The leveling off of rates may indicate that public health campaigns are actually starting to work…
A third of children in England are overweight/obese, finds a 20-year King’s College London study of electronic health records. But the rapid rise in prevalence may be starting to level off — at least in younger children — the findings indicate, although there are no grounds for complacency, warn the researchers.
They scrutinised the anonymised electronic healthcare records of more than 370,500 children, aged 2 to 15, who had accumulated more than half a million weight (BMI/body mass index) assessments, between them, over a period of 20 years (1993 to 2013).
The researchers wanted to track any changes in the prevalence of overweight and obesity over these two decades.
The children were patients at 375 general practices across England. Their anonymised health data had been entered into the UK Clinical Practice Research Datalink, a large database containing the health records of around 5.5 million patients registered with 680 general practices around the UK.
The analysis showed that between 1994 and 2003 the prevalence of overweight and obesity in all children increased by just over 8 percent each year. But the rate slowed substantially between 2004 and 2013 to 0.4 percent a year, suggesting that it may have levelled off, say the researchers.
Trends were similar for both boys and girls, but differed by age group.
Among the boys, the prevalence of overweight/obesity among 2-5 year olds ranged from around one in five (19.5 percent) in 1995 to one in four (26 percent) in 2007. Among 6-10 year olds, prevalence ranged from 22.6 percent in 1994 to 33 percent in 2011.
The highest figures were seen in 11-15 year olds, among whom the prevalence of overweight/obesity ranged from around one in four (26.7 percent) in 1996 to almost four out of 10 (37.8 percent) in 2013.
These patterns were similar among girls. The prevalence ranged from 18.3 percent in 1995 to 24.4 percent in 2008 among the youngest, and from 22.5 percent in 1996 to 32.2 percent in 2005 among 6-10 year olds.
Once again, the highest rates were among 11-15 year olds, ranging from 28.3 percent in 1995 to 36.7 percent in 2004 and 2012.
Overall, the increase in rates of overweight/obesity was significant for all age groups in the first decade of the study, but it was only significant in the second decade for 11-15 year olds.
Rates among this age group continued to rise in the second decade, albeit more slowly than in the first.
‘There are several possible theories for the recent stabilisation of childhood overweight and obesity rates,’ write the researchers. ‘One explanation may be that rates have reached a point of saturation.’ Alternatively, public health campaigns may actually be starting to work, they say.
In a linked editorial, Professor Julian Hamilton-Shield and Dr. Debbie Sharpe, of the University of Bristol, point out that the implications for such levels of teen obesity are ‘profound’ in terms of current and future health.
They go on to say that many of the techniques used by local authorities in England, who have assumed responsibility for obesity as part of their public health remit, are not based on strong evidence, and there is little in the way of outcomes data to determine how successful they are.
Furthermore, many parents and clinicians remain to be convinced that childhood obesity is a serious enough health concern, they say, suggesting that it may be time to revisit the idea of implementing a ‘fat tax.’
‘Thus far, we simply do not seem to have the tools to manage this problem effectively,’ write the editorialists. ‘The childhood obesity crisis in England is far from over, and our current weapons in the war against fat seem unlikely to provide the answer.’
They add: ‘The recent call to the chief medical officer to develop a ‘child obesity action group’ may prove a first step in what is likely to be a very long campaign.’
King’s College London News Release. Cornelia H M van Jaarsveld. Childhood obesity trends from primary care electronic health records in England between 1994 and 2013: population-based cohort study. Archives of Disease in Childhood, pub online Jan 29, 2015 doi:10.1136/archdischild-2014-307151.