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This paper summarises and discusses some of the aspects of the Public Health White Paper, Healthy Lives, Healthy People, published for consultation at the end of 2010, and the framework of the Public Health Responsibility Deal, published in March 2011 by the UK government. Healthy Lives, Healthy People emphasises that a one-size-fits-all approach to public health improvement has been shown not to work as challenges vary from one neighbourhood to the next, and a new approach that empowers individuals to make healthy choices and gives communities the tools to address their own needs is required. It highlights the government's intention to shift power and decision making on public health matters to local authorities, with ring fenced budgets. A feature of the document that has proved controversial is the proposal to work collaboratively with business and the voluntary sector to deliver the government's ambition, through the Public Health Responsibility Deal, launched on 15 March, which comprises a series of 5 networks on food, alcohol, physical activity, health at work, and behaviour change, and the associated pledges. The initial pledges for the food network focus on salt and trans fatty acid reduction, and out-of-home calorie labelling of foods. [ABSTRACT FROM AUTHOR]

Background Obesity is the greatest health issue for this generation; schools have improved food offered within their grounds. The built environment surrounding schools and pupils' journeys home have not received the same level of attention. This review identified papers on impacts of hot food takeaways surrounding schools in the UK. Methods Methods were informed by the PRISMA (QUORUM) guidelines for systematic reviews. Searches were completed in 12 databases. Results A total of 14 papers were included and quality assured before data extraction. Three descriptive themes were found; descriptions of hot food takeaway's geography and impacts concerning schools, strategic food policy and pupils reported food behaviour. Conclusions Most included studies compared anthropometric measures with geographical location of hot food takeaways to find correlations between environment and childhood obesity. There was good evidence of more hot food takeaways in deprived areas and children who spend time in deprived neighbourhoods tend to eat more fast food and have higher BMIs. Few studies were able to quantify the correlation between school's environment and obesity amongst pupils. This lack of evidence is likely a factor of the studies' ability to identify the correlation rather than lack of a correlation between the two variables. [ABSTRACT FROM AUTHOR]

Background: The small Atlantic island of St Helena is a United Kingdom Overseas Territory (UKOT) with a high prevalence of childhood obesity (over a quarter of 4–5 and 10–11 year olds) and, anecdotally, adulthood obesity and its associated health detriments. St Helena have taken a whole systems approach to obesity (WSAO) to address the issue. A WSAO recognises the factors that impact obesity as a complex system and requires a 'health in all policies' approach. UK academic and public health technical support was provided to the local St Helena delivery team. This process evaluation sought to explore the early stages of the WSAO implementation and implications for the transferability of the approach to other small island developing states and UKOT. Methods: Data was collected via eight semi-structured interviews, paper based and online surveys, and document analysis. Thematic analysis was used to analyse the data. Results: The analysis identified three factors which aided the first phase of WSAO implementation: (1) senior leaders support for the approach; (2) the academic support provided to establish and develop the approach; and (3) effective adaptation of UK Government resources to suit the local context. Key challenges of early implementation included: maintaining and broadening stakeholder engagement; limited local workforce capacity and baseline knowledge related to obesity and systems thinking; and limited capacity for support from the UK-based academic team due to contract terms and COVID-19 restrictions. Conclusions: Early stages of implementation of a WSAO in a UKOT can be successful when using UK's resources as a guide and adapting them to a small island context. All participants recommended other small islands adopt this approach. Continued senior support, dedicated leadership, and comprehensive community engagement is needed to progress implementation and provide the foundation for long-term impact. Small island developing states considering adopting a WSAO should consider political will, senior level buy-in and support, funding, and local workforce knowledge and capacity to enable the best chances of successful and sustainable implementation. [ABSTRACT FROM AUTHOR]

This Special Issue is part ofEducational Review’s Hall of Fame, comprising the journal’s most read and highly cited papers. As part of this I will be critiquing a milestone paper within the field(s) of Sport, PE and (I will extend to) PA by Professor Richard Bailey. The paper has been amongst the most-cited in the journal and I have personally cited the paper numerous times in my own work thus far. Upon its original publication (nearly 13 years ago), the article (managed to provide a very useful distinction between PE and sport (and PA), which is important given the constant slippage between the terms in many articles since. In this response article, I will try to provide a brief summary of the paper from Bailey, but at the same time examine closely the notion of social inclusion through sport and PE by summarising work that has subsequently been conducted. I will conclude by summarising that some 13 years later spurious claims about effective inclusive practices through sport abound, and we still lack clear evidence to support the rhetoric about the ways in which sport and PE can contribute to social inclusion. [ABSTRACT FROM PUBLISHER]

Qualitative research may be able to provide an answer as to why adults and children do or do not participate in sport and physical activity. This paper systematically examines published and unpublished qualitative research studies of UK children's and adults' reasons for participation and non-participation in sport and physical activity. The review covers peer reviewed and gray literature from 1990 to 2004. Papers were entered into review if they: aimed to explore the participants' experiences of sport and physical activity and reasons for participation or non-participation in sport and physical activity, collected information on participants who lived in the United Kingdom and presented data collected using qualitative methods. From >1200 papers identified in the initial search, 24 papers met all inclusion criteria. The majority of these reported research with young people based in community settings. Weight management, social interaction and enjoyment were common reasons for participation in sport and physical activity. Concerns about maintaining a slim body shape motivated participation among young girls. Older people identified the importance of sport and physical activity in staving off the effects of aging and providing a social support network. Challenges to identity such as having to show others an unfit body, lacking confidence and competence in core skills or appearing overly masculine were barriers to participation. [ABSTRACT FROM AUTHOR]

This paper examines the multiple ways in which health policy relating to obesity, diet and exercise is recontextualised and mediated by teachers and pupils in the context of social class in the UK. Drawing on a case study of a middle-class primary school in central England, the paper documents the complexity of the policy process, its uncertainty, its intended and unintended affects and effects on the lives and bodies of young people as they negotiate ‘health’ across a range of social contexts. Particular attention is paid to the voices of young people, whom by way of embodying imperatives found in health discourses become ‘troubled bodies’, ‘emboldened bodies’, or ‘insouciant bodies’, as such imperatives intersect with pupils' various subjectivities. It is argued that whilst all pupils appear to be affected by health policy, they are differently effected by it. The paper will outline how pupils were effected by health policy in emboldened and privileged ways and how the young people seem to not only remain unscathed by health imperatives but are also positively emboldened and privileged by them. This paper adds to understandings of social class and relationships between public health discourse and individual (e.g. pupil) subjectivity, and highlights both the complexity of the policy process itself as a product of the organisational and social relations of schooling, as well as the complex and idiosyncratic nature of young people's embodied subjectivities. [ABSTRACT FROM AUTHOR]

