.
Pic: Walking In ScHools study.