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Childhood Obesity Clearinghouse

Childhood Obesity

The prevalence of childhood obesity in Counties Manukau, particularly for Māori and Pacific communities is unacceptably high and contributes to health inequities. Childhood obesity is not just a problem for individual families and whānau; it is connected to a range of systemic and environmental drivers which shape eating and activity behaviours. The following resources will help you understand how childhood obesity relates to health equity, what is being done about it in New Zealand and overseas, how effective these approaches are, and the challenges for health professionals and communities wanting to create healthier lives for children.

 

Contents 

Plans to Address Childhood Obesity
Health Promotion Initiatives
Research and Resource Websites
Toolkits
Clinical Guidance and e-Learning
Selected Reading
Selected Journals
Social Media
CM Health Library Clearinghouses

 

Plans to Address Childhood Obesity

 

Metro-Aukland DHB Healthy Weight Action Plan for Children 2017-2020

This plan is focused on articulating the role health services have in contributing to children maintaining
a healthy weight.

see also The Healthy Auckland Together Plan 2015 - 2020 and Healthy Auckland Together website

Action to reduce obesity and reduce it’s impact across the life course: evidence review. [RACP, 2018]

Obesity is a multifactorial problem and the causes are deeply embedded in our societal structures which means that there are no simple solutions. However, there are many opportunities to tackle obesity at individual, community and population levels. While some of the opportunities to act are within the reach of people and their families, cross-sectoral actions are needed to create a whole of society approach to reducing obesity and its related inequalities. The health sector can play many important roles in reducing the burden of obesity and, for obesity prevention, this largely involves advocating for stronger government-led policies and actions. The sector can actively support the implementation of specific policies and actions, as recommended by authoritative bodies such as WHO, to create healthier food and physical activity environments for the prevention of obesity. The sector can also advocate for action to address the deeper, underlying societal drivers of health and disease. The main areas for action are outlined [in this report].

 

OECD Obesity Update 2017 [OECD, 2017]

In the last few years, new policy strategies devised to fight obesity have emerged. This Obesity Update focusses on a selection of those, specifically at communication policies aimed to tackle obesity, in particular by improving nutrient information displayed on food labels, using social and new media to sensitise the population, or by regulating the marketing of food products. Better communication helps empower people to make healthier choices. However, comprehensive policy packages, including not only communication but also broader regulatory and fiscal policies, are needed to tackle obesity effectively.

Report of the Commission on Ending Childhood Obesity [WHO, 2016]

The Commission has developed a comprehensive, integrated package of recommendations to address childhood obesity. It calls for governments to take leadership and for all stakeholders to recognize their moral responsibility in acting on behalf of the child to reduce the risk of obesity.

Draft Implementation Plan for the Recommendations of the Commission on Ending Childhood Obesity [WHO, 2016]

NZ Childhood Obesity Plan [launched October 2015]

The plan has three focus areas, made up of 22 initiatives, which are either new or an expansion of existing initiatives:

  1. Targeted interventions for those who are obese
  2. Increased support for those at risk of becoming obese
  3. Broad approaches to make healthier choices easier for all New Zealanders.

The focus is on food, the environment and being active at each life stage, starting during pregnancy and early childhood. The package brings together initiatives across government agencies, the private sector, communities, schools, families and whānau.

see also :

Children and Young People Living Well and Staying Well: New Zealand Childhood Obesity Programme Baseline Report 2016/17 [June 2017]

The report builds on the work that these organisations did in 2016 to develop an intervention logic model for reducing childhood obesity, which includes a set of 15 performance indicators that we will use to monitor the New Zealand Childhood Obesity Programme over the next five years.The report includes a description of each of the indicators and presents a baseline view of their performance. It also provides a brief overview of the New Zealand Childhood Obesity Programme and an update on the programme’s first year of implementation (2015/16).

This report will form the basis of future monitoring reports on the New Zealand Childhood Obesity Programme. The first monitoring report will be published in 2018 and will provide information on the second year of implementation (2016/17) and updated performance against the reducing childhood obesity indicators.

Subscribe to the Reducing Childhood Obesity Update to keep informed of progress and activities associated with the NZ Childhood Obesity plan.

UK government's Childhood Obesity Plan for Action [August 2016]

The government’s plan to reduce England’s rate of childhood obesity within the next 10 years by encouraging:

  • industry to cut the amount of sugar in food and drinks
  • primary school children to eat more healthily and stay active.

