OBESITY

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OBESITY
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Definition
The Clinical definition of obesity is based on
the body mass index (BMI), defined
as BMI body mass (height)² Where body
mass is in kilograms and height in meters. In
adults, a BMI of 20 25 kg/m² is considered
normal, 25-30 kg/m² is termed overweight and
those with a BMI over 30 kg/m² are classed as
obese. The definition of childhood obesity is
necessarily different, reflecting the fact that
the body composition of a child changes markedly
through infancy, pre-school and school years and
into late teenage years. Two age and
sex-specific schemes are commonly used as a basis
for definition and both are based on BMI.
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Health Risks from Obesity

• Overall mortality,
• Coronary heart disease,
• Type 2 diabetes,
• Hypertension and stroke
• Some cancers e.g. cancer of the endometrium,
  colon, breast (post menopausal) and kidney
• Gall bladder disease
• Back pain and Osteoarthritis
• Poor mobility, low self esteem

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Relative Risk of Obese compared to non-Obese
PeopleInternational Studies in National Audit
Office Report on Obesity HAD 2002
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Health benefits of losing weight Is it worth it?

• 10 loss of weight in a100kg obese person with
  other diseases such as coronary heart disease or
  diabetes
• Fall in more than 20 overall mortality
• Fall of 10mmHg in diastolic systolic blood
  pressure
• Fall of 10 of total cholesterol
• Fall of 30 triglycerides
• Fall of 50 in fasting glucose levels
• As body weight increases, so does the risk of
  dying as a result

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Obesity The scale of the problem

• 2003 (YH)
• Males 25
• Females 24
• Slightly higher than England levels

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Distribution of overweight and obesity with the
adult population
Source Forecasting Obesity to 2010, DH
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Estimated number obese adults in 2003 2010
Source Forecasting Obesity to 2010, DH
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Key Facts

• Proportion of obese (and overweight) makes and
  females In Yorkshire and Humberside is increasing
  and mirrors the England picture.
• There are currently no routinely available data
  to support monitoring of obesity at local level.
• New requirements are being placed on PCTs to
  monitor pertinence of adult and childhood obesity
  (CHOOSING HEALTH).
• Total cost of obesity in England 2002 is
  estimated at 3.3 3.7 billion.

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Adult obesity in Yorkshire and Humber
Age standardised proportion of adults who are
overweight (BMI over 25, ie including obese), by
year (3-year moving average)
Source Briefing, Yorkshire Humber Public
Health Observatory Number 1 November 2005
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Adult obesity in Yorkshire and Humber
Age standardised proportion of adults who are
obese (BMI over 30), by year (3-year moving
average)
Source Briefing, Yorkshire Humber Public
Health Observatory Number 1 November 2005
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Child Obesity Data for Year 6 Pupils2005 - 2006
As a percentage of all children on school
roll As a percentage of all children measured
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Physical Activity
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Levels of even light physical activity are low in
the City. As light physical activity is more
likely to be done regularly, initiatives to
encourage the population to be more active should
focus on activities at this intensity level, eg
walking.
Source Health in the City, Lifestyle Survey
2005, Bradford City PCT Public Health April 2006
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In total, only 11 of all residents are achieving
the recommended 2.5 hours per week. There are
no significant differences in the proportion
achieving the target by gender or ethnicity, but
there are differences by age.
Source Health in the City, Lifestyle Survey
2005, Bradford City PCT Public Health April 2006
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Proportions of residents achieving physical
activity target ()
Source Health in the City, Lifestyle Survey
2005, Bradford City PCT Public Health April 2006
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Participation Rates Local Authorities
(Bradford) Interim Survey results taken from Oct
2005 April 2006
Note Interim data was collected from the period
October 2005 to April 2006, therefore
participation rates are expected to be lower due
to seasonality. The minimum survey sample size
per LA is 385, the maximum survey sample size is
619
Source Sport England / IPSOS MORI Active People
Survey
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School Children Physical Activity
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School hours per week on physical activities
Source Children Exercise 2005 Survey Findings,
Bradford Met District Council
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Frequency of exercising outside school hours
Source Children Exercise 2005 Survey Findings,
Bradford Met District Council
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Hours per week exercising outside school
Source Children Exercise 2005 Survey Findings,
Bradford Met District Council
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Days exercising moderately for at least 30 mins
Source Children Exercise 2005 Survey Findings,
Bradford Met District Council
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Healthy Eating
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• Many people still adding SALT when cooking
• Significant use of Saturated fats in cooking
• High consumption of whole milk
• High red meat consumption
• Significant consumption of
• Processed meat and pies
• Chocolate, crisps and biscuits
• Fizzy drink
• High consumption of take-away meals
• Poor achievement
• Missing meats

