It is my pleasure as the new Chief Executive of safefood to welcome you to this edition of All-island Obesity News.
Presentations from the most recent All-island Obesity Action Forum workshop are now available on the event page. Hosted by safefood, the Health Service Executive and the Public Health Agency, the workshop addressed Maternal Obesity and highlighted the implications of maternal obesity and current interventions on the island of Ireland. The next workshop will be held on the 11th November 2014 in the Gibson Hotel in Dublin.
This edition is once again packed full with news, events, research updates and training opportunities and as usual, the first section contains information directly submitted by Forum members including a spotlight piece from the Centre of Excellence for Public Health, Northern Ireland. I would encourage you to circulate All-island Obesity News among your colleagues and to share your work via this publication by submitting any relevant news items to Laura Keaver at email@example.com
Chief Executive, safefood and Chair, All-island Obesity Action Forum
Minutes of Forum meetings, events and further details about the Forum can be accessed on the All-island Obesity Action Forum webpage
What's in this issue?
If you would like to subscribe to or include any information in this bi-monthly e-bulletin please email us at firstname.lastname@example.org.
The effectiveness of weight management interventions in breastfeeding women
The postpartum period is a vulnerable time-point for excess weight retention, particularly for the increasing number of women who are overweight at the start of their pregnancy and subsequently find it difficult to lose the additional weight gained during pregnancy. While postpartum weight management interventions play an important role in breaking this potentially vicious cycle of weight gain, the effectiveness of such interventions in breastfeeding women is unclear. A recent systematic review published in Birth examined the effectiveness of weight management interventions (diet and/or exercise) on weight loss in breastfeeding women. The review which was undertaken by Dr Charlotte Neville (Research Fellow) and colleagues from the Centre for Public Health at Queen’s University Belfast found that weight management interventions which include an energy-restricted diet are the most efficacious in promoting postpartum weight loss in breastfeeding women. The findings highlight a need for future studies to explore attitudes, and barriers (behavioural, emotional, cognitive, social) to weight loss, in terms of dietary restriction and increased physical activity, to determine if breastfeeding women face specific challenges that should be considered when devising postpartum weight management interventions.
The full review is available at Birth.
Forum Member Updates
- Health Service Executive (HSE)
The HSE National Expert Group consisting representation from Dietitians, Procurement, Catering Managers, Estates and Health Promotion – Obesity, developed a HSE Healthy Vending Policy which has been signed off by the Senior Management Team. Initially the policy mandates a ratio of 60:40 mix of “Better Choice” and “Other Choice” products, which may be revised upwards e.g. 80:20 on subsequent revisions. The policy contains a caveat that 100% Better Choice products be provided, at the discretion of local management, in paediatric hospitals or paediatric clinics, wards and diabetic clinic and waiting areas. Calorie posting of all vended products has been included in the policy. A mini tender process is underway, following prequalification of the market, to award a HSE National Healthy Vending Contract. This should be in place by the end of September with commencement of national roll out. The Expert Group have been further tasked with the development of a HSE Calorie Posting Policy for all staff canteens and visitor restaurants and coffee shops.
- Food Standards Agency, Northern Ireland
SACN Report on Carbohydrates and Health
Following an extensive review of literature, the Scientific Advisory Committee on Nutrition (SACN) published a draft report on Carbohydrates and Health for public consultation on 26 June 2014. A final report is anticipated early 2015. FSA in NI is working closely with colleagues within Public Health England to consider any changes to dietary advice on fibre and sugars that may be necessary as a result of SACN recommendations. FSA in NI continues to work closely with industry and stakeholders to further explore approaches to reduce sugar intake.
Balance of promotions within NI food retail
Research entitled, ‘Three stage investigation into the balance of healthy versus less healthy food promotions among Northern Ireland food retailers’ was commissioned by the FSA in NI in partnership with the Consumer Council for Northern Ireland (CCNI). The aim of the NI-specific research is to provide recommendations for strategies to increase consumer accessibility to healthier food products (in terms of number, range, and variety) sold on promotional offer within retail stores. The contract has been awarded to the University of Ulster and commenced in July 2014. The three stages of the research will be designed to understand how it may be possible to influence the retail sector to increase accessibility to healthier food promotions.
