National Assembly for Wales

Children and Young People Committee

CO 42

Inquiry into Childhood Obesity

 

Evidence from : Public Health Wales

1.     Context for response:

Obesity is an important population health problem

The following table describes the relative risks for some diseases in obese individuals: obesity confers a several hundred percent greater absolute risk for some already common diseases.

 

The next table describes the ‘Population Attributable Fraction’ of obesity in some common diseases – ie the proportion of each disease which could be prevented if obesity was eliminated. Obviously elimination of obesity is unrealistic, but as the relationship between obesity and disease risk is generally proportional it does suggest that substantial reductions in the burden of disease could be made with reductions in obesity:

 

Population Attributable Fraction

Population Attributable Fraction

Disease

Men (% )

Women (% )

Angina pectoris

15.0

17.2

Colon cancer

30.6

30.7

Gall bladder diseases

15.0

17.2

Hypertension

26.0

45.4

Myocardial infarction

9.9

36.6

Osteoarthritis

16.5

9.4

Ovarian cancer

n/a

15.4

Stroke

6.2

7.2

Type 2 Diabetes

48.0

75.3

 

The cost of obesity to the NHS in Wales has been documented in a 2011 report for Welsh Government [1] . Obesity was estimated to cost the NHS in Wales over £73 million per annum, with hospitalisation costs at around £3.5 million per annum. Assuming costs for ABHB residents are pro rata for population (although obesity rates in ABHB are slightly higher than the all Wales levels), the overall costs to the NHS for obesity in ABHB is around £14.6 million, and for hospitalisation in ABHB residents is around £700,000.

Being overweight or obese in childhood has negative consequences for health in both the short term and the longer term. Although many of the most serious consequences may not become apparent until adulthood, the effects of obesity can be identified in obese children and adolescents. For example, type 2 diabetes, previously considered an adult disease, has increased in overweight children. Other health risks of childhood obesity include early puberty, eating disorders such as anorexia and bulimia, skin infections, asthma and other respiratory problems. Some musculoskeletal disorders are also more common, including slipped capital femoral epiphysis (SCFE) and tibia vara (Blount disease).

In addition to the physical harms to children, the emotional and psychological effects of bei

style='margin-bottom:12.0pt;line-height:115%'> Display nutritional content and calories in chain restaurants menus

Ensure communities are able to make informed choices about food , have appropriate access to a variety of affordable nutritious  food and have the skills and knowledge to prepare food.

Increase uptake of Healthy Options Award in all food retail outlets

European Union Common Agricultural Policy

Marketing - larger supermarkets

 

Local Authority, takeaways and cafes popular with families

Welsh Government

 

Welsh Government and local authorities – school curriculum, Flying Start and parenting initiatives 

Health Boards – Nutrition Skills for Life nutrition training in communities

Public Health Wales – local food poverty agenda 

 

Low levels of physical activity

Ensure health is on environment and planning curricula

Mandatory Health Impact Assessment

Wide choice of physical activity opportunities provided and promoted in local communities

Specific measures to make walking and cycling the easiest and fastest option for short journeys

Ensuring use of public transport is the cheapest and easiest option as an alternative to car use

Promote options for active travel

HIA on all community Infrastructure Levy agreements and Section 106 in Local Authority Planning departnments

Improve access to high quality green space in disadvantaged areas

Welsh Government in collaboration with Universities

 Welsh Government

 

Local Authority

 

Welsh Government/Local Authority/Employers

Local Authority/ Architects/Planners

 

 

Such actions would go some way to making it easier for people to live healthier lives, and to make healthy choices easy choices.  Welsh Government should also lobby the UK government on tax, subsidies, food labelling and most particularly in tackling the food industry head on, so that they are ultimately sanctioned against producing processed food with very high levels of sugar, salt and fat. 


[1] Phillips C J., Christie Harper, Jaynie Rance, Angela Farr (2011) Assessing the costs to the NHS associated with alcohol and obesity in Wales http://wales.gov.uk/about/aboutresearch/social/latestresearch/alcoholobesity/?lang=en

 

[2]Welsh Health Survey (2012), http://wales.gov.uk/topics/statistics/headlines/health2012/120919/?lang=en, [accessed 25 April 2013].

[3] Using a classification system based on the 85th and 95th percentiles of the 1990 UK BMI reference curves, and not comparable with estimates produced on a different basis or with adult estimates.

 

[4] Public Health Observatory for Wales (2010), Measuring Childhood heights and weights in Wales, National Public Health Service for Wales and the Wales Centre for Health.

Welsh Government (2010) The All Wales Obesity Care Pathway