Obesity in children, is physical activity the answer?

00107840 Advanced Human Nutrition

Obesity in children; is physical activity the answer?

The Climbing Higher Strategy was published in 2005. It is the Welsh Assembly Governments long term strategy for sport and for physical activity to be at the heart of the Welsh Assembly Governments policy. It will require radical actions to emphasise the role of sport and physical activity throughout Wales and an approach of working together is needed.

This strategy aims for sport and physical activity to be at the heart of Welsh life and to maximise a well being in Wales. The strategy incorporates dimensions such as health standards, economy, where the sport and physical activity industries will support around 12,000 jobs in Wales. Culture, where the government aims for 40% of adults and 80% of children will be members of a health club or leisure centre society, and finally the environment. This targets children and expects them to experience an outdoor activity by the age of twelve. They want people of today’s society to be ‘physically literate’ which can be described as the ability and motivation to take advantage of our movement potential to make a significant contribution to the quality of life.

In 1997 the World Health Organisation declared obesity a global epidemic with major health implications (WHO, 1997)

Global increases in the prevalence of overweight and obesity among children and adolescents has been clearly documented and publicised, and there has never been a more urgent need for an effective physical activity programs.

Obesity is seen as a problem of the imbalance between energy intake and energy expenditure. The higher the energy intake and the lower the participation in sport and physical activity, weight gain is guaranteed.

Obesity levels, particularly in children have also increased dramatically in recent years. It has adverse health consequences and an urgent need for Government or population based interventions to help its prevention. In the U.K. the percentage of young children overweight or obese between the ages of 2 to 10 years old rose from 22.7% in 1995 to 27.7% in 2003, with the highest percentage being in the older groups. (Dept. of Health, 2005)

Nowadays, weight gain is almost inevitable due to the pace at which technology is advancing as a consequence of exposure to a modern lifestyle, watching television and playing computer games may be a predictor as to the subsequent childhood obesity today. So is physical activity the answer?

Physical activity is described as ‘’any bodily movement produced by skeletal muscles that requires energy expenditure’’ (World Health Organisation)

There are various different forms of physical activity and a physical activity spectrum has been produced to illustrate the various different forms.

The types of activities included are: Active Occupation, indicating jobs which require a high level of energy expenditure. Active Living: incorporates the day to day tasks e.g. gardening and other tasks and hobbies, Opportunistic activity like taking the stairs, running for a bus and carrying the shopping, and active travel, so walking and cycling. Play is a section on its own incorporating both structured play and unstructured opportunistic play. Active recreation including walking, cycling, dancing, and exercise is classified as structured physical activity.

The final is Sport, which is split into recreational sport (e.g. football in the park etc) and formal sport, which requires regular commitment, performance work and excellence.

The Department of Health suggest that the recommendation for physical activity in children is for them to participate in 60 minutes of exercise or moderately intense physical activity and at least two hours curricular based. Although, a study by the European Youth Heart Study in July 2006, suggest that children should do at least 90 minutes of exercise daily. Results from a study by Khunti et al. 2007 found that children are not achieving this level. It is important however for those who are responsible for the future of young people to be able to address this problem which is ...

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The levels of inactivity in Wales are among the highest in U.K. As a result of this too many people are dying at a younger age. As prevention, the Welsh Assembly Government proposed the Climbing Higher strategy to promote sport and physical activity to the Welsh population.

The Welsh Assemblies objective is that health targets are to meet the global standards for levels of sport and physical activity. This strategy was the followed up by ‘Next Steps’ (2006) document which highlighted the allocations of funding to fulfill the targets of the climbing Higher Strategy, moving towards a greater integration between nutrition and physical activity and its relationship with obesity.

The Climbing Higher Report (2005) is a continuing strategy by the Welsh Assembly Government, setting out a direction for the next twenty years.

A number of initiatives have stemmed from the Climbing Higher report and are already helping to create an environment to help children to access opportunities for physical activity and healthy eating across Wales.

Dragon Sport is just one initiative that is supported by Sport Council for Wales and is funded by the National Lottery. Support is being implemented by the Sports Council for Wales to provide a better quality of coaching.

The scheme aims to improve sports provision for children aged 7-11 years and is already running in 22 Local Authorities. The scheme intended to encourage children to become involved in a variety of sporting activities.

The Dragon Sports scheme introduces children to coaching, skill development and competition. They launched 8modified sports: rugby, athletics, cricket, football, hockey, netball, tennis and golf to meet the children’s needs and skills. Whilst the primary focus of Dragon Sports is improving sports provisions across Wales, it also looks on focusing to recruiting parents and other volunteers to help support the development of the after school sports club and to integrate the whole community. We need to ensure that parents are aware

of the importance of physical activity for young people’s health, so they will

encourage their children to lead an active lifestyle and set a good example

themselves. This of course means that we need to address the behaviour’s of adults as well as children.