£ for lbs challenge
Earlier this year a team of 16 from FSA in NI took part in Business in the Community’s £ for lb challenge. Twenty companies across NI (40 offices) were involved in the twelve week challenge of developing healthier eating habits, becoming more active and losing weight by following the NHS plan. http://www.nhs.uk/livewell/loseweight/Pages/Loseweighthome.aspx
Research has proven that it takes the body twelve weeks to develop new habits so our challenge is to try and change bad habits in regards to eating and physical activity and then to maintain a healthier lifestyle from which our diet, weight and mental well-being all benefit.
Louise Beggs and Ruth Balmer from the Standards and Dietary Health team held weekly sessions to promote a different lifestyle change each week with short presentations, group activities and lunchtime walks all playing a part. Weekly weigh-ins determined how much we raised for our chosen charity, Chest, Heart and Stroke- for every pound lost in weight, staff will donate £1 in cash. The final results for FSA in NI were fantastic- 124lbs weight loss, 72cm lost from our waists and a reduction of overall BMI by 22.
This challenge was great for team work, improving our health and really practising what we preach!
- Institute of Public Health in Ireland (IPH)
‘Active Travel’ is a key theme at this year’s IPH Open Conference
The 3rd Public Health Open Conference will take place on Tuesday, 14 October 2014 in the Titanic, Belfast. We invite people from all sectors North and South, to submit proposals for oral presentation at this dynamic, informal, free public health event. Proposals are to be submitted on the conference website at www.iphopenconference.com no later than Friday, 15 August 2014. ‘Active Travel’ is one of the key themes this year. Other themes include:
Food Poverty Trends in the Republic of Ireland
- Positive Ageing
- Promoting Mental Health and Wellbeing
- Public Health Approaches to Poverty
- Research, Policy, Practice Cycle – Closing the Gap
Food poverty is about the inability to access an affordable ‘healthy’ diet. The main drivers of food poverty include low incomes, affordability, availability, poor education levels, and poor living standards. Therefore households with insufficient financial resources are at risk of food poverty. IPH has examined household food and non-food spending data from CSO’s Household budget surveys to describe how food poverty risk has changed between 2004/05 and 2009/10 in Republic of Ireland households. This work was recently presented in poster format at the 5th annual Conference of the UKCRC Public Health Research Centres of Excellence in Leeds entitled “Food Poverty Trends in the Republic of Ireland”. Click here to view the poster. Please contact Lorraine.email@example.com for further details.
Northern Ireland Obesity Prevention Steering Group (OPSG)
The OPSG was established to drive forward obesity-related action and policy under the auspices of
‘A Fitter Future for All: Framework for Preventing and Addressing Overweight and Obesity in Northern Ireland 2012-2022’. In compiling its interim report, the Group compiled a list of obesity-related interventions in Northern Ireland and these are now searchable on the Obesity Hub’s Interventions Catalogue and the Physical Activity and Nutrition Intervention (PANI) Tool on The Health Well Website. Please contac
t Fiona.firstname.lastname@example.org for further details.
23.06.14: Higher maternal protectiveness is associated with higher odds of child overweight and obesity: a longitudinal Australian study. Results show at age 10-11 years, a 1 standard deviation increase in maternal protectiveness was associated with a 13% increase in the odds of children being overweight or obese. Read the full text on PLoS One.
28.06.14: Five-year medical and pharmacy costs after a medically supervised intensive treatment program for obesity. An intensive medical intervention may reduce pharmaceutical expenditures in severely obese individuals. Read the abstract on American Journal of Health Promotion.
29.06.14: Ethnic-Specific Obesity Cutoffs for Diabetes Risk: Cross-sectional Study of 490,288 UK Biobank Participants. To compare the relationship between adiposity and prevalent diabetes across ethnic groups in the UK Biobank cohort and to derive ethnic-specific obesity cutoffs that equate to those developed on white populations in terms of diabetes prevalence. Read the abstract on Diabetes Care.
