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EDITORIALS: Billie Giles-Corti and Jo Salmon Encouraging children and adolescents to be more active BMJ 2007; 335: 677-678 [Full text]

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Working harder together to tackle obesity

Shalini Pooransingh   (12 October 2007)

Encouraging Children, Adolescents, or Adults?

Simon J Howard   (19 October 2007)

Working harder together to tackle obesity 12 October 2007
Shalini Pooransingh, Locum Consultant in Public Health Medicine Walsall Teaching PCT, Jubilee House, Bloxwich Lane, Walsall WS2 7JL Send response to journal: Re: Working harder together to tackle obesity	Editors, We agree with Giles- Corti and Salmon(1) about a multi component interventions approach to tackling exercise levels in children and adolescents, particularly its emphasis on involving parents and families. In fact this is the basis of health promotion strategies (2)which recognize the need for healthy public policy, supportive environments, strong community action, personal skill development and a reorienting of health services which may all be necessary to effect change. Our interest in this editorial stems from the fact that in Walsall we engaged in measuring children on a pilot basis in 2006 (3) before Department of Health (DoH) stipulated that these measurements ought to be done routinely. 1904 children were measured in reception year and years 6, 7 and 10. This equated to 11% of all school children in those years. There were 6% opt outs and those who were absent or withdrew were from higher years and were found to be obese from previous measurements. We would like to share the findings from this pilot. Six out of eight schools returned evaluation forms and five of these (83%) reported that they clearly understood the aims of the project. Forty-eight younger children (26% response rate) returned evaluation questionnaires and of these, 58% didn’t know how they felt about being measured and 30% didn’t know why they were being measured. Many of the year 7s and 10s said they would have liked more information about the measurement process. Although DoH doesn’t recommend sharing results several children wanted to know their measurements and we support this because how can you engage people to take responsibility for their health without providing full information. Feedback recommended that there should be a coherent approach to tackling obesity across all agencies as it appears that the link between the healthy schools initiative and the measurement process was not being made by some participants. We therefore need to work harder together because despite all initiatives over the years it appears that children still don’t understand why they were being measured. We have identified another key group of persons – parents as they are the ones who make decisions about foods available in the household and give permission and money for sporting and exercise related activities. Indeed Blair et al (4) report that maternal factors including maternal activity and television watching are associated with percentage body fat in children at 7 years of age. Dr Sam Ramaiah Director of Public Health Dr Shalini Pooransingh Locum Consultant in Public Health Medicine Walsall teaching PCT References (1)Giles- Corti B, Salmon J Encouraging children and adolescents to be more active Well evaluated complex interventions are still neededEditorial BMJ 2007; 335:677-8. (2)Donaldson LJ Donaldson PJ Essential Public Health Medicine Libra Pharm Limited 2000. (3)Evaluation of a Pilot Study to Monitor Childhood Obesity in Walsall Walsall tPCT August 2006. (4) Blair N, Thompson J, Black P et al Risk factors for obesity in 7 – year – old European children: the Auckland Birthweight Collaborative Study Arch Dis Child 2007; 92:866-871. Competing interests: None declared
Encouraging Children, Adolescents, or Adults? 19 October 2007
Simon J Howard, Medical Student Newcastle University Send response to journal: Re: Encouraging Children, Adolescents, or Adults?	Reading this editorial, in addition to the factors identified, I wonder if a good way to encourage children and adolescents to be more active is to target their parents rather than the children directly. Children pick up habits from their parents, and since it seems that parents now live more sedentary lifestyles than ever before, perhaps healthy habits are not being picked up at an early age. Furthermore, children would experience postivies parental habits consistently throughout their formative years, rather than variable levels of activity which may be experienced as the child moves through various schools, health services, and after-school activities. If parents were more active, perhaps their children would also be more active. Anecdotally, this appears to be the case - it would certainly make an interesting area for research, and may help us to better target limited resources in this area. Competing interests: None declared