This paper draws together recent geographical work on fatness, pre-emptive biopolitics, affect and childhood in order to question the spatiotemporalities of obesity policy in the UK. Through analysis of key policy documents and associated media coverage, the paper questions the dystopian production of the future nation in obesity policy; the role of affect in making futures felt as realities which can be acted on in the present; and the role of childhood and children’s bodies within such policy. It argues that children are central to the production and pre-emption of obese futures because of the affective potential of childhood and the paradoxical position of children’s bodies both as children in the present and adults of the future. The paper concludes by arguing that obesogenic environment theories are fundamentally problematic and that recognition of the temporalities as well as the spatialities of obesity is necessary for a balanced critical geography. [ABSTRACT FROM AUTHOR]

A link between higher rates of childhood obesity and deprivation has been noted in the UK, as well as several other European countries and the US. The drivers of obesity are complex and multi‐factorial, but socially and economically disadvantaged groups may be more vulnerable to many of these. Evidence that rates of obesity are rising faster in low‐income population groups, resulting in widening inequalities indicates that prevention policies must take account of socio‐economic factors. It has been suggested that community‐wide approaches placing less emphasis on individual responsibility or 'agency' (i.e. have less emphasis on aspects that require cognitive, psychological and material resources and time) can be more effective and equitable. This paper outlines examples of community approaches that may have contributed to the reported reductions in childhood obesity in some areas, particularly amongst deprived groups including Health, Exercise and Nutrition in the Really Young in Leeds, UK; Ensemble Prévenons l'Obésité Des Enfants and Amsterdam's citywide Healthy Weight Programme. The policies enacted that improved the nutrition environment and increased opportunities for physical activity in four US sites (the Childhood Obesity Declines project) are also considered. It is clear that there is no silver bullet for tackling childhood obesity. A whole systems approach that takes into account more holistically the reasons why healthy diet and lifestyles may be less available to families on low incomes is needed. [ABSTRACT FROM AUTHOR]

A mother's nutritional choices while pregnant may have a great influence on her baby's development in the womb and during infancy. There is evidence that what a mother eats during pregnancy interacts with her genes to affect her child's susceptibility to poor health outcomes including childhood obesity, pre-diabetes, allergy and asthma. Furthermore, after what an infant eats can change his or her intestinal bacteria, which can further influence the development of these poor outcomes. In the present paper, we review the importance of birth cohorts, the formation and early findings from a multi-ethnic birth cohort alliance in Canada and summarise our future research directions for this birth cohort alliance. We summarise a method for harmonising collection and analysis of self-reported dietary data across multiple cohorts and provide examples of how this birth cohort alliance has contributed to our understanding of gestational diabetes risk; ethnic and diet-influences differences in the healthy infant microbiome; and the interplay between diet, ethnicity and birth weight. Ongoing work in this birth cohort alliance will focus on the use of metabolomic profiling to measure dietary intake, discovery of unique diet-gene and diet-epigenome interactions, and qualitative interviews with families of children at risk of metabolic syndrome. Our findings to-date and future areas of research will advance the evidence base that informs dietary guidelines in pregnancy, infancy and childhood, and will be relevant to diverse and high-risk populations of Canada and other high-income countries. [ABSTRACT FROM AUTHOR]

Background: Childhood obesity is a serious public health challenge and schools have been identified as an ideal place to implement prevention interventions. The aim of this study was to measure the cost-effectiveness of a multi-faceted school-based obesity prevention intervention targeting children aged 6–7 years when compared to ‘usual activities’. Methods: A cluster randomised controlled trial in 54 schools across the West Midlands (UK) was conducted. The 12-month intervention aimed to increase physical activity by 30 minutes per day and encourage healthy eating. Costs were captured from a public sector perspective and utility-based health related outcomes measured using the CHU-9D. Multiple imputation using chained equations was used to address missing data. The cost effectiveness was measured at 30 months from baseline using a hierarchical net-benefit regression framework, that controlled for clustering and prespecified covariates. Any uncertainty in the results was characterised using cost-effectiveness acceptability curves. Results: At 30 months, the total adjusted incremental mean cost of the intervention was £155 (95% confidence interval [CI]: £139, £171), and the incremental mean QALYs gained was 0.006 (95% CI: -0.024, 0.036), per child. The incremental cost-effectiveness at 30 months was £26,815 per QALY and using a standard willingness to pay threshold of £30,000 per QALY, there was a 52% chance that the intervention was cost-effective. Conclusions: The cost-effectiveness of the school-based WAVES intervention was subject to substantial uncertainty. We therefore recommend more research to explore obesity prevention within schools as part of a wider systems approach to obesity prevention. Trial registration: This paper uses data collected by the WAVES trial: Controlled trials (registered May 2010). [ABSTRACT FROM AUTHOR]

Copyright of Acta Scientiarum Polonorum. Oeconomia is the property of Wydawnictwo SGGW and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Islamic leaders, staff, and Muslim parents in the UK are supportive of healthy lifestyle intervention delivery through Islamic Religious Settings. Such interventions are necessary given high obesity rates in British South Asian (40%) compared to White British (32%) children of equivalent age. Co-production can facilitate the development of culturally appropriate health interventions, however it can be theoretically and practically challenging, and evaluation of co-production within an Islamic Religious Setting context is lacking. The aim of this study was to examine the feasibility and acceptability of taking a co-production approach to develop an obesity-prevention toolkit for Islamic Religious Settings. Methods: An obesity-prevention toolkit for use in Islamic Religious Settings, incorporating physical activity, healthy diet, and organisational change, has been co-produced to be evidence-informed and contextually relevant. A qualitative process evaluation was employed to examine experiences of co-production. Semi-structured interviews (n = 15) and a focus group (n = 5) were conducted with toolkit co-production stakeholders, e.g., subject experts, an Islamic scholar, and Islamic Religious Setting staff. Transcripts were analysed inductively using reflexive thematic analysis. Results: The analysis revealed four major themes regarding stakeholders' experiences of co-producing a childhood obesity-prevention toolkit for Islamic Religious Settings. These themes are: (1) attitudes towards obesity-prevention through Islamic Religious Settings, (2) benefits of co-production including capacity building and ownership (3) negotiating involvement, power, and perspectives within the co-production process, and (4) the complexities of effective communication in co-production. Conclusion: This study adds to the evidence-base in support of delivering health promotion through faith settings. Taking a co-production approach to develop an obesity-prevention toolkit for Islamic Religious Settings provided benefit to the toolkit product and local stakeholders. The toolkit is currently being implemented across Bradford, UK and there is potential to adapt the toolkit to other geographical contexts, and for evaluating effectiveness for preventing obesity in British Muslim families. [ABSTRACT FROM AUTHOR]

