childhood obesity in merton including an update on the ncmp programme eva van velzen, public health...
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Childhood obesity in Mertonincluding an update on the NCMP programme
Eva van Velzen, Public Health registrar NHS Sutton and MertonJulia Groom, Public Health consultant Merton27 April 2012
Merton
• One in five children in Reception year is overweight or obese
• One on three children in Year 6 is overweight or obese
So what?• Children experience psychological effects: teasing and discrimination by
peers; low self-esteem; anxiety and depression
• Childhood obesity is associated with a higher chance of premature death and disability in adulthood from:– cardiovascular diseases – diabetes– musculoskeletal disorders– certain types of cancer (e.g. breast and colon)
• Many overweight children will become overweight adults (and parents!)
Sources: NOO, WHO
Outline
• Causes of childhood obesity• Background NCMP• National results• Merton results• NCMP actions• Local support programme: Alive ‘n Kicking• Discussion
Determinants of Obesity
Source: http://www.cdc.gov/pcd/issues/2009/jul/09_0013.htm
In words:• Childhood obesity is mainly associated with unhealthy eating and low
levels of physical activity, but the problem is linked not only to children's behaviour but also, increasingly, to social and economic development and policies in the areas of agriculture, transport, urban planning, the environment, food processing, distribution and marketing, as well as education
• The problem is societal and therefore it demands a population-based multi sectoral, multi-disciplinary, and culturally relevant approach.
• Children and adolescents cannot choose the environment in which they live or the food they eat. They also have a limited ability to understand the long-term consequences of their behaviour.
Source: WHO
Background• National Child Measurement Programme (NCMP) is a
national programme to measure the weight of children in Reception and Year 6 in English state schools
• Aim: to monitor overweight and obesity to guide effective policy making to reduce obesity
• Parents receive individual feedback about measurement• Measure used = BMI, adjusted for normal growth variation
between Reception and Year 6, and sex.
National child measurement results 2010 - 2011
© NOO 2012
Merton child measurement results 2010 - 2011
© NOO 2012
Lower than UK
Higher than UK
NCMP results – action
• National data for monitoring and policy
• Local feedback of measurements• to parents (NHS community services)• to headmasters (NHS Public Health)• referrals to treatment programme ‘Alive n Kicking’
What is Alive ‘N’ Kicking?• Specialist healthy weight programme for
children aged 4-19
• Physical activity sessions for children
• Interactive nutrition workshops for parents, focusing on practical ways to improve the family diet.
Group programmes for 4-6yrs, 7-11yrs, 12-15yrs and 16-19yrs, with capacity of 20 participants per group
Results so far March 2012...
• 70% of graduates reduced their BMI
• 84% of graduates reduced their waist circumference
• Average weight loss was -1.05 kg
Discussion
• One in five Merton children in Reception year is overweight or obese
• One on three Merton children in Year 6 is overweight or obese
Extra slides
Obesity trend data
Merton – England, NCMP 2007/08 to 2010/11
Reception Year
Year 6
Prevalence of obesity by Local AuthorityYear 6 children (age 10-11 years) resident in London, NCMP 2009/10
Low prevalence
High prevalence
Child obesity: BMI ≥ 95th centile of the UK90 growth reference © NOO 2011
http://www.noo.org.uk/visualisation/eatlas
Uptake and trends
Training: 88 local candidates trained including EY staff and Health
Completers:Jul ’09 - Mar ‘11 = 105 / yrApr’11 – June ‘12 = 161 / yr53% increase in completers
Referrals: on average 26 referrals per month
We’re aiming for 70 this term
Local feedback to schools
• National guidelines: detailed school data may not be shared with schools
• We use a national but ‘Mertonised’ tool for feedback about the 2010-2011 results to Merton headmasters
• The letter will include information about local support to help children and their families to keep a healthy weight
• Participation rate Merton - England: – 87.1% Reception = lower than nationally– 91.2 % Year 6 = same as nationally
School prevalence indicator:
No data or insufficient
data
Below the regional average
Similar to the regional average
Higher than the regional average
Reception
Underweight2 2 2 2
Overweight2 2 2 2
Obese2 2 2 2
Year 6
Underweight2 2 2 2
Overweight2 2 2 2
Obese3 3 3 3
Example feedback from 09-10 data
Note: big increase in overweight and obesity between Reception and Year 6!
23.6%22.9%
21.7%
20.5%
18.9%17.9%
16.6%15.7%
14.6%
12.6%12.6%12.0%
11.4%10.7%
9.7%9.0%
8.3% 7.9% 7.5%6.8%
Mostdeprived
Leastdeprived
© NOO 2011
Prevalence of obesity by deprivation decile Children in Reception and Year 6 (National Child Measurement Programme 2009/10)
Child obesity: BMI ≥95th centile of the UK90 growth referenceDeprivation deciles assigned using the Index of Multiple Deprivation 2010
Reception Year 6