Taffy Makaya, Rebecca Poole and Kavitha Rozario
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LIFESTYLE MODIFICATION PROGRAMMES
Introduction
Many healthcare providers and public health workers believe that the
focus of management strategies for childhood obesity should target lifestyle
interventions. An essential aspect of promoting such interventions is early,
accurate identification of overweight and obese children. In the UK the
National Child Measurement Program (NCMP) was established to identify
children at the start of school life. [34] This program involves measuring
children and providing comprehensive data on obesity among children.
Children are measured in the reception year, age 4 to 5 and in the final year of
primary school aged 11. The findings of the NCMP are used to inform local
planning and delivery of services for children and gather population-level
surveillance data to allow analysis of trends in weight. One of the key findings
of the NCMP for England is that there has been a strong positive relationship
between deprivation and obesity prevalence for children in each school year,
with obesity prevalence being significantly higher in deprived areas. The
prevalence of obesity is also found to be higher in urban areas than rural areas.
The following section focuses on the outcomes of various community and
government initiatives for weight-loss management in children in the UK.
MEND
One of the first, and probably most successful community weight
programmes, was the MEND (Mind, Exercise, Nutrition, Do it) program
study. The intervention was designed to be run by non-specialists in
community settings and was a family-based obesity intervention, aimed at
children aged 7-13 years, and it was funded by a variety of partners including
corporate organisations and government agencies. In a randomised controlled
study [35] obese children (BMI ≥ 98th percentile, UK 1990 reference data)
from five different sites in the UK were randomly assigned to intervention or
waiting list control (6-month delayed intervention). Parents and children in the
intervention group attended eighteen 2- hour group educational and physical
activity sessions. These sessions were held twice weekly in sports centres and
schools, followed by a 12-week free family swimming pass. Waist