The State of the Nation's Health

This piece, written by Dr Justin Varney, Interim Deputy Director for Health and Wellbeing (Healthy People) from Public Health England, gives us an insight into the current state of the health of the average UK family. 

The state of the nation’s health

Obesity, poor diet and physical activity are three of the biggest problems to affect the health of families in England. They are directly responsible for many of the preventable conditions such as type two diabetes, heart disease, stroke and kidney disease that are impacting on people’s lives and causing early death.

Around 40% of ill health in this country could be prevented by people leading a healthy lifestyle, including eating a balanced diet and being regularly active to improve the quality and length of our lives.

We know that choices made about diet and exercise at every age can make a difference to health in both the short and long term. Fundamentally it’s never too late to make a change.

Supporting individuals and families to make a healthy choice is at the heart of Public Health England’s (PHE) mission. It is reflected in the work we do, such as our Change4life campaign and services such as NHS Health Checks, which we will be discussing more in upcoming articles.

In this article we want to provide an overview of where we currently stand as a nation in terms of physical activity, diet and obesity and how it affects the health of families. Future articles will delve into the below topics, and others that impact family health, in more depth and will look at how you can make your family healthier.

Obesity

Obesity and being overweight is a complex problem and is one of the biggest health issues facing families in England today. People rarely become overweight overnight; obesity is the result of bad choices made repeatedly over time, the extra sugar cube in the daily cup of tea, the treat cakes that become everyday habits, the sugary drink that undoes all the hard work from the swimming pool, the sofa day that becomes supper in front of the TV every night.

These everyday habits can lead to piling on the pounds and it’s this gradual weight gain that makes it so hard for families and parents particularly to step in early. There is no single ‘silver bullet’ solution to tackling obesity.

Today 1 in 4 people in England are obese and over a third (37%) are overweight. We know that almost one in ten 4-5 year olds are obese (9.5%) and by age 10-11 this doubles to nearly one in five (19.1%).

Obese children are more likely to experience bullying, low self-esteem, anxiety, depression and have a higher risk of developing type 2 diabetes and heart disease as adults.

Many of us who struggle with weight issues know that getting back to a healthy weight is a journey that takes time and continued support from family and friends. Families working together to make healthier choices is a great way to help anyone deal with weight issues, whatever their age, and make it fun and part of everyday life.

Simple steps to improve the family diet and get everyone more active every day will help the whole family achieve and maintain a healthy weight.

Diet

Tackling our high sugar consumption is an area of particular focus for PHE. The Scientific Advisory Committee on Nutrition (SACN), an independent expert body, has looked at the link between sugar consumption and a range of health issues, and found that too much sugar is detrimental for health. It now recommends that no more than 5% of our daily calories should come from sugar, down from the previous recommendation of 10%.

The government has adopted this as official dietary guidance which now means adults are now

consuming over double the amount of sugar, and children and teenagers almost three times as much.

The latest statistics from the National Diet and Nutrition Survey (NDNS) showed that sugary drinks are the largest contributor to sugar intake in teenagers, Twenty nine percent of the sugar in teenagers’ diets comes from sugary drinks (16% for younger children (4 to 10 years) Too much sugar also causes tooth decay.

One in three five-year olds have tooth decay, which could eventually lead to a hospital visit to have teeth removed.

Parents and carers can help their children achieve and maintain a healthier weight by following a balanced diet as shown in the eatwell plate, choosing ‘me sized’ meals, avoiding sugary drinks and snacks high in sugar, salt or fat. Too much fat or sugar contributes towards excess calorie intake, which overtime can lead to weight gain.

Change4Life also has a range of tools and information to support parents and families in making healthier choices from decisions in the supermarket using the Sugar Swaps barcode scanner to the Smart Swaps menu planner.

In future articles we will look at other dietary issues facing the nation around vitamin intake, salt and other nutritional factors.

Physical Activity

As well as helping to maintain a healthier weight, being physically active can improves the health and other aspects of life. In addition to healthy development of bones and muscles, it improves concentration and learning, develops confidence and improves sleep.. But most importantly it makes you feel good and is fun!

The UK Chief Medical Officers launched guidelines for physical activity, Start Active, Stay Active. These outline the quantity and types of physical activity necessary for good health at different ages.

These guidelines encourage physical activity from birth, particularly through floor-based play and water-based activities in safe environments.

For pre-school aged children who are capable of walking unaided, at least 180 minutes (3 hours) of physical activity is recommended spread throughout the day.

Anything from running or skipping to playing with balls counts, so it is easiest to mix it up.

For children and young people aged 5-18 years, at least 60 minutes of at least ‘moderate’ to physical activity (i.e. makes you breathe faster and feel warmer) is recommended every day. On at least three days a week children should do activities to strengthen muscles and bone, such as climbing in the park.

All children and young people should minimise the amount of time spent being ‘sedentary’ (sitting or being restrained) for extended periods, except time spent sleeping.

However the most recent statistics show that we are far from meeting these recommendations:

• At ages 2-4 years only one in ten children meet the guidelines (boys 9%, girls 10%). There is a high proportion of ‘low levels’ of activity in this age group

• For 5-15 year olds only two in ten meet the guidelines (boys 21%, girls 16%)

• Physical activity is declining amongst children and young people;  the number of boys achieving the guidance fell from 28% to 19%  and girls from 19% to 16%

Sedentary behaviour has been identified as an area of particular concern, with around four in ten children aged 5-15 years physically inactive (boys 39%, girls 45%). For all age groups and sexes, levels of sedentary time are higher at weekends compared to weekdays.

• On weekdays, fewer than 1 in 10 children under 10 are sedentary for six hours or more. The proportion of children aged 13-15 years is much higher, at 1 in 4for boys and 1 in 16 for girls

• At weekends, there is a steady increase from the youngest age group (around 1 in 10 to the oldest (43% of boys and 37% of girls)

  Sedentary behaviours habits appear to be formed in early childhood and develop during adolescence and into adulthood with screen time, including TV and internet viewing the biggest contributor.

When we talk with families about becoming more active, it’s great to see how families really view this as fun family time. Whether it’s about walking the kids to school on the way to work, or having family time in the park at the weekend with a football, going to a local tea dance with granddad or granny, being active everyday should be fun and about spending time with family and friends.

Over the next few months we will focus in more detail on some of these issues to help you and your families get the best start in life and work towards achieving your potential in school, work and life in general.