 

Government response to the House of Commons Health and Social Care Select Committee report, on childhood obesity: Time for action, eighth report of session 2017–19 [January 2019]
 

This Command paper sets out the government’s response to the conclusions and recommendations in the Health and Social Care Select Committee’s report, Childhood obesity: time for action. The committee’s report covered the following areas: a whole systems approach; marketing and advertising; price promotions; early years and schools; takeaways; fiscal measures; labelling; and support for children living with obesity. The government’s response addresses each of these areas.

 

Health Promotion Initiatives

 

Healthy Families NZ [NZ]

The Ministry of Health’s a large-scale initiative that brings together community leadership in a united effort for better health.

Eat Move Live [NZ]

This website supports the NZ government’s Big Change Starts Small campaign to help families make healthy choices with fast, easy and low-cost recipes, tips and fun ideas to get kids moving.

Nutrition Resources for Schools [NZ]

Here you can access free resources from the Health Promotion Agency to promote drinking water, eating breakfast and healthy snacks.

Healthy Together Auckland [NZ]

A coalition of 26 organisations representing local government, mana whenua, health agencies, NGOs, university and consumer interest groups which aims to change policy, infrastructure design and planning, so Auckland’s environments can encourage physical activity and good nutrition.

INFORMAS (International Network for Food and Obesity / non-communicable Diseases Research, Monitoring and Action Support) [NZ led]

A global network of public-interest organisations and researchers that aims to monitor, benchmark and support public and private sector actions to create healthy food environments and reduce obesity and non-communicable diseases (NCDs) and their related inequalities.

Project Activate [NZ]
Project Activate equips young people to make lifelong healthy choices by learning about the science of good health.

 

Research and Resource Websites

 

Global Atlas on Childhood Obesity
The atlas presents data for every country based on their current and predicted levels of obesity in children, the risk factors and the presence of government policies to tackle obesity, such as restricting marketing of foods to children, encouragement of physical activity and nation guidelines for healthy diets. Based on these factors the Atlas gives each countries a score for their childhood obesity risk.

Obesity Evidence Hub [Aus.]
The Obesity Evidence Hub is a joint project resulting from a partnership between the Cancer Council Victoria, the Bupa Health Foundation and the Obesity Policy Coalition. It is a foundational component to the Obesity Collective, a modern movement to drive action on important obesity initiatives in Australia. The Obesity Evidence Hub’s objective is to identify, analyse and synthesise the evidence on obesity.  

FAB Weight Management [NZ]

A Health Improvement and Innovation Resource Centre portal for the latest published, unpublished and in progress research on nutrition, physical activity, obesity and weight management. There is also news and events information, links to NZ health promotion resources and other useful tools. You need to register to access the site, but this is open to anyone and allows you to contribute to discussions, post comments and subscribe for email alerts to new content.

Partners in Information Access for the Public Health Workforce [US]

Run by a collaboration of U.S. government agencies, public health organisations and health sciences libraries, this site provides a portal of news and research resources on obesity.

Obesity Prevention Source [US]

This Harvard School of Public Health website is an in-depth resource of science-based information for all who seek to understand the causes of obesity and to reverse the epidemic of obesity in children and adults.

Obesity in the Early Childhood Years: State of the Science and Implementation of Promising Solutions [US]

The Roundtable on Obesity Solutions of the Institute of Medicine workshops, including links to videos of speakers.

Childhood Obesity Intervention Cost Effectiveness Study [US]

The Harvard T.H. Chan School of Public Health is working to help reverse the US obesity epidemic by identifying the most cost-effective childhood obesity interventions.

NZ Child and Youth Epidemiology Service [NZ]

see publications that report on obesity : Craig E, Reddington A, Adams J, Dell R, Jack S, Oben G, Wicken A and Simpson J. The Health of Children and Young People with Chronic Conditions and Disabilities in New Zealand. Dunedin: New Zealand Child and Youth Epidemiology Service, University of Otago; 2013.Permanent link to OUR Archive version: http://hdl.handle.net/10523/6126

Healthier Lives
The Healthier Lives National Science Challenge is a national research collaboration dedicated to achieving healthier lives for all New Zealanders.  The key to this is delivering the right prevention to the right population and the right treatment to the right patient.

