Issues and action in childhood obesity
Press release issued: 17 September 2002
UNIVERSITY OF BRISTOL
Issues and action in childhood obesity
A joint conference of the Association for the Study of Obesity and the University of Bristol
Experts on obesity are meeting at a two-day conference (17-18 September 2002) to discuss issues and actions in childhood obesity. This meeting will be held at At-Bristol, Harbourside in Bristol.
Childhood obesity has almost doubled since the mid 1980's and the trend shows no signs of stopping. Overweight or obese children are more likely to become obese adults than their lean friends, increasing the risk of ill health in later life. Obesity in children is therefore a great concern both clinically and to public health. This meeting brings together scientists and health professionals from a number of disciplines to consider the latest research into the causes, prevention and treatment of childhood obesity. It will identify key issues for the development of successful strategies for the prevention, diagnosis and treatment of this increasing health problem.
Over 20 speakers will address childhood obesity with particular focus on the following topic areas:
< src="/images/blueball.gif" alt="* " />Defining the problem of childhood obesity?
What are the contributors to the increase in obesity in children?
Approaches to treatment and prevention of obese children: evidence and issues
Moving from research to practice
Options for prevention programs
Options and issues for treatment
Presentations at the conference include:
There have been major changes in the types of foods eaten by young children in the past 50 years, but the role of diet in the current increase in obesity in young children is still unclear. Now data from the Avon Longitudinal Study of Parents and Children (ALSPAC) living in Bristol adds new light. Dr Pauline Emmett (Research Nutritionist/Dietitian, Department of Child Health University of Bristol) who is involved in this study relates her findings to the development of obesity. She says: "We found that children's diets are influenced by the educational level of their mother and that groups with the least educated mothers had higher levels of obesity. Our findings show that it is important that health professionals have a role especially in encouraging the less educated mothers to follow best practice."
Consequences of childhood obesity: results of a systematic review and critical appraisal
Dr John Reilly, (Department of Human Nutrition, University of Glasgow) discusses the health and psychological problems that effect children with obesity and looks at the possible clinical and public health effects. He says: "Many parents and health professionals see childhood obesity as a cosmetic problem. In fact, obesity causes ill health in childhood, and long-term health problems for adults who were obese as children." In his talk Dr Reilly shows that obese children suffer from psychological problems, and have a number of heart disease risk factors. He says: "Obesity in childhood tends to persist into adulthood, and adults who were obese as children have increased risk of heart disease. Adults who were obese as children also have poorer social, educational, and economic prospects. In conclusion, childhood obesity has a high cost in health and economic terms, and we should be making greater efforts to prevent it."
Secondary care and pharmacotherapy in childhood
The role of the hospital specialist in the care of children with obesity is relatively limited but important for those with severe morbid obesity (extreme obesity). Specialists are needed to rule out treatable endocrine causes for weight gain and then provide a clinical setting in which optimal weight loss can be managed in those with severe morbid obesity. Type II diabetes is increasingly being seen in children with obesity and this condition needs specialist attention. Dr Julian Shield (University of Bristol & Bristol Royal Hospital for Sick Children) looks at these issues in light of his experiences in treating morbidly obese children at his clinic in Bristol and discusses the role of medical staff, dieticians and specialists in health and exercise. He says: "Although new pharmacological agents will undoubtedly become available for the treatment of adult obesity one might hope that behaviour modification in obese children may circumvent the necessity for such agents in the majority of individuals."
Recent evidence confirms that obese young people are generally considerably less active than non-obese young people, especially outside of school time. Dr Angie Page (Department of Exercise & Health Sciences, University of Bristol) reviews how an inactive lifestyle relates to obesity in children. In her presentation she discusses how an increased risk of obesity is related to higher levels of television watching and that TV viewing is also associated with eating more calorie dense foods and less fruits and vegetables. She says: "Recent interventions aimed at reducing television viewing are encouraging, showing significant reductions in fatty tissue in those children who have decreased television viewing. But there is a need to integrate diet and physical activity in future research to understand the interaction between these behaviours in relation to developments in obesity and treatment."
Defining childhood obesity and prevalence
There are many different definitions of childhood obesity and they are all incompatible. Professor Tim Cole, (Institute of Child Health, London) and colleagues have now developed a new international definition which for the first time can compare obesity rates in different countries. Professor Cole says: "The new definition shows that childhood obesity has been increasing since the 1980's all over the world, with some of the highest rates to be found in the USA and urban China. This rise is set to continue, and if not checked will lead to increased deaths in adults through heart disease, diabetes and high blood pressure."