Food and drink are distributed via corporate institutions in categories, such as ready meals or carbonated drinks. Within these categories, a minority of brands advertise, capitalizing upon the popularity of the categories. The issue of childhood obesity and health has led to a focus upon these advertised brands in terms of their being targeted at children, but nothing has been done about the categories they represent. Furthermore, parents have an influence upon their children's diet, as their expenditure accounts for the majority of their children's consumption. This paper accounts for UK children's perceptions of the effect of advertising and marketing of food and drink upon their parents, and concludes that the children see advertising as having very little influence. Rather, they see that their parents' involvement with certain categories have become, over time, their norm. Children do not see that the regulation of advertising of food and drink to them will have any significant effect upon their diet, as their parents will continue to consume from within the categories supplied by the retail sector, which in their view constitutes the most influential aspect of food and drink marketing. Given the international focus upon the advertising of food brands, this paper draws attention to other, potentially more influential issues. [ABSTRACT FROM AUTHOR]

This paper describes global (whole of Leeds) and local (super output area) analyses of the relationship between childhood obesity and many ‘obesogenic environment’ variables, such as deprivation, urbanisation, access to local amenities, and perceived local safety, as well as dietary and physical activity behaviours. The analyses identify the covariates with the strongest relationships with obesity, and highlight variation in these relationships across Leeds, thus identifying ‘at-risk’ populations. This paper seeks to demonstrate the importance of analysis at the micro-level in order to provide health planners with additional information with which to tailor interventions and health policies to prevent childhood obesity. [ABSTRACT FROM AUTHOR]

In 1995, the World Health Organisation launched a Global School Health Initiative to reduce health risks among young people. In the UK, the National Healthy School Programme (HSP) developed as part of a wider government commitment to promoting social inclusion. One of the key issues to be tackled by the programme is childhood obesity, for obesity is widely argued to be a public health problem for which a solution needs to be found. However, the assumption that obesity is necessarily problematic and that a higher body weight leads to health problems and social exclusion, is not without challenge. Critics of anti-obesity campaigns question the significance of weight per se and highlight the potential implications of discrediting not only fatness, but also the people who are seen as fat. This paper therefore explores the experiences of young people with obesity within the secondary school environment in relation to areas of concern prioritised by the HSP. The paper draws upon data from a qualitative research study involving 18 children and young people, between the ages of 10 and 17. Data were generated in focus group discussions and individual interview with participants of a community-based obesity intervention programme in South Yorkshire, UK. Data collection took place in 2005, and thematic analysis of the data was undertaken. Findings suggest that the issues prioritised in the HSP, particularly physical exercise and healthy eating, present challenges to young people with obesity and can reinforce their vulnerability to bullying in schools and contribute to their social exclusion. It concludes that social exclusion is a process experienced by, and pertinent to, children and young people, which has meaning for their experiences of, and during, childhood and youth. The whole-school approach of the HSP may fail to adequately address the experiences of marginalised and vulnerable groups of young people within schools, challenging and undermining the social inclusion agenda in which the programme is grounded and contributing to the construction of undesirable, fat, young bodies. [ABSTRACT FROM AUTHOR]

Background: Childhood and adolescent obesity are major, preventable public health concerns. Studies to date are inconclusive regarding an association between caesarean section (CS) delivery and offspring obesity, with fewer studies conducted in late adolescence. This study examined the association between CS delivery, with a specific focus on planned CS, and induction of labour and adolescent body mass index (BMI) and body fat percentage (BF%) at age 17 years. Methods: Data on 8,880 mother-child pairs from the United Kingdom Millennium Cohort Study were analysed. The exposures were mode of delivery (normal vaginal delivery (VD) (reference), assisted VD, planned CS and emergency CS) and mode of delivery by induction of labour status. Crude and adjusted binary logistic regression and linear regression models were fitted examining BMI and BF% at age 17 years respectively, adjusting for several potential confounders. Results: Adolescents born by CS did not have an elevated BMI or BF% compared to those born by normal VD. The fully adjusted results for overweight and obesity in children born by planned CS, compared to VD, were 1.05 (95% CI: 0.86–1.28) and 0.94 (95% CI: 0.72–1.23), respectively. The results were similar for the associations between CS and BF%, and between induction of labour and BMI. Conclusion: Overall, this large longitudinal study did not support an association between CS or induction of labour and overweight, obesity or BF%. It is possible that previously reported associations are due to residual or unmeasured confounding and/or underlying indications for CS delivery. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Agricultural Economics is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Parents typically do not recognise their child's weight status accurately according to clinical criteria, and thus may not take appropriate action if their child is overweight. We developed a novel visual intervention designed to improve parental perceptions of child weight status according to clinical criteria for children aged 4-5 and 10-11 years. The Map Me intervention comprises age- and sex-specific body image scales of known body mass index and supporting information about the health risks of childhood overweight. Design: This cluster randomised trial will test the effectiveness of the Map Me intervention. Primary schools will be randomised to: paper-based Map Me; web-based Map Me; no information (control). Parents of reception (4-5 years) and year 6 (10-11 years) children attending the schools will be recruited. The study will work with the National Child Measurement Programme which measures the height and weight of these year groups and provides feedback to parents about their child's weight status. Before receiving the feedback, parents will complete a questionnaire which includes assessment of their perception of their child's weight status and knowledge of the health consequences of childhood overweight. The control group will provide pre-intervention data with assessment soon after recruitment; the intervention groups will provide post-intervention data after access to Map Me for one month. The study will subsequently obtain the child height and weight measurements from the National Child Measurement Programme. Families will be followed-up by the study team at 12 months. The primary outcome is any difference in accuracy in parental perception of child weight status between pre-intervention and post-intervention at one month. The secondary outcomes include differences in parent knowledge, intention to change lifestyle behaviours and/or seek advice or support, perceived control, action planning, coping planning, and child weight status at 12 month follow-up. Discussion: The Map Me tool has potential to make a positive impact on children's health at a population level by introducing it into current intervention programmes to improve accuracy of parental perception of child's weight status. This trial will inform the action of researchers, educators, health professionals and policy makers. [ABSTRACT FROM AUTHOR]

Background Both the prevalence of childhood obesity and the consumption of sugar-sweetened beverages ( SSBs) have increased globally. The present review describes interventions that reduce the consumption of SSBs in children and determines whether this leads to subsequent changes in body fatness. Methods Three databases were searched from 2000 to August 2013. Only intervention control trials, ≥6 months in duration, which aimed to reduce the consumption of SSBs in >100 children aged 2-18 years, and reporting changes in body fatness, were included. The quality of selected papers was assessed. Results Eight studies met inclusion criteria. Six interventions achieved significant ( P < 0.05) reductions in SSB intake, although this was not always sustained. In the two interventions providing replacement drinks, significant differences in body mass index (12- or 18-month follow-up) were reported ( P = 0.001 and 0.045). The risk of being overweight/obesity was reduced ( P < 0.05) in three of the five education programmes but in one programme only for girls who were overweight at baseline and in one programme only for pupils perceived to be at greater risk at baseline. In the one study that included both provision of water and education, the risk of being overweight was reduced by 31% ( P = 0.04) in the intervention group. Conclusions The evidence suggests that school-based education programmes focusing on reducing SSB consumption, but including follow-up modules, offer opportunities for implementing effective, sustainable interventions. Peer support and changing the school environment (e.g. providing water or replacement drinks) to support educational programmes could improve their effectiveness. Home delivery of more suitable drinks has a big impact on reducing SSB consumption, with associated reductions in body weight. [ABSTRACT FROM AUTHOR]