Healthier Lives is working on the prevention and treatment of four of New Zealand’s main non-communicable diseases:

Cancer
Cardiovascular disease
Diabetes
Obesity

 

Toolkits

NICE Guidance for Delivering or Commissioning Weight Management Services for Children and their Families [UK]
An evidence-based approach to designing weight management services for overweight or obese 4-12 year olds and their families.

Obesity Evaluation Toolkit: Resources for Evaluating Community-Level Obesity Prevention Efforts [US]

This page provides an overview of the key steps and principles in a community-level evaluation, as well as links to related resources from the Institute of Medicine, government agencies, and the Community Tool Box.

Health Equity Resource Toolkit for State Practitioners Addressing Obesity Disparities [US]

The purpose of the Centers for Disease Control and Prevention Division of Nutrition, Physical Activity, and Obesity Health Equity Resource Toolkit for State Practitioners Addressing Obesity Disparities is to increase the capacity of state health departments and their partners to work with and through communities to implement effective responses to obesity in populations that are facing health disparities.

 

Clinical Guidance and e-Learning

 

Psychological Perspectives on Obesity: Addressing Policy, Practice, and Research Priorities [UK]

The document seeks to guide professionals and policy makers working with individuals, groups, and populations that are impacted by obesity to take an approach that is guided by psychology.

It provides a series of recommendations based around the following areas:

Reducing weight-related stigma
Psychologically informed policy
Standards and guidelines
Training and supervision
Weight management services 

 

Promoting healthy weight in children, young people and families [UK]

This resource is made up of briefings and practice examples to promote healthy weight for children, young people and families as part of a whole systems approach. The briefing papers help to:

- make the case for taking action to reduce childhood obesity
- give examples of actions that can be taken
- provide key documents that form the evidence base and other useful resources 

 

How We Eat – Reviews of the evidence on food and eating behaviours related to diet and body size [NZ]

How We Eat is a review of the available evidence on the effect of selected eating behaviours on diet and body size. The topics reviewed are: breastfeeding, parental feeding practices and parenting style, adult role modelling, responsive eating, mealtimes and food literacy.  A review of relevant New Zealand research was included.

 

Sit Less, Move More, Sleep Well: Active play guidelines for under-fives [NZ]

These Guidelines provide population health advice to support health practitioners, early childhood educators, regional sports trusts and others who provide advice to parents, caregivers and whānau or families on physical activity for children under five years of age.

Clinical Guidelines for Weight Management in New Zealand Children and Young People [NZ]

These updated clinical guidelines for primary health care practitioners and others who provide advice on weight management for New Zealand children and young people aged 2 to 18 years help support the government’s Raising Healthy Kids Health Target: Weight Management in 2-5 year olds. 

Weight Managment in 2–5 Year Olds [NZ]

A practical resource to equip health providers with the most up-to-date advice to monitor, assess and manage children who are overweight and obese.

Healthy Start Education Programme [NZ]

This e-learning programme is offered free-of-charge to all maternity, child and whānau professionals through funding from the Ministry of Health. It gives participants a rich background knowledge and rationale to reinforce discussions with mothers and their families about why nutrition and physical activity are such critical factors during pregnancy and an infant’s early life.  

Guidance for Healthy Weight Gain in Pregnancy [NZ]

This is a health practitioner resource that includes practice points for pre-pregnancy, during pregnancy and postpartum. It is accompanied by resources for health practitioners and information for women.

Routing out childhood obesity [UK] 

This report outlines a range of recommendations for transforming the street environment, particularly around schools, with the ambition that all children should have access to a healthy route home.

 

Selected Reading


Public Health Concerns

Environmental, social, and economic factors related to the intersection of food security, dietary quality, and obesity: an introduction : a special issue of the Translational Behavioral Medicine journal (2019)                                  

Every Child a healthy Weight. Ten Ambitions for London (an call to action in which we have set out ten ambitions to transform ten aspects of the daily lives of children and their parents )
London's Child Obesity taskforce (2019)

Ranked Importance of Childhood Obesity Determinants: Parents’ Views across Ethnicities in New Zealand
Nutrients 2019, 11(9), 2145 [NZ] (2019)

Obesity prevention and the role of hospital and community-based health services: a scoping review
BMC Health Services Research   19   ( 5 Jul. 2019) 

Role of government policy in nutrition—barriers to and opportunities for healthier eating
BMJ   361   (2018) 

