Statistics on Obesity, Physical Activity and Diet: England

Transcription

Statistics on Obesity, Physical
Activity and Diet: England, January
2008
Summary
This statistical report presents a range of information on obesity, physical activity and diet,
drawn together from a variety of sources. The topics covered include:
• Overweight and obesity prevalence among adults and children;
• Physical activity levels among adults and children;
• Trends in purchases and consumption of food and drink, and energy intake;
• Health outcomes of obesity.
This publication also summarises government plans and targets in this area, as well as
providing sources of further information and links to relevant documents and key sources.
The report combines data from a variety of sources and presents it in a user-friendly format.
Most of the data contained in the report have been published previously; either by the
Information Centre, the Department of Health, the Government Office for Science, Eurostat,
the Scottish Executive, the Welsh Assembly Government, the Department for Culture, Media
and Sport, Sport England, the Department for Children, Schools and Families, the Department
for Transport, the Department for Environment, Food and Rural Affairs, the Food Standards
Agency, the Office for National Statistics and the National Audit Office.
There are several notable additions to this, the Information Centre’s second report on obesity,
physical activity and diet. Waist circumference analysis has been included where possible to
reflect the importance of using this measurement in conjunction with Body Mass Index (BMI) in
order to identify those at increased risk of health problems associated with obesity.
Logistic regression carried out using data from the Health Survey for England (HSE) is also
included for the first time showing the odds of obesity, raised waist circumference and
associated health problems in relation to a range of factors such as income, age, gender and
physical activity.
More regional data is presented in this report with a greater number of tables providing
Government Office Region and Strategic Health Authority breakdowns. Where possible,
information at a more local level has been provided. Data from the Scottish Health Survey and
the Welsh Health Survey have been included where appropriate to provide a Great Britain
perspective.
Main findings:
Obesity
•
•
•
In 2006, 24% of adults (aged 16 or over) in England were classified as obese. This
represents an overall increase from 15% in 1993.
Men and women were equally likely to be obese, however women were more likely than
men to be morbidly obese (3% compared to 1%).
Thirty seven per cent of adults had a raised waist circumference in 2006 compared to 23%
in 1993. Women were more likely then men to have a raised waist circumference (41% and
32% respectively).
I
Copyright © 2008. The Information Centre, Lifestyles Statistics. All rights reserved
•
•
•
•
Using both BMI and waist circumference to assess risk of health problems, of men 20%
were estimated to be at increased risk, 13% at high risk and 21% at very high risk.
Equivalent figures for women were 14% at increased risk, 16% at high risk and 23% at very
high risk.
In 2006, 16% of children aged 2 to 15 were classed as obese. This represents an overall
increase from 11% in 1995. Despite the overall increase since 1995, the proportion of girls
aged 2 to 15 who were obese decreased between 2005 and 2006, from 18% to 15%.
There was no significant decrease among boys aged 2 to 15 over that period. Among
children aged 2 to 10, 15% were classed as obese in 2006.
Boys were more likely than girls to be obese (17% compared to 15%).
Of children aged 8 to 15 who were classed as obese, two thirds (66%) of girls and 60% of
boys thought that they were too heavy.
Physical Activity
•
•
•
•
•
•
Overall, physical activity has increased among both men and women since 1997, with 40%
of men and 28% of women meeting the recommended levels in 2006 (at least 30 minutes
of at least moderate intensity activity at least 5 times a week).
There is a clear gradient across the income quintiles for both men and women, with those
in the lowest income quintile more likely to be in the low participation group than those in
the highest income quintile. Those with the highest income were also most likely to
participate in active sport: 89% of those earning over £50k had done so at least once in the
previous 12 months while for those whose income was less than £10k the figure was 61%.
Men and women with low physical activity levels were more than twice as likely as to have
a raised waist circumference than those with high levels of physical activity.
Three in ten adults had not participated in active sport in last 12 months in 2005/06. The
main reasons for not participating were ‘health isn’t good enough’ (47%) followed by
‘difficulty in finding the time’ and ‘not being interested’ (both 18%).
In 2006, boys were more likely than girls to meet the recommended levels of physical
activity with 70% of boys and 59% of girls reporting taking part in 60 minutes or more of
physical activity on all 7 days in the previous week.
During 2006/07, 86% of pupils took part in at least two hours of high quality PE and sport a
week, a gradual increase since 2003/04 when the figure was 62%.
Diet
•
•
•
In 2006, 28% of men and 32% of women consumed five or more portions of fruit and
vegetables a day, the proportion doing so generally increases with age and income.