Globally, childhood obesity is on the rise and the effect of objectively measured movement behaviour on body composition remains unclear. Longitudinal and causal mediation relationships of accelerometer-based sedentary time (ST), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) with dual-energy X-ray absorptiometry-measured fat mass were examined in 6059 children aged 11 years followed-up until age 24 years from the Avon Longitudinal Study of Parents and Children (ALSPAC), UK birth cohort. Over 13-year follow-up, each minute/day of ST was associated with 1.3 g increase in fat mass. However, each minute/day of LPA was associated with 3.6 g decrease in fat mass and each minute/day of MVPA was associated with 1.3 g decrease in fat mass. Persistently accruing ≥60 min/day of MVPA was associated with 2.8 g decrease in fat mass per each minute/day of MVPA, partly mediated by decrease insulin and low-density lipoprotein cholesterol. LPA elicited similar and potentially stronger fat mass-lowering effect than MVPA and thus may be targeted in obesity and ST prevention in children and adolescents, who are unable or unwilling to exercise. Childhood obesity remains a global epidemic. Here, using objective measurements, the authors show that sedentary time increased from 6 h/day in childhood to 9 h/day in young adulthood, and was cumulatively associated with increased total and trunk fat mass. Both light or moderate-to-vigorous physical activity similarly partly reversed risk. [ABSTRACT FROM AUTHOR]

The paper introduces the prevalence of overweight and obesity in children and adolescents in the current UK and some knowledge of British researches focused on the role of psychosocial and environmental variables in the creation, development and maintenance of overweight and obesity. The United Kingdom is country with ethnically more diverse composition, that has always raised doubts about the value of the compared data of overweight and obesity, that has been thus obtained in different ethnic groups living here. This problem and its solution in the current country is devoted one part of this contribution. Further part introduces the researches concerned with the relationships between overweight and obesity of British native population and various ethnic groups and their psychosocial and environmental variables, that are always formed, accompanied or mutual differ in a characteristic way of interpersonal communication. The conclusion of the paper is devoted to the strategies, that are currently applied to address the problem of overweight and obesity in some administrative areas of this country. Creators of project Foresight (Butland et al., 2007) propose solutions of increasing incidence of overweight and obesity, in which are involved various ministries and that could be realised through the responsible institutions. These changes would better fit the (psycho) human biology and so could more naturally lead to a healthier lifestyle. [ABSTRACT FROM AUTHOR]

The incidence of childhood obesity is rising in the United Kingdom and this has far-reaching and serious consequences both for the physical and psychological well-being of the child, as well as significant financial implications for the health service. General practitioners (GPs) play a central role in identifying and assessing such children and directing them to the best services. While most cases of obesity are simply due to an imbalance in calorie intake and expenditure, children do need to be formally assessed to ensure that red flags are not missed, which might signify an important underlying aetiology, co-morbidity or complication. To date, there have not been tools available to guide a GP through this assessment. In this paper, we present and explain the thinking behind a tool, which was developed for use by GPs from Bristolas part of a trial to assess the transferability of a childhood obesity clinic into primary care. We look at the evidence base behind the guidelines and then assess the appropriateness and safety of the 152 referrals made using this tool. We believe that this screening tool would enable over 85% of obese children to seek their initial weight management in primary care. Additional evaluation is needed in different regions to ensure effectiveness, sensitivity and specificity of this new tool. [ABSTRACT FROM PUBLISHER]

Unhealthy foods and drinks are among the top products advertised to young children. Considering the growing childhood obesity epidemic and the soaring number of children accessing the Internet, even online junk food advertising has come under increasing scrutiny. Many countries are in the process of expanding and revising existing regulation to account for the realities of the digital age and to respond to health and other social concerns. This paper focuses on two European countries in particular to examine and compare these processes through the lens of junk food advergames aimed at children. Our questions are: 1) Given the differences in the media landscapes of the UK and Hungary, what types of junk food advergames target children?; and 2) In light of the growing childhood obesity problem faced by both nations, how have government bodies, advocacy groups, and advertisers approached junk food advertising targeting children in general and online advertising including advergames in particular? The United Kingdom represents a country with the highest Internet usage by children and the most developed online advertising market in Europe, while Hungary, a post-communist country, represents an emerging media market where young people have less access to the Internet and buying power but constitute a crucial "entry point" for food advertisers. [ABSTRACT FROM AUTHOR]

This paper draws upon a review of empirical and policy literature to provide an analysis of the development of surveillance and screening for childhood obesity in the UK. It is argued that policy in this area has lacked coordination and that the intended application of surveillance and screening for childhood obesity in the UK has neither been clearly articulated nor adequately explored. At present, universal measurement of school children's height and weight is conducted as part of the National Child Measurement Programme. Results are not fed back to parents since this amounts to screening and there is insufficient evidence to satisfy National Screening Programme Committee criteria. Results will be fed back to parents beginning from the 2008/9 school year, but whilst expert committees globally have been divided on the effectiveness of screening, its benefits and harms remain uncertain. Experience internationally suggests that to date, inadequate attention has been given to psychological implications of intervention. Similarly, the benefits and harms of surveillance remain uncertain and evidence indicates that the stated purposes of the UK programme are unrealistic. In consideration of the rates, trends and potential consequences of childhood obesity, it is clear that the intended application of screening and surveillance for childhood obesity merits clear definition and rigorous examination. [ABSTRACT FROM AUTHOR]

The article presents perspectives concerning the papers of D. Fayter et al and F.K. Grote et al on the effectiveness of growth monitoring in children in relation to probable associated diseases. The author commends the scientists suggestion that height monitoring of children is a beneficial and a must as a public health measure. He expresses his surprise over the averse feelings parents feel in explaining to their children about body mass index (BMI) for fears that it would cause a hysteria over obesity and result to eating disorders. The author commends the British government's efforts in undertaking an online BMI calculator, as a sign of its resolve in the issue of childhood obesity.

Examines the prevalence of obesity in children in Great Britain. Measurement of body mass index and skinfold thickness; Levels of overweight and obesity in children; Association of children obesity on adult health.