Healthy Auckland Together: Monitoring Report 2017 - the state of Auckland’s “obesogenicity” (2017)

Improving food environments and tackling obesity: A realist systematic review of the policy success of regulatory interventions targeting population nutrition
 PLoS ONE   12.8   ( 4 Aug. 2017)  

Planning for the worst: estimates of obesity and comorbidities in school-age children in 2025
Pediatric Obesity, 11: 321–325 (2016)

The childhood obesity plan – brave and bold action? [UK] (2016)

Government's childhood obesity plan flawed [NZ] (2016)

Getting serious about protecting NZ children against unhealthy food marketing [NZ]
New Zealand Medical Journal 128:1417 (2015)

Patchy progress on obesity prevention: emerging examples, entrenched barriers, and new thinking
Lancet (London, England)   385.9985   ( 13 Jun. 2015)   : 2400-2409  
see also Lancet Obesity Series 2015

FIZZ [NZ]
This group of researchers and public health doctors have come together to advocate for ending the sale of sugar sweetened beverages (sugary drinks) from New Zealand.

Equity Issues

Understanding inequalities: summary report. The impact of inequalities in the early
years on outcomes over the life course: Using international evidence to identify creative policy solutions.
Growing up in New Zealand, 2019.
The findings from the Growing Up in New Zealand study demonstrate that Maori and Pasifika children experience the highest burden of socioeconomic disadvantage in their early years as well as an unequal burden of significant co-morbidities in terms of health and development throughout their life course. By the time they start school (at age 5 years) many are already falling behind their peers in terms of preparedness for formal education and readiness to engage in learning.

The study has shown that inequalities in developmental opportunities and outcomes have their origins in early in life. Risk factors for early vulnerability cluster and there is no one single proxy marker of disadvantage. Additionally, morbidity and poor outcomes cluster. Persistent adversity is associated with a graded likelihood of poor outcomes (across the population). Further service use is not meeting measured need. Currently, access to early life universal services may be widening inequalities. A proportional-universalism approach to services is required if they are to meet real need and reduce inequalities.

Child obesity prevalence across communities in New Zealand: 2010–2016 [NZ] (2019)
"Implications for public health: Addressing deprivation and ethnic inequalities in obesity could substantially reduce community‐level differences in obesity in NZ."

A Health Equity Approach to Obesity Efforts: Proceedings of a Workshop—in Brief
National Academy of Sciences. 2019
On April 1, 2019, the National Academies of Sciences, Engineering, and Medicine held a public workshop, A Health Equity Approach to Obesity Efforts, in Washington, DC. The workshop explored the history of health equity issues in demographic groups that have above-average obesity risk, and considered principles and approaches to address these issues as part of obesity prevention and treatment efforts. Speaker presentations addressed three areas: current policies and practices that either perpetuate health inequities or advance health equity; mechanisms to support community-driven solutions that can influence the social determinants of health; and approaches for fostering multisector collaboration to address disparities by exploring the issues related to the creation, implementation, and evaluation of equity-oriented programs, policies, and systems changes. Participants also discussed research needs to inform and mobilize equity-centered obesity prevention and treatment actions. This publication briefly summarizes the presentations and discussions from the workshop.

Bite Size: Breaking down the challenge of inner-city childhood obesity [UK] (2018)
One of the most comprehensive explorations of the issue in disadvantaged areas, the report concludes that we need to break the link between obesity and deprivation and create environments that make the healthy thing to do, the easy thing to do.

How effective are family-based and institutional nutrition interventions in improving children’s diet and health? A systematic review
BMC Public Health 17:818 (2017) 

A novel home-based intervention for child and adolescent obesity: The results of the Whānau Pakari randomized controlled trial [NZ]
Obesity (2017)

Effects of parent and child behaviours on overweight and obesity in infants and young children from disadvantaged backgrounds
BMC Public Health 16:151 (2016) 

Reducing childhood obesity in Ontario through a health equity lens [Canada]
Paper prepared by Steve Barnes (2012)

Creating equal opportunities for a healthy weight [US]
The summary of a workshop convened by the Institute of Medicine's Standing Committee on Childhood Obesity Prevention in June 2013 to examine income, race, and ethnicity, and how these factors intersect with childhood obesity and its prevention. *To access the free report you need to register.

