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Obesity- Tipping Back the Scales of the Nation 19th April, 2017
- 1. Professor Gareth Stratton Professor of Paediatric Exercise Science, Director A-STEM Research Centre Swansea University
- 2. A-STEM Applied Sports, Technology Exercise and Medicine Research Centre “The road to an active and healthy childhood, from fitness to fatness and back again.!” Gareth Stratton Professor of Paediatric Exercise Science Director A-STEM Research Centre Swansea University 2009 2020
- 3. A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre Aims • Introduction to physical activity • Part 1 : From Fitness to Fatness • Part 2: From Fatness to Fitness
- 4. A-STEM Applied Sports, Technology Exercise and Medicine Research Centre Physical Activity and Fitness is MORE Important than Obesity
- 5. A-STEM Applied Sports, Technology Exercise and Medicine Research Centre How Active Should Children Be?
- 6. A-STEM Applied Sports, Technology Exercise and Medicine Research Centre Activity Levels by Age (Wales) 0 5 10 15 20 25 30 35 11 13 15 girls boys 20-21st/39 countries Age (yrs)
- 7. A-STEM Applied Sports, Technology Exercise and Medicine Research Centre Part 1 From Fitness to Fatness
- 8. A-STEM Applied Sports, Technology Exercise and Medicine Research Centre AIMS: To promote the health of the Liverpool population through school based activities promoting physical activity, sport and healthy eating in 9-10 year old children in the most deprived communities. 1996-2013 105 schools per year Same core staff N=80000
- 9. A-STEM Applied Sports, Technology Exercise and Medicine Research Centre Mapping the fitness fatness epidemic in Liverpool 9-12 year olds N=80000 1996-2013: Fitness, fatness, parents activity, diet, sports preference.
- 10. A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre Obesity & Overweight Plateau 5% 7% 9% 11% 13% 15% 17% 19% 21% 23% 25% 27% 29% 31% 33% 35% 37% 1998- 1999 1999- 2000 2000- 2001 2001- 2002 2002- 2003 2003- 2004 2004- 2005 2005- 2006 2006- 2007 2007- 2008 2008- 2009 2009- 2010 PrevalenceofOverweightandObesity (Coleetal.,2000) Year Boys Girls
- 11. A-STEM Applied Sports, Technology Exercise and Medicine Research Centre -0.5 -0.4 -0.3 -0.2 -0.1 0.0 0.1 0.2 0.3 0.4 0.5 98/99 99/00 00/01 01/02 02/03 03/04 Year zscore BMI 20mMST Changes in Cardiorespiratory Fitness Stratton et al. Int J Obes (Lond). 2007 Jul;31(7):1172-8. Epub 2007 Feb 20
- 12. A-STEM Applied Sports, Technology Exercise and Medicine Research Centre -2.0 -1.6 -1.2 -0.8 -0.4 0.0 0.4 0.8 1.2 1.6 2.0 98/99 99/00 00/01 01/02 02/03 03/04 98/99 99/00 00/01 01/02 02/03 03/04 98/99 99/00 00/01 01/02 02/03 03/04 Obese Overweight Normal weight Weight category 20mMSTzscore Boys Girls Decreasing fitness in all groups
- 13. A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre Community to Laboratory Cardiometabolic Health
- 14. A-STEM Applied Sports, Technology Exercise and Medicine Research Centre Cardio-metabolic Risk Fit vs Unfit 0 2 4 6 8 10 12 14 16 18 TC (≥ 5 mmol.L-1) TC:HDL-C (> 4.0) LDL-C (≥ 3.4 mmol.L-1) hs-CRP (< 3 mg.L-1) HDL-C (< 1.03 mmol.L-1) TG (≥ 1.7 mmol.L-1) Glucose (≥ 5.6 mmol.L-1) Unfit Fit Percentage Rees et al. BMC Public Health. 2009 Mar 24;9:86. doi: 10.1186/1471-2458-9-86
- 15. A-STEM Applied Sports, Technology Exercise and Medicine Research Centre 0.00 5.00 10.00 15.00 20.00 25.00 30.00 35.00 40.00 45.00 50.00 55.00 60.00 1 2 3 4 5 6 7 8 9 10 11 12 Prevalenceofrisk(%) Year Prevalence of Risk Over Time: 1998-2010 in Boys and Girls Boys Girls Cut points 25 shuttles-girls 33 shuttles boys
- 17. A-STEM Applied Sports, Technology Exercise and Medicine Research Centre Swanlinx 2013-15 Proportion of Children who Pass the Fitness Test 0 10 20 30 40 50 60 2013/14 (300 Boys & 322 Girls) 2014/15 (398 Boys & 366 Girls) Proportionthatreachedfitness threshold(%) Year Boys Girls
- 18. A-STEM Applied Sports, Technology Exercise and Medicine Research Centre Sufficient Fitness for Health 5% 41% 9% 45% 0 50 100 150 200 250 Passed MSFT Failed MSFT Passed MSFT Failed MSFT Boys Girls NumberofChildren Overweight & Obese
- 19. A-STEM Applied Sports, Technology Exercise and Medicine Research Centre European Childhood Obesity Group Award 2011!