Fundamental movement skills (FMS) are basic movements in children that represent the building blocks for more complex motor skill development and act as a prerequisite for enduring sport and physical activity (PA) engagement and positive health-related behaviours. The FMS proficiency is currently inadequate worldwide, and consequently there are alarming levels of inactivity and childhood obesity. However, parents are role models to their children and possess the power to influence their PA behaviour. This review investigated if parent-focused interventions could improve FMS in 2–7-year-old children and evaluated which setting and method of parent engagement was most impactful. Keyword searches were conducted via Scopus, Web of Science, SPORTDiscus, PubMed, Science Direct, and Google Scholar. Only nine articles met the inclusion criteria. No research originated from the United Kingdom, highlighting the urgent need for further FMS interventions involving parents. The FMS improved in all nine studies, with significant changes in seven of the articles (p < 0.05). Parent–child co-activity, the education and empowerment of parents, and the provision of clear FMS guidance, messaging, and structure can positively influence children's FMS. Recently, smartphone apps have increased the feasibility and accessibility of FMS practice at home and may be integral to future interventions. Further research with direct parental involvement is clearly warranted. [ABSTRACT FROM AUTHOR]

Childhood obesity has become a major focus of public health and subject to increased news coverage. News can shape public understanding of childhood obesity by selective reporting (framing) which can affect policy support and weight stigma. As news is consumed on social media, comments on articles present a novel method to explore public understanding. This study examined how childhood obesity is framed by news articles on Facebook and how individuals commenting understand and react to these articles. This study used a qualitative research design. Facebook pages of 11 national UK news outlets were searched for news articles on childhood obesity published between May 2015 and May 2020. Of those, 30 articles were randomly selected. Framing analysis was used to determine whether childhood obesity was portrayed as a behavioral, societal or medical issue. Responding comments (N = 1,104) were grouped according to the dominant frame of the corresponding article and analyzed using qualitative content analysis. Of the 30 articles, 28 mentioned societal, 26 behavioral and 18 medical aspects of childhood obesity, highlighting that most articles included more than one frame. Three themes were generated from responding comments: Culprits and Remedies, Appraising Childhood Obesity and Making Sense of the News Article. Findings showed that comments related to Appraising Childhood Obesity differed between differently framed articles, while the other themes did not. This study highlights the need for improved communication on childhood obesity to address weight stigma and improve understanding of news articles. [ABSTRACT FROM AUTHOR]

Background: Obesity in adolescents is a growing public health issue. Bariatric surgery is an effective, yet controversial treatment option for adolescents. The moral acceptability of this procedure by health-care professionals as well as the general public can be influenced by its portrayal in the news media. Our objective was to analyze how newspaper articles portrayed adolescent bariatric surgery, with attention to the language used and moral arguments made. Methods: Using an inductive thematic analysis approach, we analyzed 26 UK and 12 US newspaper articles (2014–2022) on adolescent bariatric surgery for implicit or explicit moral evaluations and use of normative language. Coding was performed after immersive reading, assisted by NVivo. Themes were identified and refined iteratively through consecutive auditing cycles to enrich the depth and rigor of our analysis. Results: The major themes identified related to (1) defining the burden of adolescent obesity, (2) sparking moral outrage, (3) sensation-seeking, and (4) raising ethical issues. The articles employed moral language, specifically non-neutral and negative discourse regarding surgery. Blame was attributed to adolescents or their parents. Sensationalist wording often reinforced the normative content, drawing the attention of the reader and contributing to stigmatization of adolescents with severe obesity as lacking will power and being lazy. Further moral issues that stood out were the challenges in obtaining an informed consent, and the unequal access to surgery for socially disadvantaged groups. Conclusions: Our findings provide insights into how adolescent bariatric surgery is represented in the print news media. Despite frequent citing of experts and studies on the efficacy, safety and unmet need for bariatric surgery, obesity and surgery in adolescents are often stigmatized and sensationalized, with (prospective) patients depicted as looking for an easy way out in the form of a solution brought by others (health systems, society, tax payers). This may increase the stigma surrounding adolescent obesity, and therefore limit the acceptability of specific treatments such as bariatric surgery. [ABSTRACT FROM AUTHOR]

Information about several papers discussed at the "Early Development and Obesity: Food Preferences, Diet and Appetite Regulation" conference on March 28, 2008 in Great Britain. The conference featured Jason Halford who chaired the first session on the epidemiology of early obesity. Topics discussed include the influence of the mother's diet on her child's body weight and food preferences, and the influence of the environment to a child's dietary choices.

Obesity and asthma are both common diseases with high population burden worldwide. Recent genetic association studies have shown that obesity is associated with asthma in adults. The relationship between childhood obesity and childhood asthma, and the underlying mechanisms linking obesity to asthma remain to be clarified. In the present study, leveraging large-scale genetic data from UK biobank and several other data sources, we investigated the shared genetic components between body mass index (BMI, n = 39620) in children and childhood asthma (ncase = 10524, ncontrol = 373393). We included GWAS summary statistics for nine obesity-related biomarkers to evaluate potential biological mediators underlying obesity and asthma. We found a genetic correlation (Rg = 0.10, P = 0.02) between childhood BMI and childhood asthma, whereas the genetic correlation between adult BMI (n = 371541) and childhood asthma was null (Rg = −0.03, P = 0.21). Genomic structural equation modeling analysis further provided evidence that the genetic effect of childhood BMI on childhood asthma (standardized effect size 0.17, P = 0.009) was not driven by the genetic component of adult BMI. Bayesian colocalization analysis identified a shared causal variant rs12436181 that was mapped to gene AMN using gene expression data in lung tissue. Mendelian randomization showed that the odds ratio of childhood asthma for one standard deviation higher of childhood BMI was 1.13 (95% confidence interval: 0.96–1.34). A systematic survey of obesity-related biomarkers showed that IL-6 and adiponectin are potential biological mediators linking obesity and asthma in children. This large-scale genetic study provides evidence that unique childhood obesity pathways could lead to childhood asthma. The findings shed light on childhood asthma pathogenic mechanisms and prevention. A comprehensive genetic analysis of the relationship between childhood obesity and childhood asthma identifies shared mechanisms and potential mediators linking the two pediatric disorders. [ABSTRACT FROM AUTHOR]

Objective: To quantify the sector-wide energy and nutritional differences of both adult and children's restaurant menu items in the UK and the USA in 2018. Design: Cross-sectional study. Setting: Energy and nutritional information provided on restaurant websites. Participants: Menu items (n 40 902) served by forty-two large UK chains and ninety-six large USA chains. Results: Mean absolute energy, fat and saturated fat values were higher in USA menu items. For example, the mean adjusted per-item differences of adult menu items between the USA and the UK were 45·6 kcal for energy and 3·2 g for fat. Comparable figures for children's menu items were 43·7 kcal and 4 g. Compared with UK menu items, USA adult menu items also had higher sugar content (3·2 g, 95 % CI (0·5, 6)), and children's menu items had higher Na content (181·1 mg, 95 % CI (108·4, 253·7)). Overall, 96·8 % of UK and 95·8 % of USA menu items exceeded recommended levels for at least one of Na, fat, saturated fat or sugars. Conclusions: Menu items served by large chain restaurants had higher mean absolute levels of energy, fat and saturated fat in the USA compared with the UK. UK adult menu items were also lower in sugars compared with the USA ones and children's items lower in Na. As more than 95 % of all items were considered to have high levels of at least one nutrient of public health concern in the USA and the UK, improvements in restaurant menu items are needed in both countries. [ABSTRACT FROM AUTHOR]

