The National Obesity Observatory Dr Harry Rutter Director, National Obesity Observatory

NOO aims to: Provide a single point of contact for wide-ranging, authoritative information on data, evidence and practice related to obesity, overweight, underweight and their determinants

NOO aims to: Provide a single point of contact for wide-ranging, authoritative information on data, evidence and practice related to obesity, overweight, underweight and their determinants

NOO aims to: Provide a single point of contact for wide-ranging, authoritative information on data, evidence and practice related to obesity, overweight, underweight and their determinants

NOO aims to: Provide a single point of contact for wide-ranging, authoritative information on data, evidence and practice related to obesity, overweight, underweight and their determinants

NOO aims to: Provide a single point of contact for wide-ranging, authoritative information on data, evidence and practice related to obesity, overweight, underweight and their determinants

NOO aims to: Provide a single point of contact for wide-ranging, authoritative information on data, evidence and practice related to obesity, overweight, underweight and their determinants

NOO aims to: Provide a single point of contact for wide-ranging, authoritative information on data, evidence and practice related to obesity, overweight, underweight and their determinants

NOO aims to: Provide a single point of contact for wide-ranging, authoritative information on data, evidence and practice related to obesity, overweight, underweight and their determinants

…to support policy makers and practitioners involved in tackling obesity and related issues

Positioning Public Health Observatory Part of APHO Based alongside SEPHO NHS organisation Academic links

Healthy Weight, Healthy Lives (Jan 2008) National Obesity Observatory commissioned to support the strategy in six key areas

Six key areas Data and evidence Surveillance Data analysis Evaluation guidance International links Support Expert Panel

Authoritative source of data and evidence on obesity, overweight and their determinants Compare IOTF, WHO, UK 90 approaches: options paper and consensus workshop Map data, evidence, policy Consult on user needs (and meet them!)

Co-ordinate surveillance on obesity and overweight Advise on National Child Measurement Programme (NCMP) Advise on other surveillance activities

Analyse surveillance and indicator data Detailed report on the NCMP 2007/08 (complementing IC report) Wide range of other analyses and analytical tools in due course

Provide guidance on assessing and evaluating pilots and demonstration sites in England Develop standard evaluation criteria and guidance

International best practice and links with key international and other supranational bodies Participate in UK, EU and international networks on obesity and related issues PREVOB HOPE ALPHA HEPA Europe WHO/CDC/IOTF etc Being here!

Provide technical support to the Expert Panel Technical papers, guidance, etc

Not forgetting… Links to research agenda Support to other national strategies Develop Foresight systems map Academic links

www.noo.org.uk

What are the population attributable fractions of the modifiable causal risk factors for obesity and what can be done to address them?

What are the population attributable fractions of the modifiable causal risk factors for obesity and what can be done to address them?

What are the population attributable fractions of the modifiable causal risk factors for obesity and what can be done to address them?

Source: Foresight - Tackling obesities: future choices - http://www

Societal influences Individual Psychology Food environment Food consumption Physical activity Activity environment Obesity Biology Source: Foresight systems map, 2007

Will Lehman Brothers have a posthumous impact on obesity? If so, what? How would we know? What could we do about it?

NCMP Records height, weight, age, sex, ethnicity, postcode Reception and year 6 Approx 1 million children / year

Deprivation (IMD 2007) and child obesity (NCMP 2006/07) based on postcode of school (100% completeness) Clear pattern of near linear increase in obesity prevalence with deprivation for both boys and girls aged 10-11 years. For girls child obesity prevalence is 80% higher in the most deprived schools than the least deprived, and 50% higher for boys. For children aged 4-5 years, there appears to a stronger link with deprivation for girls than for boys. For girl, child obesity prevalence appears about 60% higher in the most deprived schools than the least deprived schools. For boys there is less of a linear relationship through the deciles, with little in the way of significant differences in obesity prevalence for deciles 1-9. Obesity prevalence in the most deprived schools is still over 30% higher than in the least deprived schools for boys of this age group. Note – this and all NCMP charts use the UK90 population monitoring definitions of childhood obesity of >=95th percentile. The prevalence figures therefore do not shown the true proportion of the population that would be clinically defined as obese. Analysis does though suggest that a similar pattern is seen if different thresholds - UK90 clinical (98th percentile), WHO or IOTF - are used.

Child obesity prevalence and average height for children aged 10-11 years by ethnic group (NCMP 2006/07) We have though looked at obesity prevalence by ethnic group in some more detail. One factor of interest is that the ethnic groups show large and significant differences in average height as well as obesity prevalence. These differences do also appear to be linked, with both highest prevalence and highest average height found amongst the Black and Black British ethnic groups. Note – chart is order by decreasing average height.

Future possibilities Detailed socio-economic analyses Ethnicity and height GIS analyses Ecological analyses Pseudonymised linkage Longitudinal follow-up

Establishing common standards Co-ordinating routine data Common standards across sectors and government departments Standard evaluation criteria

Learning from interventions Cycling Cities and Towns - £100 million Healthy Towns - £60 million Connect2 - £100 million

Knowledge from experience

What we cannot speak of we must pass over in silence Ludwig Wittgenstein Tractatus Logico-Philosophicus

Evidence trajectories Speculation Evidence-based interventions Number of interventions Time

Prevalence and incidence of evidence Number of studies Prevalence Time

Knowledge into action

Conclusions Use Foresight map as a template Consult on priorities Don’t reinvent the wheel (or buy spares) Understand this stuff Interpret and translate this stuff Disseminate this stuff Evaluate our effectiveness Improve…

info@noo.org.uk www.noo.org.uk