1. Somerset Primary PE & Sport Conference Lara Snowdon Health & Wellbeing Manager Public Health England
March 2017

2. Good Morning! Introduction - Overview and CMO Guidelines Epidemiology
The importance of physical activity
Policy context
What works? The role of schools
Childhood Obesity A Plan for Action

3. Note
In Public Health we use the term “physical activity” as a broad term referring to all bodily movement that uses energy. includes physical education and sport but also active play and active travel - walking and cycling.
In comparison, Physical Education is planned, progressive learning that takes place in school curriculum timetabled time as the domain of DfE.
Both play a role in a fit and healthy childhood
Childhood Obesity A Plan for Action

4. Introduction
Childhood Obesity A Plan for Action

5. Introduction
The scale of the problem - At a population level the level of physical activity has decreased significantly since the 1960s
UK adults are 20% less active - by 2030 we will be 35% less active
Overall physical inactivity is killing us: Physical inactivity is the fourth largest cause of disease and disability resulting in the equivalent of 1 in 6 UK deaths (equal to smoking)
There are multiple benefits of encouraging regular physical activity amongst children and young people that extend into adulthood – mental and physical health and wellbeing
If being active was a pill, we would be rushing to prescribe it
Overview of 3 key points:
The risks associated with sedentary behaviour and physical inactivity span the life-course and have consequences for children’s physical, cognitive, social and emotional development. These consequences impact on, and extend into adulthood.
For certain subgroups of children and young people there is marked inactivity
We have some evidence available to know what works. The challenge is how best to accelerate effective practice at population level.
Childhood Obesity A Plan for Action

6. CMO Guidelines
Launched in 2011, in the Start Active, Stay Active report
From birth, PA should be encouraged, particularly through floor- based play and water-based activities in safe environments
Pre-school age children who are capable of walking unaided should be physically active daily for at least 180 minutes (3 hours), spread throughout the day.
All CYP (aged 5-18 years) should engage in moderate to vigorous intensity PA for at least 60 minutes and up to several hours every day. vigorous intensity activities, including those that strengthen muscle and bone, should be incorporated at least three days a week
All children and young people should minimise the amount of time spent being sedentary (being restrained or sitting) for extended periods (except time spent sleeping)
*It is important to consider individual physical and mental capabilities when interpreting the guidelines.
Childhood Obesity A Plan for Action

7. Epidemiology
Childhood Obesity A Plan for Action

8. Physical activity levels of CYP
Table 1: Physical activity levels of Children and Young people
Age
Girls
Boys
2-4
10% 9%
5-15
16%
21%
15-24
57%
83%
Table 1 illustrates the proportion of children and young people meeting the CMO guidelines for physical activity.
Levels of physical activity have dropped between 2008 and 2012 for both boys and girls (from 28% boys and 19% girls meeting the recommendations in 2008 to.19% and 16% in 2012)
Health Survey for England (2012)

9. Time spent sedentary in leisure time
Children aged 2-15 years; Health Survey for England 2012
Proportion of children who spent six or more hours being sedentary per day by age group
Weekdays
Weekends
Sedentary time is elevated at the weekend
Sitting time increases as children age
In comparison with physical activity (in which boys are more likely to participate the girls), boys are also more likely to be more sedentary than girls.
Sedentary behaviours appear to track from childhood to adolescence or adulthood at low to moderate levels, with the strongest tracking shown for TV viewing

10. Inequalities
For certain subgroups of children and young people there is marked inactivity:
Age Levels of activity decline with age in 4-10 year olds. Beyond primary age, levels of physical activity continue to fall with age and are worse for girls
Girls: from age 5 a lower percentage of girls compared to boys meet the recommended levels of physical activity. As girls get older their physical activity levels drop
Socio-economic differences: people living in the least prosperous areas are twice as likely to be physically inactive as those living in more prosperous
Lower levels of physical activity amongst those with a limiting illness or disability
Certain ethnic populations amongst adult population studies have shown low levels of physical activity among ethnic minority groups within the UK, particularly South Asians (Health Survey for England 2012)
Childhood Obesity A Plan for Action

11. The Importance of Physical Activity
Childhood Obesity A Plan for Action

12. Why is promoting physical activity an important public health issue?
Lifecourse stage
Benefits
Under 5s
Contributes to a healthy weight*
Improves bone health
Improves cardiovascular health
Supports physical, social and emotional development
Develops movement and co-ordination
Life course impact: is associated with higher physical activity levels later in life.
*Diet makes a bigger contribution to a child’s energy intake and weight status.
E.g. If a child consumes a full sugar beverage, a standard chocolate bar and a bag of crisps they would need to run for an average of 50 minutes to burn off the energy consumed.
Start Active, Stay Active, 2011
APPG 'the role of physical education and activity in a fit and healthy childhood‘ - E.De Sousa

