Intensive lifestyle interventions can help obese young people lose weight

O’Connor EA, Evans CV, Burda BU, et al. Screening for Obesity and Intervention for Weight Management in Children and Adolescents: Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2017;317(23):2427-44.

BikeObese children and adolescents can lose up to seven pounds over six to 12 months when they engage in at least 52 hours of behaviour-based lifestyle interventions. Minimal benefit was seen with shorter contact time, with less than 25 hours ineffective. The control group gained weight.

Rising obesity in the young is a global concern, which may lead to high rates of obesity-related diseases in adulthood. This review identified trials covering various weight management strategies. Lifestyle-based-interventions with sufficient contact time – as recommended by UK guidelines – showed clear benefits with no evidence of harms.

Investing in effective strategies to manage child obesity will ultimately save healthcare costs. Behaviour-based support should now be assessed for long-term weight loss and maintenance.

The evidence is still lacking whether universal child screening for obesity should be performed in the UK.

Advertisements

‘Upselling’ adding to the UK obesity crisis

Published by the Royal Society for Public Health and Slimming World, ‘Size Matters’ reveals that the average person consumes an additional 330 calories each week as a result of businesses upselling high calorie food and drink

This report, which includes a survey of 2,055 UK adults, shows that consumers face an average of 106 verbal pushes towards unhealthy choices each year as they are asked whether they would like to upgrade to larger meals and drinks, add high calorie toppings or sides to their order or take advantage of special offers on unhealthy food and drink.

It reveals that, in the course of a week, upselling techniques used by businesses resulted in 34% of people buying a larger coffee than intended, 33% upgrading to a large meal in a fast food restaurant, 36% buying chocolate at the till at a newsagents or petrol station and 35% adding chips or onion rings to the side of their pub or restaurant meal.

The findings showed that young people are even more likely to be exposed to upselling, with 18-24 year-olds experiencing it 166 times each year – nearly every other day – and going on to consume an extra 750 calories per week as a result. This could lead to an estimated weight gain of 11lbs (5kg) over the course of a year.

 

Full report: Size matters: the impact of upselling on weight gain. | The Royal Society for Public Health | Slimming World

See also: BBC News: Public ‘tricked’ into buying unhealthy food 

Next stage of childhood obesity plan

Public Health England (PHE) announces plans to consider the evidence, set guidelines and closely monitor progress on calorie reduction.

burger-987255_1920

One year on from the publication of the childhood obesity plan, Public Health England has announced it will consider the evidence on children’s calorie consumption and set the ambition for the calorie reduction programme to remove excess calories from the foods children consume the most.  Ready meals, pizzas, burgers, savoury snacks and sandwiches are the kinds of foods likely to be included in the programme.

In addition, the Department of Health has announced £5 million of funding for a new Obesity Policy Research Unit to provide resources for long term research into childhood obesity.  Also, the Obesity Health Alliance has published a report card assessing progress during the first year of the childhood obesity plan.

Burden of child and adolescent obesity on health services in England.

Viner RM, Kinra S, Nicholls D, et al. Burden of child and adolescent obesity on health services in England. Archives of Disease in Childhood. Published Online First: 01 August 2017. doi: 10.1136/archdischild-2017-313009

Abstract

Objective To assess the numbers of obese children and young people (CYP) eligible for assessment and management at each stage of the childhood obesity pathway in England.

Design Pathway modelling study, operationalising the UK National Institute for Health and Care Excellence guidance on childhood obesity management against national survey data.

Setting Data on CYP aged 2–18 years from the Health Survey for England 2006 to 2013.

Main outcome measures Clinical obesity (body mass index (BMI) >98th centile), extreme obesity (BMI ≥99.86th centile); family history of cardiovascular disease or type 2 diabetes; obesity comorbidities defined as primary care detectable (hypertension, orthopaedic or mobility problems, bullying or psychological distress) or secondary care detectable (dyslipidaemia, hyperinsulinaemia, high glycated haemoglobin, abnormal liver function).

Results 11.2% (1.22 million) of CYP in England were eligible for primary care assessment and for community lifestyle modification. 2.6% (n=283 500) CYP were estimated to be likely to attend primary care. 5.1% (n=556 000) were eligible for secondary care referral. Among those aged 13–18 years, 8.2% (n=309 000) were eligible for antiobesity drug therapy and 2.4% (90 500) of English CYP were eligible for bariatric surgery. CYP from the most deprived quintile were 1.5-fold to 3-fold more likely to be eligible for obesity management.

Conclusions There is a mismatch between population burden and available data on service use for obesity in CYP in England, particularly among deprived young people. There is a need for consistent evidence-based commissioning of services across the childhood obesity pathway based on population burden

Using healthcare models to inform obesity interventions.

One in four adults are now obese and the Government has introduced several initiatives to combat this problem and its growing cost on NHS services | Evidence-Based Nursing blog

Examples of Government schemes include:

But this alone is not enough to prevent cardiovascular disease. The Health Belief Model, when applied to nutrition and hydration, indicates that people are more likely to follow a healthy diet and make changes to their lifestyle if they feel that failure to change would increase their risk of developing a serious disease; the benefits of the change outweigh the barriers faced due to the change; they place enough value in their life to make the change and they are prompted to make the changes.

The theory of planned behaviour addresses three aspects: the attitude, the subjective norm and the perceived behavioural control. The attitude is the values and judgement we hold about a healthy diet. The subjective norm refers to what is important to the patients’ family and friends. Perceived behavioural control is how much control the person believes they have over their ability to keep to a healthy diet i.e. whether or not they have the skills or resources to succeed.

Read the full blog post here

Liver disease financial costs

The financial case for action on Liver disease. Escalating costs of alcohol misuse, obesity and viral hepatitis | The Foundation for Liver Research

This report makes the financial case for concerted preventative action through public health measures to tackle the three main causes of liver disease: alcohol misuse, obesity and viral hepatitis. It summarises the escalating financial costs to the health and care system as well as the wider societal costs related to the three lifestyle-related factors.

Full report: The financial case for action on liver disease

Factors influencing eating behaviours in overweight and obese South Asian men living in the UK

It is widely recognised that South Asian men living in the UK are more likely to develop type 2 diabetes mellitus (T2DM) than their white British counterparts | BMJ Open

indian-sweet-371357_960_720.jpg

Despite this, limited data have been published quantifying current dietary intake patterns and qualitatively exploring eating behaviours in this population. The objectives of this study were to (1) assess diet, (2) explore perceptions of T2DM, (3) investigate factors influencing eating behaviours in overweight/obese South Asian men and (4) determine the suitability of the UK Diet and Diabetes Questionnaire (UKDDQ) for use in this population.

Many of the areas of dietary improvement and factors affecting eating behaviours identified in this study are similar to those observed in the general UK population. Consumption of sugar-sweetened beverages in particular was high; given the association between their consumption and the risk of T2DM, this should be an area of primary focus for healthcare professionals. Nevertheless, there are sociocultural factors unique to this population that need to be considered when designing culturally specific programs to reduce the development of T2DM in this high-risk population.

Full reference: Emadian, A. et al. (2017) Dietary intake and factors influencing eating behaviours in overweight and obese South Asian men living in the UK: mixed method study. BMJ Open. 7:e016919