Tackling Obesity in England - National Audit Office

TACKLING OBESITY IN ENGLANDAppendix7Department of Health policies andinitiatives which address obesity, diet andphysical activityInitiativeSummaryNHS Plan (July 2000)Five-a-day Pilot ProjectNational School Fruit SchemeGuidance on Implementing thePreventive Aspects of the NationalService Framework for CoronaryHeart DiseaseHealthy Schools ProgrammeBreakfast ClubsActive for Life ProgrammeThe National Alliance for PhysicalActivity (NAPA)Inter-Ministerial Group to ImproveChildren's Diet and ActivitySafe and Sound ChallengeTeacher Training Guide on Safe andActive School TravelThe Infant Feeding InitiativeHealth Survey for EnglandSystematic Review of Interventionsin the Treatment and Prevention ofObesityDirectory of Weight ManagementServicesEvaluation of Weight ManagementServicesDiet and nutrition and physical activity are important elements of the NHS Plan for improving health and reducinginequalities. Action is planned to tackle obesity and physical inactivity, informed by advice from the new HealthDevelopment Agency established in April 2000. The NHS Plan also includes action to increase fruit and vegetableconsumption and work with the food industry to improve the overall balance of the diet including salt, fat and sugar infood, working with the Food Standards Agency.Local initiatives are underway in five pilot sites to increase consumption of fruit and vegetables across the wholecommunity, particularly in poorer areas. Based on evidence of effective interventions, the national roll-out of the schemewill begin in 2002.The NHS Plan aims to establish a National School Fruit Scheme by 2004. Under the scheme every school child aged fourto six will be entitled to a free piece of fruit each school day, as part of a national campaign to improve children's diets.The practicalities of the scheme will be examined through pilots, beginning in Health Action Zones.The Health Development Agency has issued guidance covering the development of local strategies and interventions topromote healthy lifestyles, relevant to coronary heart disease prevention. This includes advice on physical activity, healthyeating and other measures to reduce the prevalence of overweight and obesity.This programme has been developed jointly with the Department for Education and Employment to improve educationalachievement and, in the longer term, to improve public health and address health inequalities. The programme encouragesschools to improve the health education and awareness of pupils, staff and the local community by developing healthyschool activities, including those which promote healthy eating and physical activity. All Local Education Authority areashave an Education and Health Partnership to support local programmes and assist schools working towards the NationalHealthy School Standard.Breakfast Club pilots were set up across the eight NHS Regions in 1999, with funding through to March 2001. TheDepartment has commissioned an evaluation of the pilots from the University of East Anglia to look at the contributionbreakfast clubs can make to health and educational improvement in schools, to examine their sustainability and cost, andto identify models of good practice.National health promotion campaign commissioned from the Health Education Authority from 1996 - 2000 to encouragemore people to take part in more physical activity. The programme involved the provision of training, guidance andpromotional material to health promotion units and physical activity campaigners across England, including advice onwhat works based on the Health Education Authority's effectiveness reviews. The campaign placed particular emphasis onactivities that were accessible to all and could be built into daily living, such as cycling and walking.NAPA was convened by the Health Education Authority, with funding and direction from the Department of Health. It metfrom 1996-2000 to provide a forum for debate on physical activity issues, and direction for the Active for Life programme.Members were drawn from across the physical activity world, including representatives from the main Governmentdepartments, sport, academia, the fitness industry, schools and local authorities. The group was disbanded following theclosure of the Health Education Authority, but the Department is considering convening a similar group in the future.The Group was set up in response to the findings of the National Diet and Nutrition Survey of Young People aged 4-18 18 ,published in June 2000. The group aims to map out cross-departmental action already taken to improve young peoples'diet and physical activity, to identify models of good practice, and to co-ordinate future projects and initiatives. The Groupis chaired by Ministers from the Department of Health and the Department for Education and Employment and involvesMinisters from several Government departments.The Safe and Sound scheme encourages schools to develop initiatives to promote healthy, active and safe modes of travelto school, with cash prizes awarded to the most innovative schemes. In 2000/01, the scheme has targeted schools insocially deprived areas.This document explains to trainee teachers how physically active modes of travel can be taught as part of the primaryschool curriculum.Research suggests that bottle-fed babies are 50 per cent more likely to become obese than babies breast-fed exclusivelyfor the first 3-4 months. The Infant Feeding Initiative was set up to reduce inequalities by encouraging those women leastlikely to breast-feed to do so.Annual survey on the health status of the people of England, including data on physical activity, eating habits, height,weight and body shape. It provides authoritative data on the prevalence of overweight and obesity analysed by gender,age group, socio-economic status, household income and geographical region.Review of published research commissioned by the Department from the NHS Centre for Reviews and Dissemination in1997. The aim of the review was to inform the work of the Department by identifying the latest state of knowledge ofobesity and highlighting future research needs.Directory of local weight management programmes compiled by self-completion pro-forma sent out by NHS RegionalOffices and published in March 1998. Contains details of several hundred initiatives, ranging from clinics and researchprogrammes to buses taking overweight and obese people to leisure centres and swimming pools.Analysis of 13 self-evaluations of weight management programmes, published in 1998. Concluded that successfulsustained clinically significant weight loss in obese patients was rare, and that more work was needed to developstrategies to improve long term weight maintenance.appendix seven63