Showing papers by "Tim Lobstein published in 2010"
TL;DR: The prevalence of overweight and obesity in children has increased worldwide and is associated with impaired health during childhood itself, including increased risk of hypertension, insulin resistance, fatty liver disease, orthopaedic dysfunction and psycho-social distress, which may continue untreated for many years.
Abstract: During the past two decades, the prevalence of overweight and obesity in children has increased worldwide. Excess fat in childhood is a risk factor for later adult disease and is associated with im...
531 citations
TL;DR: The ENERGY-project is an international, multidisciplinary effort to develop and test an evidence-based and theory-informed intervention program for obesity prevention among school-aged children.
Abstract: There is an urgent need for more carefully developed public health measures in order to curb the obesity epidemic among youth. The overall aim of the "EuropeaN Energy balance Research to prevent excessive weight Gain among Youth" (ENERGY)-project is the development and formative evaluation of a theory-informed and evidence-based multi-component school-based and family-involved intervention program ready to be implemented and evaluated for effectiveness across Europe. This program aims at promoting the adoption or continuation of health behaviors that contribute to a healthy energy balance among school-aged children. Earlier studies have indicated that school and family environments are key determinants of energy-balance behaviors in schoolchildren. Schools are an important setting for health promotion in this age group, but school-based interventions mostly fail to target and involve the family environment. Led by a multidisciplinary team of researchers from eleven European countries and supported by a team of Australian experts, the ENERGY-project is informed by the Environmental Research Framework for Weight gain Prevention, and comprises a comprehensive epidemiological analysis including 1) systematic reviews of the literature, 2) secondary analyses of existing data, 3) focus group research, and 4) a cross European school-based survey. The theoretical framework and the epidemiological analysis will subsequently inform stepwise intervention development targeting the most relevant energy balance-related behaviors and their personal, family-environmental and school-environmental determinants applying the Intervention Mapping protocol. The intervention scheme will undergo formative and pilot evaluation in five countries. The results of ENERGY will be disseminated among key stakeholders including researchers, policy makers and the general population. The ENERGY-project is an international, multidisciplinary effort to develop and test an evidence-based and theory-informed intervention program for obesity prevention among school-aged children.
107 citations
TL;DR: The methodology used, and the recommendations made, by the group tasked with inequalities in priority public health conditions are described, which provides a reasonably sound and pragmatic basis for evidence-based policy-making.
Abstract: Background In November 2008, the Secretary of State for Health (England) commissioned an independent review to propose effective strategies for reducing health inequalities. Review task groups were given just 3 months to make preliminary evidence-based recommendations. In this paper, we describe the methodology used, and the recommendations made, by the group tasked with inequalities in priority public health conditions. Methods A series of rapid literature reviews of the policy-relevant international evidence base was undertaken. Quantitative studies of any design, which looked at the effects on health inequalities, the social gradient or overall population health effects, of interventions designed to address the social determinants of selected public health priority conditions were examined. Recommendations were distilled using a Delphi approach. Results Five key policy proposals were made: reduce smoking in the most deprived groups; improve availability of and access to healthier food choices amongst low income groups; improve the early detection and treatment of diseases; introduce a minimum price per unit for alcohol and improve the links between physical and mental health care. Conclusion The combination of rapid review and Delphi distillation produced a shortlist of evidence-based recommendations within the allocated time frame. There was a dearth of robust evidence on the effectiveness and cost-effectiveness of the interventions we examined: our proposals had to be based on extrapolation from general population health effects. Extensive, specific and robust evidence is urgently needed to guide policy and programmes. In the meantime, our methodology provides a reasonably sound and pragmatic basis for evidence-based policy-making.
50 citations
05 May 2010
TL;DR: The by-product of a vastly changed society is that today’s children are not only less active, but are eating far too much of the wrong types of foods.
Abstract: The by-product of a vastly changed society is that today’s children are not only less active, but are eating far too much of the wrong types of foods. The frightening result has become an epidemic of children that are obese. In the past 20 years the number of obese children in the United States has doubled. In 1999, this meant 13 percent of children ages 6 to 11 and 14 percent of adolescents ages 12 to 19.
43 citations
TL;DR: Although applying taxes/subsidies could be useful to combat obesity, the study suggests that most stakeholders still need to be convinced of their viability and acceptability when compared with other measures.