July 2014: Prevalence of overweight and obesity in a large clinical sample of children with autism. Through a large integrated health care system's patient database, we identified 6672 children ages 2 to 20 years with an assigned ICD-9 code of autism, Asperger syndrome, and control subjects from 2008 to 2011 who had at least 1 weight and height recorded in the same visit. We calculated age-adjusted, sex-adjusted body mass index and classified children as overweight or obese. We used multinomial logistic regression to compare the odds of overweight and obesity between groups. Read the abstract on Academic Pediatrics.
July 2014: Obesity and Prognosis in Chronic Diseases - Impact of Cardiorespiratory Fitness in the Obesity Paradox. Despite the adverse effects of obesity on CVD risk factors and CVD, obesity has a surprising association with prognosis in patients with established diseases, often showing an "obesity," where overweight and obese patients with established CVD frequently have a better prognosis than that of their leaner counterparts with the same diseases. Read the abstract on Current Sports Medicine Reports.
July 2014: Comparison of traditional and nontraditional weight loss methods: an analysis of the national health and nutrition examination survey. To evaluate the real-world use of various weight loss techniques and to compare the effectiveness of nontraditional methods with diet and exercise in helping nongeriatric adults lose weight. Read the abstract on Southern Medical Journal.
01.07.14: Household and family factors related to weight status in first through third graders: a cross-sectional study in Eastern Massachusetts. A cross-sectional analysis of household and family factors associated with overweight was conducted on a culturally diverse, urban dwelling sample of 820 first through third graders (mean age 7.6 +/- 1.0 years) residing in three eastern Massachusetts cities. Read the full text on BMD Paediatrics.
01.07.14: A Mixed-Methods Study on Factors Influencing Prenatal Weight Gain in Ethnic-Minority Women. The purpose of this descriptive mixed-methods study was to explore factors related to excessive weight gain in pregnancy. Read the abstract on Journal of Midwifery and Women’s Health.
01.07.14: Influence of specific individual and environmental variables on the relationship between body mass index and health-related quality of life in overweight and obese adolescents. The finding that individual-level factors, such as body image and self-esteem, influence the relationship between BMI and HRQOL while environmental factors, such as neighbourhood environment and acculturation, do not extends previous research. Read the abstract on Quality of Life Research.
01.07.14: Work Participation Among the Morbidly Obese Seeking Bariatric Surgery: An Exploratory Study from Norway. The aim of this study is to assess the rate of work participation and disability pension, and identify predictors for sickness absence and disability pension, among morbidly obese individuals. Read the abstract on Obesity Surgery.
01.07.14: Impact of the 'Healthy Dads, Healthy Kids' lifestyle programme on the activity- and diet-related parenting practices of fathers and mothers. Intention-to-treat analysis using linear mixed models revealed significant group-by-time effects for fathers' limit setting and reinforcement for multiple lifestyle behaviours. Read the abstract on Pediatric Obesity.
02.07.14: Weight stigma is stressful. A review of evidence for the Cyclic Obesity/Weight-Based Stigma model. This model characterizes weight stigma as a "vicious cycle" - a positive feedback loop wherein weight stigma begets weight gain. Read the abstract on Appetite.
02.07.14: Bioimpedance in 7-Year-Old Children: Validation by Dual X-Ray Absorptiometry - Part 1: Assessment of Whole Body Composition. To validate the bioimpedance analyzer (BIA) Tanita BC-418 for its clinical and epidemiological use in children compared to dual-energy X-ray absorptiometry (DXA). Read the abstract on Annals of Nutrition and Metabolism.
02.07.14: Change in body size and mortality: results from the melbourne collaborative cohort study. We investigated the association between mortality and changes in directly measured waist circumference, hips circumference and weight from baseline (1990-1994) to wave 2 (2003-2007) in a prospective cohort study of people aged 40-69 years at baseline. Read the full text on PLoS One.
03.07.14: Child overweight and obesity are associated with reduced executive cognitive performance and brain alterations: a magnetic resonance imaging study in Mexican children. The purpose of this study was a neurobiopsychological approach to examine the association between overweight and obesity, brain structure and a paediatric neuropsychological assessment in Mexican children between 6 and 8 years of age. Read the abstract on Pediatric Obesity.
