1. Childhood obesity in Merton including an update on the NCMP programme
Eva van Velzen, Public Health registrar NHS Sutton and Merton
Julia Groom, Public Health consultant Merton
27 April 2012

2. Merton One in five children in Reception year is overweight or obese
One on three children in Year 6 is overweight or obese

3. So what?
Children experience psychological effects: teasing and discrimination by peers; low self-esteem; anxiety and depression
Childhood obesity is associated with a higher chance of premature death and disability in adulthood from:
cardiovascular diseases
diabetes
musculoskeletal disorders
certain types of cancer (e.g. breast and colon)
Many overweight children will become overweight adults (and parents!)
Sources: NOO, WHO

4. Outline Causes of childhood obesity Background NCMP National results
Merton results
NCMP actions
Local support programme: Alive ‘n Kicking
Discussion

5. Determinants of Obesity
Source:

6. In words:
Childhood obesity is mainly associated with unhealthy eating and low levels of physical activity, but the problem is linked not only to children's behaviour but also, increasingly, to social and economic development and policies in the areas of agriculture, transport, urban planning, the environment, food processing, distribution and marketing, as well as education
The problem is societal and therefore it demands a population-based multi sectoral, multi-disciplinary, and culturally relevant approach.
Children and adolescents cannot choose the environment in which they live or the food they eat. They also have a limited ability to understand the long-term consequences of their behaviour.
Source: WHO

7. Background
National Child Measurement Programme (NCMP) is a national programme to measure the weight of children in Reception and Year 6 in English state schools
Aim: to monitor overweight and obesity to guide effective policy making to reduce obesity
Parents receive individual feedback about measurement
Measure used = BMI, adjusted for normal growth variation between Reception and Year 6, and sex.

8. National child measurement results 2010 - 2011
© NOO 2012

9. Merton child measurement results 2010 - 2011
Higher than UK
Lower than UK
© NOO 2012

10. Merton 2007-08 and 2009-2010 combined results
% of Reception yr children (4-5 yrs old) obese by MSOA
% obesity varies from (no data) 5% to 14%

11. NCMP results – action National data for monitoring and policy
Local feedback of measurements
to parents (NHS community services)
to headmasters (NHS Public Health)
referrals to treatment programme ‘Alive n Kicking’

12. What is Alive ‘N’ Kicking?
Specialist healthy weight programme for
children aged 4-19
Physical activity sessions for children
Interactive nutrition workshops for parents, focusing on practical ways to improve the family diet.
Group programmes for 4-6yrs, 7-11yrs, 12-15yrs and 16-19yrs, with capacity of 20 participants per group

13. Results so far March 2012... 70% of graduates reduced their BMI
84% of graduates reduced their waist circumference
Average weight loss was kg

14. Discussion
One in five Merton children in Reception year is overweight or obese
One on three Merton children in Year 6 is overweight or obese

15. Extra slides

16. Merton – England, NCMP 2007/08 to 2010/11
Obesity trend data
Merton – England,
NCMP 2007/08 to 2010/11

17. Reception Year

18. Year 6

19. Prevalence of obesity by Local Authority
Year 6 children (age years) resident in London, NCMP 2009/10
Low prevalence
High prevalence
Child obesity: BMI ≥ 95th centile of the UK90 growth reference
© NOO 2011
This slide shows an example of obesity prevalence mapped at LA level – extracted directly from the e-Atlas.

20. Uptake and trends Referrals: on average 26 referrals per month
Completers:
Jul ’09 - Mar ‘11 = 105 / yr
Apr’11 – June ‘12 = 161 / yr
53% increase in completers
We’re aiming for 70 this term
Training:
88 local candidates trained including EY staff and Health

21. Local feedback to schools
National guidelines: detailed school data may not be shared with schools
We use a national but ‘Mertonised’ tool for feedback about the results to Merton headmasters
The letter will include information about local support to help children and their families to keep a healthy weight
Participation rate Merton - England:
87.1% Reception = lower than nationally
91.2 % Year 6 = same as nationally
Reasons:
Small numbers: no meaningful comparisons
Pupils may be identifiable
Results depend on deprivation, sex, ethnicity etc

22. Example feedback from 09-10 data
School prevalence indicator:
No data or insufficient data
Below the regional average
Similar to the regional average
Higher than the regional average
Reception
Underweight 2
Overweight
Obese
Year 6 3
Note: big increase in overweight and obesity between Reception and Year 6!

23. Prevalence of obesity by deprivation decile
© NOO 2011
Prevalence of obesity by deprivation decile
Children in Reception and Year 6 (National Child Measurement Programme 2009/10)
Child obesity: BMI ≥95th centile of the UK90 growth reference
Deprivation deciles assigned using the Index of Multiple Deprivation 2010
Reception
Year 6
Child obesity prevalence is closely associated with socioeconomic status. More deprived populations tend to have higher obesity prevalence.
Not shown: variation between regions: mostly explained by differences in socio-economic status