Abstract: Background Obesity implies costs not only for the individual but also for society. The authors explore the opinions of stakeholders on the potential of taxes or subsidies, as measures for tackling obesity in Europe. Methods Structured interviews were conducted using Multicriteria Mapping, a computer-based, decision-support tool, with 189 interviewees drawn from 21 different stakeholder categories across nine members of the EU interviews, to appraise 20 predefined policy options aimed at reducing obesity, including 'taxing obesity-promoting foods' and 'subsidising healthy foods.' A four-step approach involved selecting options, defining criteria, scoring options quantitatively and weighting criteria to provide overall rankings of options. Interviews were recorded and transcribed to yield qualitative data. Results Compared with other policy options appraised, taxation and subsidies were not favourably received, mainly because they were considered difficult to implement. Overall, trade unions rated both options more favourably than all other stakeholder groups. As anticipated, both options received their lowest scores from representatives of the farming, food processing and advertising industries. Nutritional/obesity advisory experts and public sector caterers gave the most positive ratings to subsidies overall. Along with public health professionals, large commercial retailers were most in favour of taxation. Conclusions Taxation and subsidies were poorly appraised compared with other policy measures, with stakeholders expressing reservations mainly focussed on the practicalities and cost of introducing such measures. Although applying taxes/subsidies could be useful to combat obesity, the study suggests that most stakeholders still need to be convinced of their viability and acceptability when compared with other measures.
20 citations
TL;DR: An estimated 270 million Chinese are under the age of 15, some 20% of the total population, which is virtually impossible to estimate, but an estimate can be made through the series of China Health and Nutrition Surveys, which have been undertaken in 1991, 1993, 1997, 2000, 2004 and 2006.
Abstract: Less than a generation ago the prevailing image of China was one of a sleeping giant whose population lived mostly in rural communes but were starting to move into the rapidly growing industrial cities. In the countryside, adults worked manually and children walked to school. In the towns they rode bicycles to school and to work. Nobody was fat. Or nearly nobody. Following the launch of the ‘ one-child-per-family ’ policy in 1978 it has become clear that some Chinese children, especially among the better off households, were putting on a bit of weight. It seemed that an unintended consequence of the one-child policy was the creation of fatter children: doted upon by parents and grandparents these children were given all the treats available to a family with a rising income and a clear memory of deprived childhoods of the past. By the late 1990s there was rising concern that a new generation of children – dubbed ‘ xiao huangdi ’ or ‘ little emperors ’ (1) – was being pampered to the point of obesity. An estimated 270 million Chinese are under the age of 15, some 20% of the total population. Weighing and measuring this many children is virtually impossible, but an estimate can be made through the series of China Health and Nutrition Surveys, which have been undertaken in 1991, 1993, 1997, 2000, 2004 and 2006. Surveys are undertaken in areas that differ in respect of geography, urban development and income levels. The selected communities have been re-sampled in subsequent years. Data collected include measured anthropometric indicators from over 1 000 children in each survey. Rapid rise in child overweight
8 citations
TL;DR: This study explored stakeholders' viewpoints of labelling in two contrasting food cultures to see whether attitudes were influenced by sectoral interests and/or national context, and found agreement between some stakeholder groups in the two different countries.
Abstract: Background: Implementing a European Union (EU)-wide mandatory nutrition labelling scheme has been advocated as part a multi-pronged strategy to tackle obesity. The type of scheme needs to be acceptable to all key stakeholders. This study explored stakeholders? viewpoints of labelling in two contrasting food cultures (France and the UK) to see whether attitudes were influenced by sectoral interests and/or national context. Methods: Using Multi Criteria Mapping, a decision analysis tool that assesses stakeholder viewpoints, quantitative and qualitative data were gathered during tape-recorded interviews. In France and the UK, 21 comparable stakeholders appraised nutritional labelling with criteria of their own choosing (i.e. feasibility, societal benefits, social acceptability, efficacy in addressing obesity, additional health benefits) and three criteria relating to cost (to industry; public sector; individuals). When scoring, interviewees provided both optimistic (best case) and pessimistic (worst case) judgements. Results: Overall, mandatory nutritional labelling was appraised least favourably in France. Labelling performed worse under optimistic (best case) scenarios in France, for five out of eight sets of criteria. French stakeholders viewed labelling as expensive, having fewer benefits to society and as being marginally less effective than UK stakeholders did. However, French interviewees thought implementing labelling was feasible and would provide additional health benefits. British and French stakeholders made similar quantitative judgements on how socially acceptable mandatory labelling would be. Conclusions: There is agreement between some stakeholder groups in the two different countries, especially food chain operators. However, cultural differences emerged that could influence the impact of an EU-wide mandatory labelling scheme in both countries.
7 citations