Psychological consequences of childhood obesity
All children develop a sense of who they are by observing responses from family, friends and the wider society. Children are aware of obesity as socially undesirable and can become aware of their own fatness. Obesity experts believe that low self-esteem may be characteristic of overweight children and adolescents, and high self-esteem may protect against obesity. Dr Laurel Edmunds (Institute of Health Sciences, Oxford) discusses these issues and also looks at the role of parenting, the family environment and potential effects childhood obesity can have on them. He says: "The consequences of obesity are many and varied for children and their families, with some long-term and serious. Childhood obesity is complex with evidence for general negative effects, but some children cope better than others."
Diet and nutrition issues
Obesity results from an imbalance between energy intake and energy needs. Children today are less active than former generations, but the increase in fatness suggests that the total calories consumed have not decreased accordingly. Dr Susan Jebb (MRC Human Nutrition Research, Cambridge) will present data from the National Diet and Nutrition Survey which provides a snapshot of what children in Britain eat today. Dr Jebb considers the role of soft drinks, fast food and other food items in relation to their risk factors for obesity. The impact of social trends on children's diets are also evaluated, including the rise in television viewing, increasing sales of 'snack foods', and 'supersizing'. The question of who should take responsibility for children's diets and their weight - (government, the food industry, schools, parents or children themselves?) is raised. She says, "Understanding the dietary factors associated with an increased risk of obesity is critical to the development of effective lifestyle strategies for the prevention of excess weight gain in young people. There is a need to integrate dietary factors with a greater understanding of the role of physical activity to understand the broader lifestyle determinants of obesity in young people and to develop partnerships which support and facilitate the necessary lifestyle changes by children and their families."
The global epidemic of childhood obesity
Excess body weight is the commonest childhood disorder in Europe and North America and is rapidly becoming a major concern in other regions of the world. In some areas the problem of excess weight now affects one child in three. In Europe, the prevalence of excess weight has risen from typically around 10% in the early 1980s to around 20% in the later 1990s. In some countries in southern Europe the rate now exceeds 30% of children. Dr Tim Lobstein (International Obesity Task Force) examines the worldwide epidemic of obesity in children and discusses the possible causes of such a rise. He says: "Although having overweight parents will raise the chances of obesity among children, genetic factors are not the full explanation. The changes have been too rapid. Cultural changes - such as the rise in snack food consumption and the decline in physical activity levels - are the most likely explanations."
School based programmes
Most obesity treatment takes place in a clinical setting, however schools provide an excellent opportunity for preventing and treating obesity. School-based approaches for childhood obesity usually focus on either the prevention of obesity, looking at the whole of the population, or they can target those with existing obesity. Dr Pinki Sahota, (School of Health Sciences, Leeds Metropolitan University) discusses the merits and disadvantages of both types of interventions that have been carried out mainly in the US since the 1960's. He says: "The population-based approach in the prevention of obesity is desirable and likely to be more effective than approaches targeted at obese children because it is difficult to predict the children that will go on to develop adult obesity. Population-based approaches have the potential to reduce children's risk of adult obesity. Two key components for obesity prevention are diet and physical activity. Within schools both should be promoted as part of a co-ordinated, comprehensive programme for school health."
Role of primary care
The involvement of UK GP's in treatment of childhood obesity is patchy and limited. Dr Penny Gibson (Royal College of Paediatrics and Child Health, Advisor on Childhood Obesity) discusses "An approach to weight management in children and adolescents (2 - 18 years) in primary care", which is a guidance document developed by the RCPCH, and the National Obesity Forum aimed at UK health professionals. It uses US recommendations of an expert committee and existing research evidence. She says: "We hope to encourage health professionals to be more positive about weight management and their role in it by providing brief, practical and safe advice that will help children and families gradually develop healthier lifestyles. The document has been distributed to all GPs and to all members of RCPCH."
Active travel to combat obesity
Sustrans is a national charity which promotes active travel on foot and by bike, through projects such as the National Cycle Network and Safe Routes to Schools. Mr John Grimshaw (Executive Director, Sustrans) highlights aspects of Sustrans work programmes and calls for more research into the impact and cost effectiveness of such practical projects. He says: "These projects are important environmental interventions to promote physical activity and so to help combat obesity in children."
Evidence for treatment and prevention
Moving from research to practice
Current UK intervention initiatives
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Copyright: 2002 The University of Bristol, UK
Updated: Tuesday, 17-Sep-2002 10:32:24 BST