A Critical Account of Promoting Healthy Nutrition in Families as an EarlyIntervention to Prevent Obesity
Overweight and obesity is on the increase in both adults and children. TheForesight: Tackling Obesities: Future Choices – Project Report(Government Office for Science, 2007) suggests that by 2050, 50% of the UK’s population will be obese. This is a major cause for concern as obesity can lead to coronary heart disease, type 2 diabetes, certain types of cancer and complications in pregnancy as well as many other well documented health complications (Ewles, 2005). Not only is obesity and poor nutrition likely to increase the cost to the NHS from £2billion per year to £5billion per year in 2025 but the social implications are huge. By reducing premature deaths people, on average would enjoy and extra 1.3 – 2.5 million years of life and 2.8 million years of illness and disability-free life (DoH, 2010).
However, in contrast, the Health Survey for England (National Heart Forum, 2009) would suggest that although obesity is still a problem, the prevalence of obese children aged 2-11 years is, in fact, declining:
“By simply incorporating the recent Health Survey for England (HSE) data into the Heart Forum model, it is shown that for children of both sexes, aged 2 to 11, the predicted prevalence of overweight and obese in 2020 drop from their Foresight predicted values of 28% overweight and 16% obese to 22% overweight and 12% obese. Since the review of obesity predictions in 2005ii, the 2006 data showed a small reduction in obesity levels and the 2007 data have tended to confirm this decrease.”
This would indicate, that some, if not all of the health promotion strategies are beginning to take effect. This essay will be critically examining the current early interventions, health promotion practices and Government policies aimed at reducing health inequalities with regards to improving nutrition and reducing obesity.All of the interventions discussed in this essay utilise the Public Health ‘Upstream Approach’ whereby the problems caused by disease and disability are addressed through prevention rather than treatment (Bournhonesque and Mosbaek, 2002). I have, therefore, not discussed weight-management clinics which aim to treat overweight and obesity – a ‘Downstream Approach’ which cannot be considered an early intervention.
The Black Report (DHSS, 1980), the Acheson Report (DoH, 1998) and the more recent Marmot Review (DoH, 2010) all identify that there are great differences between health behaviours and outcomes across a socio-economic gradient – widely known as health inequalities. In simple terms, the more money you have, the better educated you are and the better your housing and social environment are (including ethnicity) the better decisions regarding your health you will make andthe healthier you and your lifestyle will be. The Determinants of Health and Wellbeing in Human Habitation model (Barton and Grant, 2006) demonstrates clearly the relationship between people and other external factors that contribute to health and wellbeing and, as stated by WHO, 2011:
“The social determinants of health are mostly responsible for health inequities.”
For example, with regards to nutrition and obesity, the National Childhood Measurement Programme (2009) shows that in England approx. 23% of people in the most deprived quintile are obese but only approx. 13% of people in the least deprived quintile are obese. It is also shown that whilst different areas of England are more obese than others (London having the highest figures and the South West having the lowest) the general trend remains the same.
Despite Government initiatives like ‘Change4Life’ (DoH, 2011) which discusses portion sizes, healthy snack options and makes recommendations such as eating five portions of fruit and vegetables a day statistics suggest that there has been limited success. The...