Obesity reduction Angela Jones Consultant in Public Health

Obesity reduction Angela Jones Consultant in Public Health Cwm Taf Public Health Team 24 April 2013

Evolution of obesity. . . Male Female 1960 (% obese) 1% Obese 2010 (% obese) 25% Obese 27% Obese 2050* (% obese) 60% Obese 50% Obese * Foresight Report, 2007

Health risks of obesity • Risk factor for chronic diseases – osteoarthritis, type II diabetes, heart disease • Risk factor for many cancers • Complications of pregnancy • Infertility • Social and psychological consequences – stigma, depression, low self esteem • Economic impact – greater than smoking

Maternal obesity Risks for mother • Maternal death or severe morbidity • Cardiac disease • Miscarriage • Pre-eclampsia • Gestational diabetes • Thromboembolism • Increased Caesareans • Anaesthetic challenges • Infection from other causes/sites Risks for foetus/child • Stillbirth • Neonatal death • Congenital anomalies • Prematurity • Macrosomia (high birth weight 4000 g+) • Lower breastfeeding rates • Increased risk of obesity and metabolic disorders in childhood • More likely to need neonatal

Body weight Balance Energy Intake = Diet Energy Expenditure = Physical activity Bodyweight

Risks of inactivity Coronary Heart Disease (20 -35%) Diabetes (30 -40%) Musculoskeletal problems (30%) Mental illness (20 -30% depression, dementia, distress) Cancer (20% breast, 30% colon) Infection Costs: £ 5. 5 billion in sickness absence £ 1 billion premature death of working age £ 1. 6 billion to NHS in UK

Causes of Obesity Societal influences and Biology individual psychology Activity: Food and environment and consumption physical Adapted from Foresight systems map, 2007

Increasing physical activity Areas of Influence • Schools • Increasing physical activity – especially girls • Curriculum – nutrition and cooking skills • Health Schools Scheme • Communities • Programmes and strategies • Planning – S. 106 • Share successful initiatives • Role of leaders/role models

Food and the Environment • • • Strategic action plan for nutrition in Wales Exploit “Grow your own” Healthy Options Award – Local Authority leadership Fast foods near schools EHO role in promoting healthy choices Research around food labelling changes Franchising contracts for public events Healthy Cities – Swansea + Cardiff Planning legislation

Mapping food outlets Map food outlets throughout Wales • Food premises need to be registered – Take away – Fruit and vegetables – Healthy options • Mapping could be explored for correlation with • Deprivation • Obesity • Proximity and density near schools.

Active Transport • Model of healthy school e. g. Pontypridd High School • Maximise opportunities for active travel through the use of Section 106 agreements with Local Planning Authorities • Increase level of active transportation and links to public transport e. g. safe bike parks at train and bus stations. • Increase road safety awareness • Targeted approach to those in greatest need • Role of workplaces: promotion, shower facilities

Role of Local Authority Planning • • • Opportunities to influence – policies & guidance Health Impact Training for planners, members Health improvement through the use of S. 106 Gloucestershire Active Planning Toolkit Include in regeneration schemes. Link in health with Highways Authorities – transport survey Targeting schemes in areas of greatest deprivation and around schools Domestic dwelling design National Guidance on protecting “Green Space” Tension between people/environment. Tension between economic recovery/burden legislation.

Legislation • Welsh Government support would be needed to enable local authorities to implement change • Look at policy and legislation in other countries that has impacted on lifestyle changes • Significant opportunities to legislate with the Public Health Bill and the New Planning legislation.

Workshop Map food outlets – Take away – Fruit and vegetables – Healthy options • Correlation – Deprivation – Obesity – Proximity/density near schools.

Workshop Will Local Authority databases hold the data? What data on obesity could be used? At what geographical level could it be used? How could the data be used in LAs to promote change? • What would be needed from others to support this? • • • Health Boards • Public Health • Welsh Government