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

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

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

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

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

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

14. 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!)

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

16. 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

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

18. 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!

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

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

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

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

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

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

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

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

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

29. 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 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.

30. Child obesity prevalence and average height for children aged 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.

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

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

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

35. Knowledge from experience

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

37. Evidence trajectories
Speculation
Evidence-based
interventions
Number of interventions
Time

38. Prevalence and incidence of evidence
Number of studies
Prevalence
Time

39. Knowledge into action

42. 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…