The impact of interventions to prevent obesity or improve obesity related behaviours in children from socioeconomically disadvantaged and/or indigenous families
BMC Public Health 14:779 (2014)

The Green Prescription Active Families Programme in Taranaki, New Zealand 2007–2009: Did it reach children in need? [NZ]
Journal of Primary Health Care 7:3 (2015): 192–197.

Ethnic differences in risk factors for obesity in NZ infants [NZ]
Journal of Epidemiology and Community Health 69 (2015): 516–522.

Dietary Intake and Eating Behaviours of Obese New Zealand Children and Adolescents Enrolled in a Community-Based Intervention Programme [NZ]
PLoS ONE 11(11) (2016) : e0166996. doi:10.1371/journal.pone.0166996

 

Treatment


Physical activity is low in obese New Zealand children and adolescents [NZ]
Scientific Reports 7, Article number: 41822 (2017)

Interventions for preventing obesity in children.
Cochrane Database of Systematic Reviews (2019)

Diet, physical activity and behavioural interventions for the treatment of overweight or obese adolescents aged 12 to 17 years
Cochrane Database of Systematic Reviews (2017)

Diet, physical activity and behavioural interventions for the treatment of overweight or obese children from the age of 6 to 11 years
Cochrane Database of Systematic Reviews (2017)

Diet, physical activity, and behavioural interventions for the treatment of overweight or obesity in preschool children up to the age of 6 years
Cochrane Database of Systematic Reviews (2016)

Brief primary care obesity interventions: A meta-analysis
Pediatrics 138:4 (2016)

Effectiveness of current interventions in obese NZ children and adolescents [NZ]
New Zealand Medical Journal 128:1417 (2015)

Early Childhood Education / Schools

Improving low fruit and vegetable intake in children: Findings from a system dynamics, community group model building study (2019)

Interventions for obesity among schoolchildren: A systematic review and meta-analyses (2019)

Effectiveness of school food environment policies on children’s dietary behaviors: A systematic review and meta-analysis (2018)

Characteristics of Effective Interventions Promoting Healthy Eating for Pre-Schoolers in Childcare Settings: An Umbrella Review (2018)

Effectiveness of a childhood obesity prevention programme delivered through schools, targeting 6 and 7 year olds: cluster randomised controlled trial (WAVES study) (2018) [UK]

Childhood obesity plan case studies (2016) [UK]

Strategies to improve the implementation of healthy eating, physical activity and obesity prevention policies, practices or programmes within childcare services
Cochrane Database of Systematic Reviews (2016)

Proven strategies to promote students' healthy eating [US]

Project Energize: Intervention development and 10 years of progress in preventing childhood obesity [NZ]
BMC Research Notes 9:44 (2016)

Ranui kindergarten healthy kai project [NZ]

 

Pregnancy and Weight Management

Maternal Obesity
The Lancet Diabetes & Endocrinology (12 October 2016)
This series of four articles examines the growing burden of maternal obesity worldwide in terms of its impact on clinical management and intergenerational health, and highlights the need for a focus on the pre-pregnancy period, along with a whole-of-society intervention approach, to reverse the cycle of ill health propagated by maternal obesity. *Register to access the articles for free or they are available through the Library in Clinical Key.

Diet or exercise, or both, for preventing excessive weight gain in pregnancy
Cochrane Database of Systematic Reviews (2015)


Health Promotion Methodologies

Practitioner insights on obesity prevention: The voice of South Australian OPAL workers [Australia] Health Promotion International (2015) 

Using the community-based participatory research (CBPR) approach in childhood obesity prevention
Journal of Child Health and Nutrition 3:4 (2014): 170–178. 

Healthy together Victoria and childhood obesity—a methodology for measuring changes in childhood obesity in response to a community-based, whole of system cluster randomized control trial
Archives of Public Health 74:16 (2016)

 

see also PubMed literature search: Childhood Obesity  (last 5 years)

 

Selected Journals

Childhood Obesity

Pediatric Obesity

Journal of Childhood Obesity

BMC Obesity

Pediatrics

Health Promotion International

BMC Public Health

 

Social Media

Twitter

#Childhoodobesity

#Obesity

#HealthyKids

 

CM Health Library Clearinghouses

Health Equity

Pacific Health

Māori Health

 

 

last updated 3rd October 2019

This page was last updated at 9:33AM on October 16, 2019.