Objectives Increased time in which children spend watching television is a well-described contributor to paediatric obesity. This study investigated the frequency and type of food and beverage placement in childrenspecific television broadcasts and compared data from UK (UK) and Irish television stations. Design Content analysis, totalling 82.5 h, reflecting 5 weekdays of children-specific television broadcasting on UK and Irish television channels was performed. To allow comparison between UK and Irish food and beverage cues, only broadcasts between 06.00 and 11.30 were analysed. Data were coded separately by two analysts and transferred to SPSS for analyses. Food and beverage cues were coded based on type of product, product placement, product use, motivation, outcome and characters involved. Results A total of 1155 food and beverage cues were recorded. Sweet snacks were the most frequent food cue (13.3%), followed by sweets/candy (11.4%). Tea/coffee was the most frequent beverage cue (13.5%), followed by sugar-sweetened beverages (13.0%). The outcome of the cue was positive in 32.6%, negative in 19.8%, and neutral in 47.5% of cases. The most common motivating factor associated with each cue was celebratory/social (25.2%), followed by hunger/thirst (25.0%). Comparison of UK and Irish placements showed both to portray high levels of unhealthy food cues. However, placements for sugar-sweetened beverages were relatively low on both channels. Conclusions This study provides further evidence of the prominence of unhealthy foods in children's programming. These data may provide guidance for healthcare professionals, regulators and programme makers in planning for a healthier portrayal of food and beverage in children's television. [ABSTRACT FROM AUTHOR]

Health Exercise Nutrition for the Really Young (HENRY) is a UK community–based early childhood obesity prevention intervention that was adopted and implemented in Israel between 2013 and 2018. The aim of this study was to explore the implementation process in Israel and compare it with that of the 'parent' programme in the UK, in order to throw light on the challenges of introducing complex interventions into different countries and cultures. Published reports from HENRY and Haifa University's evaluation of the Israeli implementation were reviewed and comparisons between the UK and Israel were carried out utilizing the RE-AIM framework. In both countries, the intention was to implement in lower SES communities. When comparing the individual items, Reach and Effectiveness, we found a difference in the Reach although Effectiveness was similar: Reach was proportionally lower in Israel, but parent and professional changes in behaviour were positive in both countries. For the organizational items Adoption, Implementation and Maintenance, we found large differences between the countries. Major challenges identified in Israel included: failing to take adequate account when planning and implementing the intervention of the different ways social and health services are organized and how local authorities are structured and provide services. In addition, differences in culture beyond language and professional variations were challenges, when trying to transfer the intervention with high fidelity from the UK to Israel. Lessons learnt may benefit others in attempting cross-country implementation of complex interventions [ABSTRACT FROM AUTHOR]

The article reports on a study which indicates that childhood obesity is caused by genetic factors. Researchers in Great Britain found that rare deletions on chromosome 16 (16p11.2) were prevalent in children who are obese as they looked at the copy number variations. Research author Sadaf Farooqi states that genetic variants can produce a strong drive to eat as shown in the study.

ObjectiveTo monitor growth trends in young children in order to ascertain success (or otherwise) in halting the rapid rise in childhood obesity prevalence, and to assess the suitability of using routinely measured data for this purpose.DesignRetrospective serial cross-sectional analyses of the proportion of obese children (logistic regression) and BMI standard deviation score (linear regression/maps) were undertaken. BMI coverage was calculated as percentage of sample with data (‘usual’), percentage of total births and percentage of census values. BMI was standardised for age and sex (British reference data set).SettingMetropolitan Leeds, UK.SubjectsChildren aged 3 to 6 years. Weight, height, sex, age and postcode data were collected from Primary Care Trust records.ResultsData were collected on 42 396 children, of whom 13 020 (31 %) were excluded due to missing data/data problems. Seventy-two per cent of 3-year-olds and 92 % of 5-year-olds had data recorded (‘usual’ coverage). From 1998 to 2003 there was a significant increase in the proportion of obese children (4·5 % to 6·6 %; P < 0·001); children were 1·5 times more likely to be obese in 2003 than in 1998.ConclusionsChildhood obesity rose significantly between 1998 and 2003. Routinely measured data are an important means of monitoring population-level obesity trends, although more effort is required to reduce the quantity of data-entry errors, for relatively low marginal cost. [ABSTRACT FROM AUTHOR]

In 2007, the British media regulator Ofcom began to implement new restrictions on the television advertising of food and drink products to children, as part of the government's broader attempts to combat child obesity. This is the first of two linked articles that explore the issues at stake in these developments, and their broader implications for the study of media and cultural policy. The focus here is on the ways in which evidence from research was used by the various contending participants in the debate about food advertising and children in the years leading up to Ofcom's decision. The emphasis is not so much on the validity of the research itself, but the political uses of research (or of the claims made about research), and the relations between research and policy-making. This analysis is set within a broader discussion of the nature and limitations of 'evidence-based' policy-making. [ABSTRACT FROM AUTHOR]

Childhood obesity and diet-related disease in the UK is rising dramatically. Which?, the UK's largest consumer organisation, has carried out extensive research into the promotion of less healthy foods to children including a recent analysis of the practices of leading UK food companies. In this article, Clare Corbett and Colin Walker identify the range of promotions used to promote less healthy foods to children, evaluate Government and industry action to date and discuss the need for action on a UK, European and global level. [ABSTRACT FROM AUTHOR]

In this paper we interrogate the ways in which supermarkets 'place' responsibility for children's 'healthy' eating with parents and/or children, as set within the contemporary British public health concern with the prevalence of childhood obesity. We use British food retailers' corporate social responsibility CSR) policies as a way of identifying specific relations of responsibility between supermarkets, parents, and children. We do this through focusing upon a critical interrogation of two supermarkets' children's 'healthy' eating initiatives; a supermarket own-brand range of children's 'healthy' food products; and a supermarket in-store 'healthy' food tour. The emergent geographies of embodied responsibility illustrate a deferral of responsibility from supermarkets to parents. This is problematic because it conversely excludes the possibilities for the child to be a consumer on the grounds that they are irresponsible and incapable of engaging with 'healthy' food. We suggest that this implied model of responsibility, which conceptualises responsibility as contained within the individual, is unhelpful because of its exclusivity and suggest that a collective notion of responsibility is necessary to understand fully the relations of responsibility that exist between bodies. This opens up possibilities for a more nuanced account of the 'child' consumer and the relationships that children have with 'healthy' food. [ABSTRACT FROM AUTHOR]

Summary The paper tracks the history of the School Medical Service over 150 years. The service has changed markedly during this period, with some cyclical recurrence of practice and policy. By 2006, the health of schoolchildren is of major concern, particularly the rise in nutrition-related problems including obesity: the demise of the School Health Service may welt be a matter for serious regret to future generations. [ABSTRACT FROM AUTHOR]

The article reports on a study to estimate the prevalence of obesity in children below 11 years old in Great Britain and makes suggestions on the proper level of reporting. It is suggested that the data to be collected should only be the date of birth, the date of measurement, gender, height and weight. It is recommended that a universal measurement of children ages 9 to 10 be done once a year as a classroom educational activity. Teachers and classroom assistants, with the support of school nurses, should conduct the measurements. The data should only be reported to the primary care trusts.