04.07.14: Eating for 1, Healthy and Active for 2; feasibility of delivering novel, compact training for midwives to build knowledge and confidence in giving nutrition, physical activity and weight management advice during pregnancy. Training was promoted via midwifery leads and delivered within the Health Board. Questionnaires based on statements from national public health guidance were used to assess changes in self-reported knowledge and confidence pre and post training. Read the full text on BMC Pregnancy and Childbirth
07.07.14: Examining the Effect of Three Low-Intensity Pediatric Obesity Interventions: A Pilot Randomized Controlled Trial. This pilot randomized controlled trial investigated the effect of 3 low-intensity (≤25 contact hours over 6 months) pediatric obesity treatments on z-BMI. Read the abstract on Clinical Paediatrics.
10.07.14: Innovative interventions to promote behavioral change in overweight or obese individuals: A review of the literature. Behavioral change therapy is an effective treatment strategy and includes goal setting, self-monitoring, problem solving, and reinforcement tactics. Read the abstract on Annals of Medicine.
11.07.14: Sleep debt and obesity. This article reviews the epidemiological, biological, and behavioural evidence linking sleep debt and obesity. Read the abstract on Annals of Medicine.
11.07.14: Associations between program outcomes and adherence to social cognitive theory tasks: process evaluation of the SHED-IT community weight loss trial for men. The objective of this study was to provide a comprehensive process evaluation of the SHED-IT weight loss program for men, as delivered in the SHED-IT community weight loss trial, and to identify key components associated with success. Read the full text on The International Journal of Behavioural Nutrition and Physical Activity.
15.07.14: The effect of a behaviour change intervention on the diets and physical activity levels of women attending Sure Start Children's Centres: results from a complex public health intervention. This study evaluated the effects of a community intervention on dietary quality and levels of physical activity of women from disadvantaged backgrounds. Read the full text on BMJ Open.
15.07.14: Life course impact of school-based promotion of healthy eating and active living to prevent childhood obesity. In the present study we estimate the life course impact of the APPLE Schools programs in terms of future body weights and avoided health care costs. Read the full text on PLoS one.
15.07.14: Longitudinal Accuracy of Web-Based Self-Reported Weights: Results From the Hopkins POWER Trial. The objective was to compare the longitudinal accuracy of self-reported weights entered online during the course of a randomized weight loss trial to measurements taken in the clinic. Read the full text on Journal of Medical Internet Research.
16.07.14: Rapid increases in infant adiposity and overweight/obesity in childhood are associated with higher central and brachial blood pressure in early adulthood. Using data from 3154 people from the Avon Longitudinal Study of Parents and Children, we assessed associations between repeated measures of BMI from birth to age 10 with central and brachial BP at age 17. Read the abstract on Journal of Hypertension.
16.07.14: Exploring Causality between TV Viewing and Weight Change in Young and Middle-Aged Adults. The Cardiovascular Risk in Young Finns Study. We explored the causal relationship of TV time with waist and BMI by classical temporality criterion and recently introduced causal-discovery algorithms (pairwise causality measures). Read the full text on PLoS one.
17.07.14: Generalized or Abdominal Obesity: Which One Better Identifies Cardiometabolic Risk Factors among Children and Adolescents? The study concluded that combined type of generalized and abdominal obesity is a predictor of cardiometabolic risk factors. Read the abstract on Journal of Tropical Paediatrics.
17.07.14: Preventing Childhood Obesity: What Are We Doing Right? After decades of increases, the prevalence of childhood obesity has declined in the past decade in New York City, as measured in children participating in the Special Supplemental Nutrition Program for Women, Infants, and Children and public school students, with the greatest reductions occurring in the youngest children. Read the abstract on American Journal of Public Health.
18.07.14: The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) study. INSIGHT's central hypothesis is that responsive parenting and specifically responsive feeding promotes self-regulation and shared parent-child responsibility for feeding, reducing subsequent risk for overeating and overweight. Read the full text on BMC Paediatrics.
21.07.14: Preschoolers' parent-rated health disparities are strongly associated with measures of adiposity in the Lifeways cohort study children. To investigate if preschoolers' body mass index (BMI) and waist circumference were associated with preschoolers' parent-reported health when controlled for lifecourse predictors. Read the full text on BMJ Open.
