Drafting in paratroopers to show overweight children that exercise is fun is just one novel initiative that has had results.
When the Paras get involved, you know it is serious. Recruiting members of the local regiment to organise fitness sessions for overweight young people is one of the innovative ideas from NHS Wakefield District, which two years ago registered the second highest percentage of obese five-year-olds in the country.
The facts about child obesity - recent figures suggest that almost three million children in the UK aged two to 15 are overweight, half of whom are obese - are now well known to health professionals.
So how are they tackling a condition that can reduce life expectancy on average by 11 years and increase the risk of illnesses, including coronary heart disease and stroke, type 2 diabetes, high blood pressure and osteoporosis?
Experts stress two themes: intervention as early as preconception and involvement of whole families.
Wakefield’s Connect 3 childhood weight management programme, with its wide range of initiatives, including an invitation to soldiers from Wakefield 299 Parachute Squadron Royal Engineers to produce an inflatable assault course, resulted in 5.5 per cent less of its five-year-olds being obese from 2006-07 to 2007-08.
The service also uses an allotment to encourage children to be active and see the benefits of growing healthy food.
Because many overweight children are the victims of bullying and already have low self-esteem, Connect 3 is careful to avoid any language that may stigmatise them, explains childhood healthy weight project manager Rachel Howard, who says that only 13 per cent of parents recognise the fact that their children are overweight.
Children are referred to as “above healthy weight” and the word “diet” is never used. The approach seems to be paying off with an increase in self-referrals, partly as a result of a community-wide poster campaign.
Now the programme has been adapted and extended to include the under fives.
“We knew there was room to develop a programme which worked in partnership with children’s centres to promote obesity prevention,” Ms Howard says. “We try to target families at risk where there can be a skills gap around cooking and diet.”
Anita Roy, consultant in public health for NHS Wakefield District, says: “There are so many influences on a child’s lifestyle there is no way we can tackle this on our own, so we focus on working closely with partners in education, school nursing, the local authority and parents, carers and the young people themselves.”
Dr Roy emphasises that monitoring the outcome is equally important.
Paediatric dietician Jessica Williams, a member of the British Dietetic Association’s paediatric specialist group, believes the problem “is everybody’s business”.
Last year she was funded by the government programme Sure Start to work in children’s centres in areas of high deprivation within Halton borough council, Cheshire, where part of her role was to provide fast track dietetic services at family drop-in clinics.
“We need to upskill others who have contact with children and families,” she says. “Within the Sure Start agenda, I was able to train childcare workers, family support assistants, those involved in social care and education and volunteers, many of whom lived in the community and so could enhance knowledge in the area, where possible helping women even before they become pregnant.”
The dietician believes early intervention is vital, before behaviours become established. “For example, when we talk about being active, it means that as soon as children are able to walk, they should be moving about as often as possible instead of sitting in pushchairs.”
If the problem is identified when children are older, different approaches are needed. As figures show that overweight children are very likely to have overweight parents, the most successful programmes involve whole families, she says.
“We must also have a consistent message to avoid families being confused over the different information they pick up, particularly around diet, from the media and internet.”
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Healthy weight strategy progress
The government’s strategy Healthy Weight, Healthy Lives aims to reduce the proportion of overweight and obese children to 2000 levels by 2020. One Year On, published in April this year, reviews the progress of the initial strategy. It includes:
- How to set and monitor goals for prevention of child obesity
- Toolkit to help PCTs and local authorities, which complements National Institute for Health and Clinical Excellence guidance
The National Child Measurement Programme guidance for PCTs in 2008-09 advises on:
- Arrangements for measuring height and weight of primary and middle school children
- Sending parents their child’s results
- Submitting data to the NHS Information Centre for inclusion in the national database