St HelensHealthy Weight

Strategy2020-2025

Our Long Term AimTo halve the number of children in St Helens that are obese by the year 2030

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National picture• One in four children in Reception class aged 4-5 are overweight or obese, rising to over

one in three by year 6.

• Obesity can affect anyone, but there are inequalities, with those with lower incomes more likely to be affected.

• Being overweight or obese can have a serious impact on health. It can lead to heart disease and stroke, type 2 diabetes, musculoskeletal disorders like osteoarthritis, and some cancers (such as endometrial, breast and colon). It can also cause substantial disability, reduced quality of life and poor mental health and wellbeing.

• The financial cost of obesity to the UK is estimated to be around £27bn, with 16 million obesity sick days, obesity medication costing £13.3m, a cost to the NHS of £5.1bn and a cost to social care of £352m.

National policyIn the UK, the Government has published the Childhood Obesity Plan which sets out the national plans to reduce obesity. Initiatives include:

• Introducing a soft drinks industry levy

• Reducing sugar by 20% in certain products

• Introducing advertising restrictions

• Supporting innovation to help businesses to make their products healthier

• Updating the Nutrient Profile model

• Making healthier options available in the public sector

• Support with the cost of healthy food for those who need it most

• Help all children to enjoy an hour of physical activity every day

In addition, the Chief Medical Officer has recently published a report on Childhood Obesity:

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/837907/cmo-special-report-childhood-obesity-october-2019.pdf

The national target is to halve childhood obesity by the year 2030. This is our long-term ambition for St Helens.

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Excess weight in St Helens compared with ‘statistical neighbours’ Children in Reception

We have greater levels of excess weight than our formal ‘statistic neighbours’ i.e. areas that are similar to us in many ways.

Trend in overweight and obesity amongst St Helens Reception pupils

Levels of overweight and obesity in Reception children have risen since 2011/12 but levelled off in recent years.

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Trend in overweight and obesity amongst St Helens Year 6 pupils

Levels of overweight and obesity have remained high at around 35-40% since 2011/12.

Excess weight in St Helens against statistical comparators – Year 6

Levels of overweight and obesity in Reception children have risen since 2011/12 but levelled off in recent years.

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What causes unhealthy weight?In general, excess weight is caused by more calories being consumed than expended. But there are many factors that can influence this such as genetics, medical conditions, disabilities and social, cultural, psychological and environmental influences. Wide social inequalities are also seen.

Tackling excess weight in children and developing a society where healthy weight is the norm is a complex challenge that requires action from a range of partners across the whole system.

A whole system approach to obesity (see diagram below) recommends 7 key areas to be addressed by society as a whole (Foresight report, 2007). These are:

1. Food production

2. Food consumption

3. Societal influences

4. Individual psychology

5. Biology

6. Individual activity

7. Activity environment

To influence all areas of the system requires partnership working between a range of stakeholders, from local authority councillors and officers to Clinical Commissioning Groups; from local businesses and organisations (including franchises, independents and nationals or internationals); to local marketing and communication; from schools to hospitals; and from GPs and nurses to individuals, families and communities. By working collectively, we can achieve a new societal and cultural norm.

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Examples of what’s worked elsewhere AmsterdamThe ‘Amsterdam Healthy Weight Programme’ was successful in reducing the number of overweight and obese children by 10% within the first two years, by implementing a whole systems approach in which organisations worked together to reduce unhealthy weight. The strategy was led from the Deputy Mayor which gave a strong voice and direction to the cause.

FinlandAn obesity programme was launched in Seinajoki, taking a multi-level intervention delivered at scale across the city. Excess weight reduced in 5 year olds from 17% in 2009 to 10% in 2015 and excess weight in 5th grade students reduced from 16% in 2011 to 8.2% in 2015. Health in all policies was key to the success along with strong community led support.

New YorkThe New York State Prevention Agenda achieved a 5.5% reduction in childhood obesity within a 4-year period. As well as having an overarching strategy to address nutrition and activity in a range of settings, complementary strategies were also used to support change in communities to increase demand for healthy food. A healthier lifestyle wasn’t just encouraged but it was made a part of everyday life. The whole system approach was led by the City Mayor.

Local ActionIn St Helens, our initial focus will be on children and young people and their families, particularly the early years. Obesity is hard to reverse, so by preventing children from becoming overweight from birth and creating an environment and culture which encourages healthy eating and physical activity, we hope children in St Helens can grow to be a healthy weight.

We have produced a framework for our action plan based on recommendations from Public Health England’s ‘Health Matters-Whole Systems Approach to Obesity’ and the Association of Directors of Public Health’s ‘What good healthy weight looks like’.

Our framework for action includes:

1. Leadership

2. Planning and creating an environment that promotes physical activity and healthy eating

3. Early years and school settings

4. Increasing healthy food consumption

5. Educating people about the benefits of healthy eating and physical activity

6. Community engagement

7. Focus on inequalities

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Measuring Success – How we will know we have made a difference

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Priorities for Action Objective 1 – Leadership and systems working

Objective 2 – Planning and creating an environment that promotes physical activity and healthy eating

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Objective 3 – Early years and school settings

Objective 4 – Increasing healthy food consumption

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Objective 5 – Educating people about the benefits of healthy eating and physical activity

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Objective 7 – Focus on inequalities

Objective 6 – Community engagement and development

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Appendix What is obesity?The term ‘healthy weight’ is used to describe when an individual’s body weight is appropriate for their height and benefits their health. Above the healthy weight range there are increasingly adverse effects on health and wellbeing. Weight gain can occur gradually over time when energy intake from food and drink is greater than energy used through the body’s metabolism and physical activity.

How do we measure and classify weight?The recommended measure of overweight and obesity in adults is body mass index (BMI). BMI is calculated by dividing body weight (kilograms) by height (metres) squared. In children this is adjusted for a child’s age and gender.

Waist circumference is also sometimes used to estimate body fat.

BMI for adults

BMI for children

Waist Measure for Adults

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