Summary: Short sleep appears to elevate obesity risk in youth; however, sleep is a multidimensional construct, and few studies have investigated parameters beyond duration. The objective of this study was to investigate if sleep onset time, duration, latency and night waking frequency are independently associated with adiposity and weight status in UK adolescents. This was a cross‐sectional observational study of 10,619, 13–15 years olds. Adjusted linear and logistic regressions were used to investigate associations of self‐reported sleep characteristics with adiposity markers (body mass index z‐score and percent body fat) and weight status. Compared with a sleep onset before 10pm, later sleep timing was associated with higher adiposity and higher likelihood of overweight and obesity in boys (after midnight, odds ratio [95% confidence interval]: 1.76 [1.19–2.60]) and girls (between 11pm and 11:59pm: 1.36 [1.17–1.65]). Sleeping ≤ 8 hr, compared with > 9–10 hr, was associated with higher odds of overweight and obesity in both sexes (boys: 1.80 [1.38–2.35]; girls: 1.38 [1.06–1.79]), and so too was sleeping > 10 hr in girls (1.31 [1.06–1.62]), indicating evidence for a U‐shaped association. Also in girls, compared to a sleep latency of 16‐30 min, sleep latencies ≥ 46 min were associated with higher adiposity (46–60 min, beta coefficient [95% confidence interval], percent body fat: 1.47 [0.57–2.36]) and higher likelihood of overweight and obesity (46–60 min: 1.39 [1.05–1.83]), and often as opposed to never waking in the night was associated with higher adiposity (body mass index z‐score: 0.24 [0.08–0.41]; percent body fat: 1.44 [0.44–2.44]). Sleep duration and timing in both sexes, and sleep quality in girls, appear to be independently associated with adiposity and weight status in adolescence, and may be important targets for obesity prevention. [ABSTRACT FROM AUTHOR]

Objective: To explore the effect of maternal BMI class pre-pregnancy (overweight/obese v. healthy weight/underweight) on childhood diet quality and on childhood overweight/obesity risk. Design: Dietary data were collected using 3-d parental-completed food records for their children at ages 18 and 43 months. An index of diet quality was derived by classification of food items into core and non-core foods. Adjusted multiple linear regression analyses were used to explore the effect of maternal BMI class on diet quality in their children. Setting: Avon, UK. Participants: A 10% subsample of the Avon Longitudinal Study of Parents and Children. Nine-hundred and eighty children provided complete dietary data at 18 months and 769 at 43 months. Results: Children with overweight/obese mothers consumed greater amounts of energy from non-core foods than children with healthy weight/underweight mothers (0·20 MJ (48 kcal)/d more at 18 months (P < 0·001); 0·19 MJ (45 kcal)/d more at 43 months (P = 0·008)) in adjusted models. Diet quality deteriorated between 18 and 43 months (children reduced their dietary energy intake from core foods (P < 0·001) and increased intake from non-core foods (P < 0·001)). However, this change was not associated with maternal BMI class in adjusted models. Having an overweight/obese mother was associated with an increased odds of the child being overweight/obese at 43 months (OR 1·74 (1·17, 2·58)). Conclusions: Children aged 18 and 43 months with overweight/obese mothers are likely to have a poorer quality diet than those with healthy/underweight mothers. Parents should be supported in discouraging the consumption of non-core foods in children at these ages. [ABSTRACT FROM AUTHOR]

Background: Higher childhood body mass index (BMI) has been associated with an increased risk of multiple sclerosis (MS). Objective: To evaluate whether childhood BMI has a causal influence on MS, and whether this putative effect is independent from early adult obesity and pubertal timing. Methods: We performed Mendelian randomization (MR) using summary genetic data on 14,802 MS cases and 26,703 controls. Large-scale genome-wide association studies provided estimates for BMI in childhood (n = 47,541) and adulthood (n = 322,154). In multivariable MR, we examined the direct effects of each timepoint and further adjusted for age at puberty. Findings were replicated using the UK Biobank (n = 453,169). Results: Higher genetically predicted childhood BMI was associated with increased odds of MS (odds ratio (OR) = 1.26/SD BMI increase, 95% confidence interval (CI): 1.07–1.50). However, there was little evidence of a direct effect after adjusting for adult BMI (OR = 1.03, 95% CI: 0.70–1.53). Conversely, the effect of adult BMI persisted independent of childhood BMI (OR = 1.43; 95% CI: 1.01–2.03). The addition of age at puberty did not alter the findings. UK Biobank analyses showed consistent results. Sensitivity analyses provided no evidence of pleiotropy. Conclusion: Genetic evidence supports an association between childhood obesity and MS susceptibility, mediated by persistence of obesity into early adulthood but independent of pubertal timing. [ABSTRACT FROM AUTHOR]

• Food advertising regulation a contentious policy issue. • Framing strategies used by policy actors important to capture for policy analysis. • Policy actors use different moral frameworks to support or oppose policies. • Tension between children's rights and industry rights moral frameworks identified. Exposure to advertising of food and beverages high in fat sugar and salt (HFSS) is considered a factor in the development of childhood obesity. This paper uses framing analysis to examine the strategic discursive practices employed by non-industry and industry responders to the Committee of Advertising Practice's consultation responses (n = 86) on UK regulation of non-broadcast advertising of foods and soft drinks to children. Our analysis demonstrates non-industry and industry responders engaged in a moral framing battle centred on whose rights were deemed as being of greatest importance to protect: children or industry. Both industry and non-industry responders acknowledged that childhood obesity and non-broadcast advertising were complex issues but diverged on how they morally framed their arguments. Non-industry responders employed a moral framework that aligned with the values represented in social justice approaches to public health policy, where children were identified as vulnerable, in need of protection from harmful HFSS product advertising and childhood obesity was a societal problem to solve. In contrast, industry responders emphasised industry rights, portraying themselves as a responsible industry that is victim to perceived disproportionate policymaking, and values more closely aligned with a market justice approach to public health policy. Our analysis provides detailed insights into the framing strategies used in the policy debate surrounding the non-broadcast advertising of HFSS foods to children. This has relevance as to how advocacy organisations can develop counter-framing to industry frames which seek to limit effective regulation. [ABSTRACT FROM AUTHOR]

