Tackling childhood obesity and improving healthy lifestyles, especially for South Asian heritage children

 

Contact: Jane West – Jane.West@bthft.nhs.uk and Sally Barber – Sally.Barber@bthft.nhs.uk

Background

There is increasing evidence that for a given BMI South Asian children have greater total and central adiposity than White British children and are potentially more metabolically sensitive to body fat. These differences have been identified in children from the Born in Bradford cohort at birth but are not identified by BMI alone and require addition measure of adiposity.  Twenty five percent of South Asian (SA) children living in the UK are obese; this is almost 10% more than white British children. A recent search found that only five studies world-wide had tested the effectiveness of obesity prevention programmes for SA children. These studies had mixed results; all of the programmes were based in schools and they included little or no parental involvement.

Aims

This project aims to improve the understanding of the risk of being overweight and obese in South Asian children as they grow up, to develop culturally appropriate interventions to prevent obesity, for South Asian children and improve healthy lifestyles for all children.

Progress

1)   School nurses have been trained to take additional measures of triceps and subscapular skin fold thickness in addition to routine height and weight measurements. Early findings suggest that despite having a lower weight and BMI, Pakistani children have similar subscapular skinfold thickness suggesting potentially greater relative central adiposity. This is an important finding which may help us develop more appropriate guidelines for child growth and reduce health inequalities for ethnic minority groups. School nurse teams were trained to take research quality measures of adiposity and visited 141 schools and almost 7000 children over three consecutive school years between 2012 and 2015.

2)   An NIHR Programme Development Grant application has been successful.  This grant will use qualitative and quantitative methodologies to explore whether it would be feasible to work with Islamic Religious Setting to develop and deliver an obesity prevention intervention for children of Islamic faith.

3)   Two feasibility controlled trials of using height adjustable desks in primary school classrooms to reduce sedentary time have been completed.  The studies were the first of its kind in Europe and found promising results with children’s sitting time reduced by 81 minutes per day.  Following the success of the first study the desk manufacturers Ergotron re-designed desks making them smaller so that every child could have their own sit-stand desk for the second study.  Interviews/focus groups with teachers and children from the second study have provided ideas to improve implementation in classrooms. 

4)   A pilot trial of using the height adjustable desks (Stand Out in Class study) is underway and is funded by NIHR Public Health Research, collaborators and the University of Loughborough and Leicester Trials Unit

Plans

We have now started repeat measurements of the same BiB children in Year 3 classes. These will be collected for school years 2015/16, 2016/17 and 2017/18 which are the three years that include the majority of BiB children. We are also collecting bioimpedance alongside these repeat measurements which will allow us to more accurately estimate body fatness.  For those children whose parents give consent, we will also be collecting a blood sample and measuring physical activity using accelerometry and questionnaire, and diet using a questionnaire.

Publications

• Bryant M, Sahota P, Santorelli G, Hill A, Wright J. An exploration and comparison of food and drink availability in homes in a sample family of White and Pakistani origin within the UK.   Public Health Nutrition 2015 18.7: 1197-205.

·       Sahota P, Greenwood D, Bryant MJ, Wright J.  Ethnic Differences in dietary intake at age 12 and 18 months: The Born in Bradford 1000 Study. Public Health Nutrition 2015

 

·       Clemes S, Barber SE, Bingham DD, Ridgers ND, Fletcher E, Pearson N, Salmon J, Dunstan DW Reducing children’s classroom sitting time using sit-to-stand desks: findings from pilot studies in UK and Australian primary schools. Journal of Public Health 2015;doi: 10.1093/pubmed/fdv084

 

·       Barber SE, Jackson C, Hewitt C, Ainsworth HR, Buckley H; Akhtar S, Bingham DD, Routen AC, Summerbell CD, Richardson G; Moore HJ, Pickett KE; O'Malley, C, Brierley S, Wright J. Assessing the Feasibility of Evaluating and Delivering a Physical Activity Intervention for Pre-school Children: A Pilot Randomised Controlled Trial.  BMC Pilot and Feasibility Studies 2016; 2:12

·       Bingham DD, Collings PJ, Clemes SA, Costa S, Santorelli G, Griffiths P and Barber SE. Reliability and Validity of the Early Years Physical Activity Questionnaire (EY-PAQ).  Sports 2016;4:30

 

·       Bingham DD, Costa S, Hinkley T, Shire KA, Clemes SA, Barber SE.  Physical activity during the early years. A systematic review of correlates and determinants.  Am J Prev Med 2016; 51(3):384-402. doi: 10.1016/j.amepre.2016.04.022.

 

·       Bingham DD, Costa S, Clemes SA, Routen AC, Moore HJ and Barber SE. Accelerometer data requirements for reliable estimation of habitual physical activity and sedentary time of children during the early years - a worked example following a stepped approach. Journal of Sport Science 2016;Feb 26:1-6

 

·       Collings PJ, Ball HL, Santorelli G, West J, Barber SE, McEachan RR, Wright J. Sleep Duration and Adiposity in Early Childhood: Evidence for Bidirectional Associations from the Born in Bradford Study.  SLEEP 2016 Nov 14.

 

·       Collings PJ, Brage S, Bingham DD, Costa S, West J, McEachan RR, Wright J, Barber SE. Physical Activity, Sedentary Time, and Fatness in a Biethnic Sample of Young Children. Med Sci Sports Exerc 2017.

 

·       Barber SE, Kelly B, Collings PJ, Nagy L,Bywater T, Wright J. (2017). Prevalence, trajectories and determinants of television viewing in an ethnically diverse sample of children from the UK. IJBNPA- in press