There are also many other initiatives implemented to help physical activity in children such as the 5x60 programme. The Welsh Assembly Government aims to target 90% of secondary schools to achieve sixty minutes of physical activity five times a week. The Welsh Assembly Government aims to invest £7.6 million over the next three years and for the programme to be implemented into every secondary school across Wales by the end of 2009.

The 5x60 programme is targeted at children who do not participate in sport or for those who are lacking in interest. Officers are based in schools to help assist with any barriers that the children may have which may prevent them participating in any physical activity.

Another initiative aimed at children is free swimming which is aimed at children under the age of sixteen. The Welsh Assembly Government’s Free Swimming initiative entitles you to free ‘splash’ sessions at selected times within your local leisure centre and at least one free structured activity session each week of the holidays. The pilot initiative is the first of a kind in Europe. In 2007 £6.3 million was invested into the free swimming initiative, (WAG, 2009)

The type of activity may include: Snorkelling, lifesaving, water polo and canoeing.

Finally, Mentro Allan is a collection of projects in Wales supported by the Big Lottery Fund and a national partnership. The programme targets specific groups that are generally less active than the wider population. Each of the projects is funded for four years to increase the physical activity levels of its target group, making best use of the local natural outdoor environment close to where people live. The programme is collecting evidence on the effectiveness of specific interventions designed to increase people’s levels of health-benefiting physical activity.

£6.5 million was invested to increase physical activity levels in ‘hard to reach’ groups, which include black and minority ethnic people and those with physical disabilities.

The social and cultural lives of people in Wales are changing. Despite increases in the wealth of the population we live in an unequal society (U.K Sport, 2002)

Many people don’t always feel safe in their communities and often hesitate at leaving children unattended which could be why Wales follows the pattern of other industrialised countries with poor levels of physical activity: only 29 per cent of adults take regular physical activity of the recommended type and frequency. Also, the balance of diet falls short of government recommendations set to reduce the risk of heart disease and cancer. Improvements in diet are urgently needed, especially among disadvantaged groups.
International research has shown that a physically active lifestyle and a healthy balanced diet produce substantial health benefits. In particular, physical activity and diet are recognised as key factors in the prevention of obesity, which is reaching epidemic proportions in many industrialised societies. It is a risk factor for many health conditions as well as being an illness in its own right.

A number of initiatives have been stemmed out from strategies like the Climbing Higher to create an environment to encourage children to access opportunities for physical activity and healthy eating in communities across Wales. However,

Socio economic differences in the prevalence of obesity are predicted to continue (McPherson et al, 2007).

One prevention for tackling obesity is the aim of the Food and Fitness Grant Scheme (2004) It provides financial support for community projects that tackle obesity by encouraging active lifestyles and healthier eating within priority groups. The Food and Fitness action plan builds on strategies and initiatives and provides a framework for integrating action on nutrition and physical activity for children and young people across Wales, and to provide the highest standard of health possible.

The Welsh Assembly Governments PE and School Sport (PESS) initiative aims to improve the opportunity available in schools, working with the Sports Council for Wales and local authorities. Development centres have been established in every local authority area. To support this, the Sports Council for Wales have worked with Local Authorities and funded all the PESS co-ordinators. The progress of this report has been monitored and found to have an increasing effect and positive impacts on children and physical activity and health opportunities available to them. The National Park Authorities plan to support the Climbing Higher targets and to try and enhance the participation of sports in the outdoor environment. In 2005, The Welsh Assembly successfully issued the CROW Act which allows the right of public access to the countryside. There is a new programme announced to improve public access to coastal areas. (WAG, 2006) The key objectives for this are to encourage the Welsh public to utilise the new countryside and coastal areas for physical recreation, and to embrace all of society targeting those who are socially disadvantages, or disabled.

Sport matters to people in Wales. The triumphs and disasters of our national teams are marked by national mood swings. By global standards the U.K is seen as a wealthy society. People and the Government can invest heavily in their priority areas. Wales is blessed with a natural environment and a climate well suited to sport and physical activity, yet participation in sport and physical activity is still a minority pursuit. In sharp contrast to other parts of the European Union, only around 30% of the adult population of Wales takes enough exercise to gain a health benefit.

‘Obesity has tripled in the last three decades.’ (Ogden et al. 2002)

Children should do at least 90 minutes exercise each day, according to the European Youth Heart Study published in July 2006.