Background: Poor and variable implementation of childhood obesity prevention programmes reduces their population impact and sustainability. We drew upon ethnographic work to develop a multi-level, theory-based implementation optimisation intervention. This intervention aimed to promote parental enrolment and attendance at HENRY (Health Exercise Nutrition for the Really Young), a UK community obesity prevention programme, by changing behaviours of children's centre and local authority stakeholders.Methods: We evaluated the effectiveness of the implementation optimisation intervention on HENRY programme enrolment and attendance over a 12-month implementation period in a cluster randomised controlled trial. We randomised 20 local government authorities (with 126 children's centres) to HENRY plus the implementation optimisation intervention or to HENRY alone. Primary outcomes were (1) the proportion of centres enrolling at least eight parents per programme and (2) the proportion of centres with a minimum of 75% of parents attending at least five of eight sessions per programme. Trial analyses adjusted for stratification factors (pre-randomisation implementation of HENRY, local authority size, deprivation) and allowed for cluster design. A parallel mixed-methods process evaluation used qualitative interviews and routine monitoring to explain trial results.Results: Neither primary outcome differed significantly between groups; 17.8% of intervention centres and 18.0% of control centres achieved the parent enrolment target (adjusted difference - 1.2%; 95% CI - 19.5%, 17.1%); 17.1% of intervention centres and 13.9% of control centres achieved the attendance target (adjusted difference 1.2%; 95% CI - 15.7%, 18.1%). Unexpectedly, the trial coincided with substantial national service restructuring, including centre closures and reduced funds. Some commissioning and management teams stopped or reduced delivery of both HENRY and the implementation optimisation intervention due to competing demands. Thus, at follow-up, HENRY programmes were delivered to approximately half the number of parents compared to baseline (n = 433 vs. 881).Conclusions: During a period in which services were reduced by external policies, this first definitive trial found no evidence of effectiveness for an implementation optimisation intervention promoting parent enrolment to and attendance at an obesity prevention programme.Trial Registration: ClinicalTrials.gov NCT02675699 . Registered on 4 February 2016. [ABSTRACT FROM AUTHOR]

Background: In the United Kingdom, rates of childhood obesity are high and inequalities in obesity have widened in recent years. Children with obesity face heightened risks of living with obesity as adults and suffering from associated morbidities. Addressing population prevalence and inequalities in childhood obesity is a key priority for public health policymakers in the United Kingdom and elsewhere. Where randomized controlled trials are not possible, potential policy actions can be simulated using causal modeling techniques. Objectives: Using data from the Southampton Women's Survey (SWS), a cohort with high quality dietary and lifestyle data, the potential impact of policy‐relevant calorie‐reduction interventions on population prevalence and inequalities of childhood obesity was investigated. Methods: Predicted probabilities of obesity (using UK90 cut‐offs) at age 6–7 years were estimated from logistic marginal structural models adjusting for observed calorie consumption at age 3 years (using food diaries) and confounding. A series of policy‐relevant intervention scenarios were modeled to simulate reductions in energy intake (differing in effectiveness, the targeting mechanisms, and level of uptake). Results: At age 6–7 years, 8.3% of children were living with obesity, after accounting for observed energy intake and confounding. A universal intervention to lower median energy intake to the estimated average requirement (a 13% decrease), with an uptake of 75%, reduced obesity prevalence by 1% but relative and absolute inequalities remained broadly unchanged. Conclusions: Simulated interventions substantially reduced population prevalence of obesity, which may be useful in informing policymakers. [ABSTRACT FROM AUTHOR]

Energy-dense food advertising affects children's eating behaviour. However, the impact of high-sugar food advertising specifically on the intake of sweet foods is underexplored. This study sought to determine whether children would increase their intake of sugar and total energy following high-sugar food advertising (relative to toy advertising) and whether dental health, weight status and socio-economic status (SES) would moderate any effect. In a crossover, randomised controlled trial, 101 UK children (forty male) aged 8–10 years were exposed to high-sugar food/beverage and toy advertisements embedded within a cartoon. Their subsequent intake of snack foods and beverages varying in sugar content was measured. A dental examination was performed, and height and weight measurements were taken. Home postcode provided by parents was used to assign participants to SES quintiles. Children consumed a significantly greater amount of energy (203·3 (95 % CI 56·5, 350·2) kJ (48·6 (95 % CI 13·5, 83·7) kcal); P = 0·007) and sugar (6·0 (95 % CI 1·3, 10·7) g; P = 0·012) following food advertisements compared with after toy advertisements. This was driven by increased intake of the items with most sugar (chocolate and jelly sweets). Children of healthy weight and with dental caries had the greatest intake response to food advertising exposure, but there were no differences by SES. Acute experimental food advertising exposure increases food intake in children. Specifically, high-sugar food and beverage advertising promotes the consumption of high-sugar food items. The debate around the negative health effects of food advertising on children should be widened to include dental health as well as overall dietary health and obesity. [ABSTRACT FROM AUTHOR]

Background: Community-based obesity prevention interventions are often commissioned despite the limited evidence base. HENRY (Health, Exercise, Nutrition for the Really Young) is a programme delivered to parents of preschool children across the UK. Early evidence suggests that it may be effective, but a robust evaluation has not been conducted. We initiated a systematic evaluation of HENRY by studying the feasibility of conducting a multi-centre definitive trial to evaluate its effectiveness and cost-effectiveness to prevent obesity. Objectives were to assess the feasibility of recruiting local authorities, centres and parents; test processes and time required to train and certify intervention staff; explore HENRY commissioning processes; identify potential sources (and associated impact) of contamination; and consider the feasibility of trial procedures. Methods: We conducted a multi-centre, open labelled, two group, prospective, cluster randomised, controlled, feasibility study, with embedded process evaluation and pre-defined criteria for progression to definitive trial. We sought to recruit 120 parents from 12 children's centres, across two UK local authority (government) areas. Within each local authority, we planned to randomise three centres to HENRY and three to 'standard care' control. Our plan was to collect data in family homes at baseline and 12 months, including parent and child height and weight, and parent-reported questionnaires on self-efficacy, feeding, eating habits, quality of life and resource use. Contamination, implementation and study acceptability were explored using parent interviews. Results: We recruited two local authorities and 12 children's centres within eight months. One hundred and seventeen parents were recruited (average 3.9 parents per programme) and follow-up data were collected from 85% of participants. Process data from 20 parents and 24 members of staff indicate that both would benefit from more detail about their involvement as participants, but that methods were acceptable. Contamination was likely, though the impact of this on behaviour was unclear. Conclusion: Our findings indicate that a cluster RCT of HENRY to assess its effect on childhood obesity prevention is feasible. This study has allowed us to design a pragmatic definitive trial with minimal bias, taking account of lessons learnt from conducting evaluation research in public health settings. Trial registration: ClinicalTrials.gov Identifier NCT03333733 registered 6th November 2017. [ABSTRACT FROM AUTHOR]