13. Why is promoting physical activity an important public health issue?
Lifecourse stage
Benefits
5-11s
Physically
Enhanced cardio-metabolic health
Muscular-skeletal health
Bone density
Cardio respiratory fitness
Mentally
Enhance mental wellbeing including positive self esteem and lower levels of anxiety and stress
Socially
Improved confidence and peer acceptance
Academically
Emerging association with academic achievement, improved concentration and attention
Lifecourse impact: children and young people who are physically active are more likely to continue the habit into adult life*
Being active plays a key role in brain development in early childhood good for longer-term educational attainment
Contributes to a healthy weight. The link between physical inactivity and obesity is well established. With more than half of adults and almost a quarter of children overweight or obese everyone would benefit from being more active every day. It helps to maintain a healthy weight and improves health, regardless of weight.
Improves bone health, develops movement and coordination
Active play is a fundamental part of physical, social and emotional development from infancy.
Good physical development in children is linked to other types of positive development, such as speech and coordination.
Lifecourse impact: Being active in childhood builds the foundation for an active adult life. Once learnt, a skill like swimming or riding a bike is there for life
APPG 'the role of physical education and activity in a fit and healthy childhood‘ - E.De Sousa

14. Policy Context
Childhood Obesity A Plan for Action

15. HM Government Childhood Obesity A Plan for Action 2016
“We are confident that our approach will reduce childhood obesity while respecting consumer choice, economic realities and ultimately our need to eat.
Although we are clear in our goals and firm action we will take, the launch of this plan represents the start of a conversation rather than the final word.
Over the coming year, we will monitor action and assess progress and take further action where it is needed.”
Childhood Obesity A Plan for Action

16. Childhood Obesity Plan
In August 2016, the Government published the “Childhood Obesity, A Plan for Action” (COP). PHE is working with DH, other government departments and a wide range of stakeholders to achieve the ambition of reducing childhood obesity, through implementing the COP, in which there are 14 deliverables:
Soft drinks industry levy
Taking out 20% of sugar in products, achieving salt targets (calories from 2017, & saturated fat considered post SACN)
Supporting innovation to help businesses to make their products healthier
Updating the nutrient profile model
Making healthy options available in the public sector
Continuing to provide support with the cost of healthy food for those who need it most
Helping all children to enjoy an hour of physical activity every day
Improving the co-ordination of quality sport and physical activity programmes for schools
Creating a new healthy rating scheme for primary schools
Making school food healthier
Clearer food labelling
Supporting early years settings
Harnessing the best new technology
Enabling health professionals to support families
PHE led actions in red
PHE actively supporting blue
Other actions in orange
Delivery Board Update

17. Childhood Obesity Plan 2016
C4L website and school zone updated with new resources for teachers, schools and school nurses
Toolkit for primary schools to increase activity levels of year old girls to be published JUST RELEASED
CSPs, YST, SE to ensure every primary school has access to sport & physical activity programmes
Clear guidelines on how much PA children should be doing to gain health benefit
Clear that not enough children in the UK do enough – huge gap – and UK lagging far behind international comparators
Schools are a really important place for children to be doing more PA (in addition to PE)
New policy context of COP etc.,
Importance of taking
Childhood Obesity A Plan for Action

18. Childhood Obesity Plan 2016
Sport England £40m fund for families and children to get active and play sport together
DfT funding for Cycling & Walking Investment
Healthy rating scheme for primary schools
Ofsted to conduct thematic review of obesity, healthy eating and physical activity in schools
DH to lead on annual competition for schools taking healthy approach to tackling obesity
Childhood Obesity A Plan for Action

19. What Works? The Role of Schools
Childhood Obesity A Plan for Action

20. Evidence about ‘what works’ to support Physical Activity
In 2014/15, PHE launched an evidence review and briefing paper outlining the contribution schools can make to supporting physical activity for children and young people.
PHE (2015) What works in schools and colleges to increase physical activity
Evidence shows effective action to increase population PA levels includes two common factors: persistence and collaboration.
Change requires all of us to take action: no single agency or organisation can respond to the challenge alone. Multi-agency.
Interventions that are multi-component or adopt a ‘whole of community (school/college) approach’ appear to be most effective.
APPG 'the role of physical education and activity in a fit and healthy childhood‘ - E.De Sousa

21. Promising Practice Principles
Develop and deliver multi-component interventions
Ensure skilled workforce
Engage student voice
Create active environments
Offer choice and variety
Embed in curriculum, teaching and learning
Promote active travel
Childhood Obesity A Plan for Action

22. What works to support physical activity in Schools and Colleges
APPG 'the role of physical education and activity in a fit and healthy childhood‘ - E.De Sousa

23. Contribution of schools and colleges
PHE (2015) What works in schools and colleges to increase physical activity
APPG 'the role of physical education and activity in a fit and healthy childhood‘ - E.De Sousa

24. Summary
The risks associated with sedentary behaviour and physical inactivity span the life-course and have consequences for children’s physical, cognitive, social and emotional development. These consequences impact on, and extend into adulthood.
Physical inactivity levels are high, with very few CYP meeting the CMO guidelines
For certain subgroups of CYP there is marked inactivity
New policy context/ opportunity – Childhood Obesity Plan
We have some evidence available to know what works and principles of best practice
Key is to work together to develop effective solutions and share ideas and best practice.
Childhood Obesity A Plan for Action

25. Enjoy your conference!
Childhood Obesity A Plan for Action