Appendix 2 Literature Review – Childhood Obesity Obesity - Background All of the literature refers to similar statistics regarding obesity. The list below gives some examples of the data available from the different sources. ♦ ♦ ♦ ♦ Obesity has more than doubled between 1990 and 2000 in Britain. One in 10 six year olds (8.5%) are obese. One in six (15%) 15 year olds is obese. If the current trends continue, one fifth of boys and one third of girls will be obese by 2020.
Obesity is measured using the Body Mass Index (BMI) for an individual. This is measured through a calculation relating height to weight and age, and there are agreed figures for obesity. This problem is not just limited to the UK. Obesity is rising in other developed countries, most notably the USA. No-one has managed to reverse this trend.1 Implications of Obesity 1) Premature mortality a) Linked to 30,000 deaths a year b) Shortening of life by an average of 9 years2 2) Cost to NHS a) £0.5 billion pa3 3) Cost to economy4 a) £2 billion b) 18 million sick days pa 4) Increased risk of disease. 5 6 Most are diseases of adult life, but overweight adolescents have a 70% chance of becoming overweight or obese adults.7 a) Heart disease – the most common cause of premature death among obese people (estimated 28000 heart attacks caused by obesity in 1998) b) Type 2 diabetes – this was previously considered to be an adult disease but has appeared in obese school children c) High blood pressure d) Osteoarthritis and back pain e) Hypertension f) Asthma g) Cancer, especially colon
Wanless, D. Select Committee on Public Accounts 3 NAO 4 NAO 5 NAO 6 Ebbeling et al. 7 POST
5) Exercise intolerance8 6) Stereotype/Stigmatisation:9 10 a) Unhealthy b) Academically unsuccessful c) Socially inept d) Unhygienic e) Lazy f) Negative self image – which could also lead to low self confidence and depression in both children and adults Causes of Obesity There are two main causes of obesity – diet and physical activity.11 However, the literature suggests that some other factors may influence it, and also goes into greater detail about the two main causes. 1) Genetic reasons12 a) Possibility that maternal obesity transfers b) Possibility that those children who were bottle fed are more at risk c) The rise in obesity has been considered to be too large for only genetic factors to account for it.13 2) Environmental stimuli14 a) As children grow older, they become more responsive to external stimuli than internal hunger pangs 3) Increasingly sedentary lifestyle15 16 although there is little direct evidence. The available data reveals: a) Television viewing – lack of physical activity combined with propensity to eat. Possibility that television advertising could affect eating habits (eg. random sample of children’s tv showed 34% of adverts were for junk food) b) Also includes video games, computers and the internet c) Reduction of physical activity in schools: i) A survey by Sport England showed that the proportion of young people spending two or more hours a week on sport in school declined from 46% in 1994 to 33% in 1999) ii) The National Diet and Nutrition survey (2000) found that 40% of boys and 60% of girls failed to meet a Health Education Authority recommendation that children should engage in at least moderate physical activity for one hour per day.17 d) Urban environments discouraging physical activity e) Decline in children walking and cycling to school 8 9
Ebbeling et al. Ebbeling et al. 10 POST 11 Wanless, D. 12 Ebbeling et al. 13 POST 14 Ebbeling et al. 15 Ebbeling et al. 16 POST 17 University of York
4) Changes in eating patterns and dietary habits a) Consuming more calories than are expended18 b) Large portion sizes19 c) Content of food (energy dense foods) e.g. fats, carbohydrates, sugar20 d) Quality of food in schools21 - including prevalence of snack vending machines in schools22 e) Increase in fast food and snacks f) Family behaviours e.g. dinner in...
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