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• Examining the distribution of fruit and vegetable
  portions consumed highlights
• 4 of residents who eat no portions of fruit
  and vegetables a day
• Almost a quarter (22) who eat 2 portions or
  less than this
• Amongst the younger group (18-24s), 7 eat no
  portions, 30 eat 2 or fewer portions

Source Health in the City, Lifestyle Survey
2005, Bradford City PCT Public Health April 2006
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5-a-day Consumption by Ward
Source Health in the City, Lifestyle Survey
2005, Bradford City PCT Public Health April 2006
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Over a quarter of all residents (28) have a
fizzy or flavoured drink such as Coke, Pepsi,
lemonade, Oasis etc, which is NOT a low calorie
or diet drink, on most days of the week or more
often. The other Pakistani and Bangladeshi
groups have high reported levels of consumption
of fizzy drinks. Amongst the 18-24 year old
group, 62 have a fizzy or flavoured drink on
most days of the week or more frequently.
Source Health in the City, Lifestyle Survey
2005, Bradford City PCT Public Health April 2006
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Percentage drinking fizzy or flavoured drinks
(not low-calorie or diet) most days of the week
or more often
Source Health in the City, Lifestyle Survey
2005, Bradford City PCT Public Health April 2006
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Percentage of people who have hot take-aways to
eat at home, most days or more often
Source Health in the City, Lifestyle Survey
2005, Bradford City PCT Public Health April 2006
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Choosing Health

• Total number of people aged 15 to 75 years on GP
  register, recorded as having a BMI of 30 or
  greater in the last 15 months.
• Total number of people aged 15 to 75 years on GP
  register, with a BMI recorded in the last 15
  months.
• Total number of people aged 15 to 75 years on GP
  register.

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Policy and Strategy

• Choosing Health 2004
• LSP priorities
• LAA
• Health Scrutiny Committee
• Draft HIMP Strategy
• Bradford Nutrition Strategy
• Bradford Food Strategy
• Draft Physical Activity and Sports Strategy
• B-Active
• National Healthy Schools Programme

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Delivery streams of work working in partnership
and cross-agency

• Community dietetics high level training,
  consultancy and supervision
• Five a Day / food and health workers practical
  interventions
• BDHDP training and support of community
  development
• BCEP local food initiatives
• Bradford Food Network sharing practice,
  expertise and resource
• Full range of community health practitioners
• SFVS
• HSS
• B-active
• Healthwise
• BEEP
• Walking for Health
• HLCs and HOM
• Voluntary sector and community-led projects

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Key Message

• Prevalence of obesity and overweight in Yorkshire
  and Humberside is increasing
• Significant proportion of school criteria are
  obese and overweight
• Physical activity levels of adults and children's
  are alarmingly low
• Nearly 50 of school children in Bradford do less
  than 1hr per week of activity in school (where
  they are captive for a total of 6 years of their
  childhood!)
• Health Easting lots of work to do (5-a-day,
  fizzy drinks, hot take always, balance of good
  health) but it needs to be targeted - right
  group, right age range etc.
• Prevention should be concern of all health
  professionals
• OBESITY its the new smoking!