1. Greater than one-third of United Kingdom (UK) children are overweight or obese, but increasing in obesity prevalence plateaued in the most recent decade for age groups under 11 years.
2. Obesity rates were still rising for the 11-15 year-old age group in the last decade and public health interventions may do well in targeting this group.
Evidence Rating Level: 2 (Good)
Study Rundown: An important determinant of obesity in adults is obesity initially as a child. In order to properly plan public health initiatives and measure their efficacy, it is important to study trends in obesity. The purpose of this study was to determine the prevalence of overweight and obese 2-15 year-olds in the UK over a period of two decades using primary care health records. Of over 370,000 total children, the prevalence of obesity among 2-5-year-old boys and girls was 19.5% and 18.3% in 1995 and 26% and 24.4% in 2007, respectively. These rates were highest in the 11-15 year-old group of boys and girls, with rates of 26.7% and 28.3% in 1996 and 37.8% and 36.7% in 2013, respectively. The odds of becoming overweight were 4.2% per year over the two decades but were much greater in the 1994-2003 period as opposed to being insignificant during the 2004-2013 period. When broken down by age groups, while increases in obesity prevalence had plateaued, the 11-15 year-old group still experienced rising rates in the second decade.
This study benefited from a tremendous sample size. With over 500,000 body-mass-index (BMI) records from both sexes and across age groups, the data are easily generalizable. One can draw conclusions and extrapolate these to the national level in England. However, it must be noted that BMI is often recorded when children present to the doctor because they are sick. Thus, their true BMI may be lower or higher than normal. Additionally, no data was presented regarding ethnic and socioeconomic differences in obesity over the decades. Overall, this study suggests that the rates of obesity may be stabilizing this decade, compared to the last, likely due to improved public health interventions and awareness.
In-Depth [retrospective cohort]: This study aimed to determine the prevalence of obesity in England between 1994 and 2013 and to track the trends in obesity in both sexes and across pediatric age groups. By utilizing primary care electronic health records from the UK Clinical Practice Research Datalink, the study authors determined the prevalence of obesity among 2-5 year-old boys and girls to be 19.5% and 18.3% in 1995 and 26% and 24.4% in 2007, respectively. Rates of obesity were highest in the 11-15 year-old group of boys and girls, with rates of 26.7% and 28.3% in 1996 and 37.8% and 36.7% in 2013, respectively. While the odds of becoming overweight increased 4.2% per study year (CI95% 3.9% to 4.5%), the rates differed significantly by decade; the annual increase was 8.1% (CI95% 7.2% to 8.9%) from 1994-2003 but only 0.4% (CI95% -0.2% to 1.1%) from 2004-2013. There were no differences in the annual increase by sex (p=0.244). Across age groups over the two decades, the annual increase in obesity rates escalated per age group. However, only the 11-15 year-old group experienced a statistically significant increase in obesity rates in the 2004-2013 decade.
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