How YHP is Contributing to the Fight Against Youth Obesity

In 2017, research that we commissioned from Imperial College London[1] showed a tenfold increase in obesity levels among young people over the past four decades. This worrying trend is often described as an ‘epidemic’. Clearly, we need to do more.  Existing measures to help young people make healthy choices are not enough – which is why the YHP is innovating to help individuals and societies act effectively.

The health impacts of childhood obesity are well-documented and range from the immediate to the very long term. At the psychological level obese children are more likely to be bullied by their peers[2]  and to suffer from lower self-esteem. The medical effects can range from sleep apnea, to gallstones and insulin resistance[3]  when young; whilst overweight children are at least twice as likely to become overweight adults compared with normal-weight children[4]. This can then lead to adult social disabilities, sleep apnea, diabetes, cancer and heart disease[5] among many other health effects.

Researching overweight and obesity in young people can be challenging, not least because the causes are often psychosocial and can vary considerably by country or region. One 2006 study found that young people with higher socio-economic status (SES) were more likely to be obese in China and Russia whilst in the United States obesity is associated with low SES groups[6]. Young people also change fast and tracking them from infancy to old age requires large sample sizes and considerable time. Even the definitions of obesity vary, with for example Japan using cutoffs for schoolchildren based on percentage overweight (POW) rather than body mass index (BMI)[7].

The Imperial College London research, published in The Lancet, provided key data on the scale and trends of childhood obesity by drawing on an information pool of 2,416 population-based studies with almost 130 million participants aged 5 years and older, including over 30 million young people aged 5–19 years.

This showed that, whilst the upward global trend was clear, obesity rates increased from 0.7% to 5.6% in girls and from 0.9% to 7.8% in boys between 2007 and 2016, this masked some quite different regional trends. Increases in mean body mass index (BMI) have recently flattened in north-western Europe and the high-income English-speaking and Asia-Pacific regions. By contrast, the rise in BMI has accelerated in east and south Asia. There are also differences by sex; for example, obesity in central and Andean Latin American girls seems to have plateaued, whilst it has accelerated in southeast Asia for boys.

This research has fulfilled a major need for researchers – being cited over 300 times in other papers in the first year since its release and becoming the 7th most discussed journal article of any type in 2017[8].

The YHP also supported the Population Reference Bureau’s new Youth and NCDs Data Center which launched at the October 2018 UN General Assembly and pulled together risk factor data for non-communicable diseases in young people from over 200 countries from the Global School-Based Student Health Survey, the Global Youth Tobacco Survey, and the Health Behaviour in School-Aged Children Study into one easy-to-access package.

The data can be viewed in map, tabular, trend line and bar chart formats by country, gender, and age or age groups.

Whilst this research is useful for researchers and policy-makers it still begs the question of how young people can be better supported to make healthy choices and live healthy lives. Here too the YHP has been active in experimenting with new approaches throughout the world.

Whilst many studies have been undertaken on the effectiveness of such programmes their size has often made it difficult to draw conclusions - although analysis suggests programmes grounded in social learning may be more appropriate for girls, while structural and environmental interventions enabling physical activity may be more effective for boys[9].

Our approach has been to trial both formal schools-based programmes and less structured ones to identify how we can work best with our in-country partners to deliver results.

YHP Canada’s ‘At My Best’ programme has been running since 2012, and reaches more than 100,000 Canadian young people each year, through a curriculum in 4500 primary schools that is focused on healthy eating, physical activity and emotional wellness.

YHP Romania’s Eating. Health. Sport. Prevention. programme has run since 2013, and again works closely with schools – although this time with 15-19 year-olds in 100 high schools. This includes a classroom course in which students set goals for a healthy life, including physical activities and eating habits. It also set up sports clubs (under the title ‘I <heart> Sport’) ‘by students, for students’ to help them to do more physical activities and to promote sport events.

For YHP Turkey’s Hey Youth Take Action the focus is again on schools, with workshops and seminars to highlight the issues. It then hands control to the students encouraging them to form groups and make videos under the supervision of their physical education (PE) teachers and school counsellors, with prizes awarded for the best entries. Pre- and post-tests monitor the change in students’ level of awareness.

YHP Spain has, since 2012, taken a more workshop-based approach running events in schools and the community to provide advice and information but crucially also focusing on building adolescents’ self-esteem, and educating them about their physical and emotional development.

Finally, YHP Australia’s is working to bring kitchen gardens to secondary schools to give students a hands-on experience of growing vegetables and fruit and so developing their understanding and uptake of healthy eating.

This approach of equipping and motivating policy makers and developing and proving on-the-ground solutions is at the heart of the YHP approach and we hope will help to turn the tide on youth obesity.
 

[1] Abarca-Gómez L, Abdeen ZA, Hamid ZA, 2017, Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016, The Lancet, Volume 390, Issue 10113, 16–22 December 2017, Pages 2627-26428

[2] Griffiths L J, Wolke D,  Page AS, et al  1999, Obesity and bullying: different effects for boys and girls,  International Journal of Obesity 23, Suppl 2, S2±S11

[3] Must A and Strauss RS, 1999, Risks and consequences of childhood and adolescent obesity, International Journal of Obesity (1999) 23, Suppl 2, S2±S11

[4] Singh AS, Mulder C, Twisk JWR, et al, 2008, Tracking of childhood overweight into adulthood: a systematic review of the literature, Obesity Reviews 2008 Sep;9(5):474-88

[5] George A. Bray, 2004, Medical Consequences of Obesity,
The Journal of Clinical Endocrinology & Metabolism.
 2004 Jun;89(6):2583-9.

[6] Wang Y, 2001, Cross-national comparison of childhood obesity: the epidemic and the relationship between obesity and socioeconomic status, International Journal of Epidemiology, Volume 30, Issue 5, 1 October 2001, Pages 1129–1136,

[7] Shirasawa T, Ochiai H, Nanri H et al, 2015, Trends of Underweight and Overweight/Obesity Among Japanese Schoolchildren From 2003 to 2012, Defined by Body Mass Index and Percentage Overweight Cutoffs, Journal of Epidemiology 2015; 25(7): 482–488.

[8]  Altmetric, Top 100 articles 2017. Available at  https://www.altmetric.com/top100/2017/#list [accessed 3 October 2018].

[9] Kropsk JA, Keckley PH, Jensen GL, 2008, School‐based Obesity Prevention Programs: An Evidence‐based Review, Obesity, Volume16, Issue5, May 2008, Pages 1009-1018