21.07.14: Prevalence of Overweight/Obesity and Its Associated Factors among University Students from 22 Countries. This study assesses the prevalence of overweight/obesity and its associated factors among a random sample of university students from 22 universities in 22 low, middle income and emerging economy countries. Read the full text on International journal of Environmental Research and Public Health.
25.07.14: The future burden of obesity-related diseases in the 53 WHO European-Region countries and the impact of effective interventions: a modelling study. This paper projects the future burden of coronary heart disease (CHD), stroke, type 2 diabetes and seven cancers by 2030 in 53 WHO European Region countries based on current and past body mass index (BMI) trends. Read the full text on BMJ Open.
August 2014: Designing and implementing a kindergarten-based, family-involved intervention to prevent obesity in early childhood: the ToyBox-study. The results of the ToyBox-study are expected to provide a better insight on behaviours associated with early childhood obesity and their determinants and identify effective strategies for its prevention. Read the full text on Obesity reviews.
30.06.2014: Food and beverage cues in UK and Irish children-television programming. This study investigated the frequency and type of food and beverage placement in children-specific television broadcasts and compared data from UK (UK) and Irish television stations. Read the full text on Archives of Disease in Childhood.
July 2014: What is the role of portion control in weight management? This study outlines that the challenge is to find strategies to effectively manage the effects of portion size. Read the full text on International Journal of Obesity.
July 2014: Changing eating behaviours to treat childhood obesity in the community using Mandolean trial – a pilot study. This pilot study aimed to test recruitment strategies, treatment adherence, clinic attendance and participants' experiences of using a device [Mandolean(®)] to slow down speed of eating as an adjunct to dietary and activity advice in treating obesity in primary school-aged children. Read the full text on Health Technology Assessment.
01.07.14: Effects of exposure to television advertising for energy-dense/nutrient-poor food on children's food intake and obesity in South Korea. The amount of television watched and exposure to energy-dense/nutrient-poor (EDNP) food advertising were associated with an increased risk of being overweight or obese. Read the abstract on Appetite.
02.07.14: Opportunities to Reduce Children's Excessive Consumption of Calories From Beverages. To describe children's consumption of sugar-sweetened beverages (SSBs) and 100% fruit juice (FJ), and identify factors that may reduce excessive consumption. Read the abstract on Clinical Paediatrics.
05.07.14: Overweight among students aged 11-15 years and its relationship with breakfast, area of residence and parents' education: results from the Italian HBSC 2010 cross-sectional study. The aim of this paper is to examine overweight (including obesity) prevalence and its association with geographic area of residence, parental education and daily breakfast consumption in Italian students aged 11-15 yrs. Read the full text on Nutrition Journal.
12.07.14: Changes in Parent Motivation Predicts Changes in Body Mass Index z-Score (zBMI) and Dietary Intake Among Preschoolers Enrolled in a Family-Based Obesity Intervention. This study concluded that given that increases in parent motivation were associated with some treatment benefits, future research should evaluate the impact of directly assessing and targeting parent motivation on weight outcomes for preschoolers participating in a weight management program. Read the abstract on journal of Pediatric Psychology.
18.07.14: Does maternal obesity have an influence on feeding behaviour of obese children? The aim was to evaluate the influence of maternal obesity on feeding practices toward their obese school children. Read the abstract on Minerva Pediatricia.
23.07.14: Maternal Diet and Weight at 3 Months Postpartum Following a Pregnancy Intervention with a Low Glycaemic Index Diet: Results from the ROLO Randomised Control Trial. The aim was to examine the impact of a low glycaemic index diet during pregnancy on maternal diet 3 months postpartum. Read the full text on Nutrients.
Physical Activity Research
02.07.14: International study of objectively-measured physical activity and sedentary time with body mass index and obesity: ipen adult study. The purpose of this study was to examine the strength, direction and shape of dose-response associations of accelerometer-based PA and sedentary time with BMI and weight status in 10 countries, and the moderating effects of study site and gender. Read the abstract on International Journal of Obesity.
03.07.14: Parental factors in children's active transport to school. Identify non-distance factors related to children's active transport (AT) to school, including parental, home, and environment characteristics. Read the abstract on Public Health.
