Behind the headlines - P1 Obesity

A recent news story reported that 27% of P1 children measured in Shetland were at risk of being overweight or obese due to their BMI, giving Shetland the fifth highest rate of obesity in the UK.  Here we look behind the headline into how BMI is measured in children and what this story means for us.

All NHS Boards in Scotland provide a child health programme, through this programme children are offered routine reviews at various stages of their life. Height and weight measurements are collected at the Primary 1 review and the majority of Boards record results on the child health school system (CHSP School). The measurements recorded on CHSP School can be used to derive estimates of the prevalence of overweight and underweight children in Primary 1 in Scotland. In April these figures were released which concluded 27.1% of P1 children measured in Shetland from 2014/15 were at risk of overweight and obesity.  In previous years this figure has fluctuated between 19% and 24%.

So what does this actually mean?

Firstly the data - we know that ‘statistically speaking’ the increase in the number of children with a high BMI in one year may not be very significant because of our small population. However, the figures still show that over a quarter of the children in P1 last year had a problem with their weight when they were measured.

How were the children measured?

A child’s BMI is calculated differently from an adult’s - the measurements are taken by trained nurses who measure and plot a child’s weight and height using growth charts – similar to the ones used post-natally (commonly referred to as ‘little red book’).

These growth charts are developed by the Royal College of Paediatrics and Child Health (RCPCH) and have recently been updated. The BMI is calculated by plotting a child’s weight and height in relation to their age and establishing what ‘centile’ they are growing on.  The height and weight centiles are then compared with what would be average for a child of their age and gender.

A child whose weight is average for their height will have a BMI between the 25th and 75th centile.

A child who is overweight will have a BMI over the 91st , and a BMI over the 98th centile suggests obesity.  

Because of the different rates of growth, and how BMI is measured it is very difficult to ‘eye ball’ overweight children as it will depend on what stage of growth they are at whether they are a healthy weight for their size. It is important to remember that BMI is only one measure of health and should be used in conjunction with other assessments of lifestyle (such as physical activity, diet and fitness) - we try to build up a whole picture and help all children to make healthy choices.  

What do we do now?

However we interpret these figures the reality is that there is a problem with overweight and obesity in Shetland’s youngsters and adults. This is not an easy problem to tackle - in the western world obesity is one of the biggest causes of death and ill health. 

There are many reasons for putting on too much weight – in general we take in more calories that we burn i.e. we eat more and do less. Our bodies are built to store excess calories as fat and the longer this continues the more overweight people become.

Helping children learn to eat well and be active every day can help to build good habits for life. We know it not as simple as just telling people to ‘eat less, do more’ – if it was that straightforward there wouldn’t be a problem! However, there are some simple steps that might make it easier for children who are currently overweight or obese to make small changes towards a healthier lifestyle:

  1. Me -Size bowls:  Plates and bowls are bigger these days - a child-size portion may not look like enough. So try getting child-sized ones for the kids; it’ll make it easier to tell if they’re getting the right amount.
  2. Focus on your food: Eating distractedly, such as in front of the TV, means we eat more without noticing or even enjoying it. Swap the TV for the table.
  3. Snack time: Set a regular healthy snack time for mid-morning and afternoon when the kids are home. It helps train their bodies to think regular food is coming, making them less likely to overeat at meal times.
  4. Variety is the spice of life: Active kids are happy kids - they like to be running around and having fun. In fact, kids aged five to 16 need to do at least 60 minutes of physical activity that gets their heart beating faster than usual.

There are services and information available for individuals or families how need support or advice.  In each health centre there is the adult Counterweight’ programme to support people to achieve a healthy weight; and ‘Counterweight Families’ and the ‘SCOTT’ programme to help families and children in particular. You can find more information in our "Tots to Teens" pages, or get in touch with a member of the team.