Together with energy dense diets and low levels of physical activity are leading to obesity levels in Britain rising with increased risks of cardiovascular disease and type II diabetes. In a multiethnic population based study by Kumanyika et al (2008) found that type II diabetes was more common among 10-17 year olds who were black, Asian, American Indian, and Hispanics. Maturation could be an important factor in the distribution of fat in children. It is found that Asian girls are entering puberty at a younger age than white girls (Novotny et al 2003).

It is however, parental participation which is of great importance to a child’s physical well being.

Reducing time in which young people spend being inactive is particularly important. Epidemiologic data suggests that ‘physical inactivity tracks better that physical activity from childhood to early adulthood’ (Malina, 1996)

‘Encouraging physical activity in young people is a priority aim of the Welsh Assembly Government’. (2003)

A study by Reilley et al. (2006) investigated the prevalence of obesity in nursery school children and found that changes are required not just at nursery but at home and in the wider environment.

In the Health Behaviour in School-aged Children (HBSC) survey, for both sexes together in Wales, physical activity is highest for 11-year-olds than compared to 13 and 15 year olds. Twice as many boys than girls in Wales reached the recommended levels of physical activity. The reasons for this could be attributable to low self esteem by teenage girls whereby they do not feel comfortable with participating in sports.

The children of today’s society will be young adults in the 2020s. Investing in developing young peoples’ participation will create long term cultural change and life long habits leading to health gains as well as increasing participation in sport. Environmental changes are also necessary, relating to nutrition and physical activity for a healthier future. I believe that the incorporation of physical activity into everyday life is likely to be more accepted across the population of all ages more than formal sporting pursuits.

The Welsh Assemblies initiatives are in place and established in all Welsh communities across Wales and a better future of physical activity and healthy living emphasised for Wales to deliver long term prosperity. The government is moving toward and integration of nutrition and physical health policies where it is appropriate as the effect of diet and physical activity on health is particularly important with the relationship to obesity especially at a younger age.

REFERENCES

Department of Health. At Least Five a Week: Evidence of the Impact of Physical Activity and Its Relationship to Health. A Report from the Chief Medical Officer. London: Department of Health, 2004.

European Youth Heart Study, July 2006. 'Physical activity and clustered cardiovascular risk in children: a cross sectional study', published in The Lancet (volume 368).

Kamlesh Khuntia, Margaret A Stonea, John Bankarta, Paul KSinfielda, Diane Talbotb, Azhar Farooqic and Melanie J Davies. Physical activity and sedentary behaviours of South Asian and white European children in inner city secondary schools in the UK. Oxford University Press; 10.1093/fampra/cmm013 Family Practice Advance Access published on 15 May 2007.

Kumanyika et al. Population –Based Prevention of Obesity. Circulation;8-21, 2008.

McPherson, K., Marsh, T. and Brown, M. 2007. Modelling Future Trends

in Obesity and the Impact on Health. Foresight Tackling Obesities: Future Choices.

National Centre for Social Research, Department of Epidemiology and Public Health at the Royal Free and University College Medical School. Commissioned by Department of Health in Collaboration with the Information Centre for Health and Social Care. Health Survey for England. Obesity among Children under 11. London: Department of Health, 2005.

Novotny, R., Daida, Y. G., Grove, J. S., Acharya, S., Vogt, TM. (2003) Formula feeding in infancy is associated with adolescent body fat and earlier menarche. Cell Mol Biol. 49: 1289–1293.

Ogden, CL. Flegal, KM. Carroll, MD and Johnson, CL. Prevalence and trends in overweight among U.S. children and adolescents, 1999-2000.JAMA 288:1728-1732, 2002.

Roberts, C., Kingdon, A., Parry-Langdon, N. and Bunce, J. (2002). Young people in Wales: Findings from the Health Behaviour in School-aged Children (HBSC) Study 1986 - 2000. Research and Evaluation Branch, Health Promotion Division. Cardiff: Welsh Assembly Government.

UK Sport (2002) The Road to Athens:Annual Review of UK Sport 2001/02. UK Sport, London.

Welsh Assembly Government (2003). Health and Well Being for Children and Young People: Action in Response to the Issues Raised by the Health Behaviour in School-aged Children (HBSC) Study 1986-2000. Health Promotion Division, Office of the Chief Medical Officer. Cardiff: Welsh Assembly Government.

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World Health Organization. Obesity: Preventing and Managing the Global Epidemic. Report of a WHO Consultation on Obesity, 3–5 June 1997, Geneva. Geneva, Switzerland: World Health Organization; 2001. WHO/NUT/NCD 98.

. Cited on 25/09/2009