- 20. A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre Part 2 From Fatness to Fitness
- 21. A-STEM Applied Sports, Technology Exercise and Medicine Research Centre Riddoch et al 2006 EYHS. Riddoch, C. J et al. Arch Dis Child 2007;92:963-969 Patterning of Physical Activity
- 22. A-STEM Applied Sports, Technology Exercise and Medicine Research Centre Exergaming Energy Expenditure Educational, Health Promoting Does Exergaming Afford Children to Increase their EE?
- 25. A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre Recess Time =Activity Time? 600 play periods per year at school
- 26. A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre Sporting Playgrounds Project Funding • £12 million DfES:YST • 30 Liverpool Schools • Aims of the project: i. Increase Physical Activity ii. Reduce negative behaviour Measures: Physical activity: movement, heart rate, Systematic observation (SOCARP).
- 27. A-STEM Applied Sports, Technology Exercise and Medicine Research Centre Zoneparc Playground Intervention 30 schools
- 28. A-STEM Applied Sports, Technology Exercise and Medicine Research Centre Changes in MVPA Ridgers et al. Int J Behav Nutr Phys Act. 2007 May 21;4:19.
- 29. A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre Time to burn off energy 2 or 3 recess periods per day • 31 KJ/minute = 7.5Kcals/minute School A: 3 recess periods 20+30+20= 70 mins/d 70 x 7.5 = 525 kcals/d 2625 kcals/wk 102375 kcals/school yr Equivalent to 29.3lbs fat School B: 2 recess periods 20+30= 50 mins/d 50 x 7.5 = 375 kcals/d 1875 kcals/wk 73125 kcals/school yr Equivalent to 20.9 lbs fat Stratton and Leonard (2002: Pediatric Exercise Science, 14 (2), pp. 170-180
- 30. A-STEM Applied Sports, Technology Exercise and Medicine Research Centre Health:- White Paper £1billion PE and School Sport (16/11/04) 4 hours PE and school sport per week??
- 31. A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre
- 32. A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research CentreCONTROL (Comparison) Interventions PASS (Behaviour- modification) FMS (multi-skill afterschool club) HIPA (high-intensity PA afterschool club) • Randomised: 2 schools-per-condition • no intervention • UK 2007: 2 hours of PE and school sport within and beyond the curriculum • 20 healthy missions (4x 6wk blocks) • action-research • ↑ physical activity • ↓ sed’ behaviour • B4: 51% returned all missions • bi-weekly, 1hr • 70 sessions • 2 skills per session • ↑ locomotor & object-control skills • 68% attendance • bi-weekly, 1 hr • 70 sessions • focus on keeping children moving/fun • HR: 150.9 ±25.4 beats.min-1 • 64% attendance
- 33. A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre Methods
- 35. A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre Measures: Locomotor Skills
- 36. A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre Percent Body Fat and Activity Groups 20.00 22.00 24.00 26.00 28.00 30.00 32.00 34.00 36.00 38.00 <60 min ≥60<90 min ≥90 min Time spent in moderate PA per day (min) Percentbodyfat(%) * * (* P<.01)
- 37. Research Institute for Sport & Exercise Sciences FACULTY OF SCIENCE 10 10.5 11 11.5 12 12.5 13 13.5 Baseline 9-months 12-months Testing time point Fatmass(kg) CONT FMS** PASS** HIPA** P<0.001 Changes in Fitness and Fat Mass at Baseline, 9 and 12 months
- 38. A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre Results: Locomotor skills 12 13 14 15 16 17 18 19 20 Baseline Mid-test Post-test Meantotallocomotorskill components CON PASS FMS HIPA PRACTICE & INSTRUCTION PRACTICE FMS moderate effect on locomotor skills HIPA small effect on locomotor skills
- 39. A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre Summary • Physical Inactivity 4th Obesity 5th in rank order of most important NCDs (WHO 2012). • Unhealthy fitness has a higher prevalence in children than unhealthy weight. • Overweight plateau but fitness continues to decrease. • Some PA programmes can work. • Achieving a healthy weight only one aim of physical activity. • Restructuring school play areas has long term impact but time spent outside is arguably more important.
- 40. A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre Thank you Any questions? ?g.stratton@swansea.ac.uk
- 41. A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre Interventions Summary Exergaming Increases energy expenditure Some evidence exergames reduce sitting time and increase energy expenditure Recess Increases energy expenditure Sustained change Over I year. Curriculum friendly Additional School PA Slows increase in adiposity. No change in fitness or overall PA. Structured programme had differential effect on FMS- sustained
- 42. A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre A-STEM Applied Sports, Technology Exercise and Medicine Research Centre Lean Body Mass and SBJ 1.2 1.21 1.22 1.23 1.24 1.25 1.26 1.27 24.5 25 25.5 26 26.5 27 27.5 28 2004 2005 2006 2007 2008 2009 2010 2011 SBJ(m) LBM(%) Year LBM(%) SBJ(m)