08.07.14: Adiposity measures, lean body mass, physical activity and mortality: NHANES 1999-2004. We studied the associations between measures of adiposity, lean body mass, leisure time physical activity , and death in those with and without chronic kidney disease. Read the full text on BMC Nephrology.
11.07.14: Effects of high-intensity intermittent running exercise in overweight children. This study examined the effects of a 6-week intermittent exercise training, at different intensities, on body composition, functional walking and aerobic endurance in overweight children. Read the abstract on European Journal of Sports Science.
16.07.14: Health-Related Quality of Life and Physical Activity in Children and Adolescents 2 Years after an Inpatient Weight-Loss Program. This study concluded that inpatient weight-loss program was associated with positive changes in health related quality of life over the long term, with particular improvements in self-esteem. Read the abstract on the Journal of Paediatrics.
Resources and Publications
Making Life Better – A Whole System Framework for Public Health 2013-2023
"Making Life Better" is the strategic framework for public health in Northern Ireland designed to provide direction for policies and actions to improve the health and wellbeing of the population and to reduce inequalities in health. It builds on the former public health strategy
"Investing for Health
" and takes account of consultation feedback on the draft framework "Fit and Well – Changing Lives" and a number of other key reports and evidence
NICE Guidance - Managing overweight and obesity in adults - lifestyle weight management services. This guideline makes recommendations on the provision of effective multi-component lifestyle weight management services for adults who are overweight or obese (aged 18 and over).
Better Outcomes, Brighter Futures: The National Policy Framework for Children and Young People 2014 – 2020. This Framework confirms a cross-Governmental approach, in line with the goals of Healthy Ireland, to seek to improve all aspects of health and wellbeing, and to reduce risk-taking behaviour in children, with a particular focus on promoting healthy behaviour and positive mental health and in disrupting the emergence of poor outcomes such as diet-related non-communicable diseases arising from childhood overweight and obesity.
Weight Management Economic Assessment Tool. PHE Obesity has produced this resource designed to help public health professionals make an economic assessment of existing or planned adult weight management interventions. It will be useful to commissioners who wish to compare the costs of an intervention with potential healthcare savings it may produce.
Early Years - the organisation for young children, is offering families the chance to take part in a free programme, known locally as the Family Health Initiative. This programme helps support families with children aged 0-5 (Prevention Programme) and children aged 8-11 (Management Programme) to become healthier and get more active together. For further information or to view gallery visit the Early Years website
Healthy Ireland - A Framework for Improved Health and Wellbeing 2013 – 2025. Healthy Ireland, a new government framework for action to improve the health and wellbeing of people living in Ireland. It has been developed in response to rising levels of chronic illness, lifestyle trends that threaten health and persistent health inequalities. Read full text online.
Health Impact of Physical Inactivity (HIPI) Tool (UK). HIPI has been developed to estimate how many cases of certain diseases could be prevented in each local authority in England, if the population aged 40-79 were to engage in recommended amounts of physical activity. HIPI uses estimates of local levels of physical activity from the Sport England Active People survey. It models the potential benefit from increased levels of physical activity for each local authority.
Little Steps, Little Steps is a step-by-step guide to eating well and being active for families. Designed to help support and empower parents and guardians as role models for children, the resource aims to show that by adopting small changes, to food habits and physical activity can have a big impact over time and lead to a healthier future.
Weigh2Live, The Weigh2Live resource focuses on free, independent advice for losing weight (and keeping it off) in a healthy and sustained way. Users can monitor their progress by using the weight and goal tracker, and food and activity diaries; this information is stored in a secure environment and can be updated on a regular basis. The resource also offers practical advice on healthy eating whether at home or when eating out, tips on food shopping, understanding food portions, and healthy recipes.
Obesity Learning Centre (OLC) – Th
is a website for anyone who works to fight obesity. The OLC has updates on the latest news and resources, including a series of case studies of local obesity initiatives. Visit the site to sign up to receive the latest weekly obesity and other public health news through our eNews Briefing, and a quarterly update of new case studies and resources from the OLC. The OLC is also accepting submissions of new case studies, so if you have an example of a local obesity initiative that you’d like to share, get in touch by emailing Jennifer.email@example.com
All-island Obesity Action Forum Members
Full details of members can be found on the Forum page of the safefood website