Among children aged 5 to 15, in 2006, 19% of boys and 22% of girls consumed five or
more portions of fruit and vegetables a day.
The proportion of adults and children consuming five or more portions of fruit and
vegetables a day remained steady between 2001 and 2004. There were increases among
adults in 2005 and 2006. For children, there was an increase among both boys and girls in
2005 and further increase among girls in 2006.
II
Health Outcomes
•
•
•
For people aged 35 and over classified as having a raised waist circumference, men were
twice as likely and women were four times more likely to have type 2 diabetes.
Over the last ten years there were 17,458 Finished Consultant Episodes (FCEs) with a
primary diagnosis of obesity. Almost a quarter of these (4,068) occurred in 2006/07.
In 2006, 1.06 million prescription items were dispensed for the treatment of obesity.
Overall, the number of prescriptions in 2006 was more than eight times the number
prescribed in 1999, when there were 127 thousand prescription items. Considering the
treatment types in 2006, around 73% of prescriptions were for Orlistat and 25%
prescriptions were for Sibutramine, the two main drugs used for treatment of obesity.
III
IV
Contents
1.
Introduction.....................................................................................................................1
2
Obesity among adults .....................................................................................................3
2.1
2.2
2.3
2.4
2.5
2.6
2.7
2.8
Introduction ......................................................................................................3
Overweight and obesity prevalence.................................................................4
Trends in obesity and overweight ....................................................................5
Obesity and socio-economic variables ............................................................6
Obesity and demographic characteristics ........................................................6
Obesity and lifestyle habits ..............................................................................7
Geographical patterns in obesity .....................................................................9
The future.......................................................................................................10
Tables...........................................................................................................................15
3.
Obesity among children................................................................................................35
3.1
3.2
3.3
3.4
3.5
3.6
3.7
3.8
Introduction ....................................................................................................35
Overweight and obesity prevalence...............................................................35
Trends in overweight and obesity prevalence................................................35
Socio-economic variables ..............................................................................36
Obesity prevalence and other factors ............................................................37
Geographical patterns in obesity ...................................................................38
Children’s perception of weight......................................................................38
The future.......................................................................................................38
Tables...........................................................................................................................41
4.
Physical activity among adults......................................................................................53
4.1
4.2
4.3
4.4
4.5
4.6
4.7
4.8
4.9
4.10
4.11
Introduction ....................................................................................................53
Meeting physical activity guidelines ...............................................................53
Participation in different activities...................................................................54
Physical activity and obesity ..........................................................................55
Physical activity, active sport and equivalised household income .................55
Physical activity among ethnic groups ...........................................................55
Demographic variables ..................................................................................56
Geographical patterns in physical activity......................................................57
Early trends in physical activity ......................................................................58
Focus on travel ..............................................................................................59
Non-engagement in active sport and perceived barriers to increased
participation....................................................................................................59
Tables...........................................................................................................................63
V
5.
Physical activity among children...................................................................................77
5.1
5.2
5.3
5.4
5.5
5.6
5.7
5.8
5.9
Introduction ....................................................................................................77
Meeting physical activity guidelines ...............................................................77
Types of physical activity ...............................................................................78
Parental participation .....................................................................................79
Socio-economic factors..................................................................................79
Regional analysis...........................................................................................79
National comparisons of physical activity ......................................................79
Participation in PE and school sport ..............................................................80
Trips to school................................................................................................81
Tables...........................................................................................................................85
6.
Diet .............................................................................................................................103
6.1
6.2
6.3
Introduction ..................................................................................................103
Adult’s diet ...................................................................................................104
Children’s diet ..............................................................................................111
Tables.........................................................................................................................117
7.
Health Outcomes ........................................................................................................145
7.1
7.2
7.3
7.4
7.5
7.6
7.7
7.8
Introduction ..................................................................................................145
Relative risks of diseases ............................................................................145
Relative risks of death..................................................................................146
Relationship between obesity prevalence and selected diseases ...............146
Hospital Episode Statistics...........................................................................148
Prescribing ...................................................................................................150
GP recording of BMI ....................................................................................151
Financial costs .............................................................................................151
Tables.........................................................................................................................155
Appendix A: Key sources .......................................................................................................173
Appendix B: Technical notes..................................................................................................187
Appendix C: Government policy and targets ..........................................................................199
Appendix D: Editorial notes ....................................................................................................205
Appendix E: Further information.............................................................................................207
VI
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Contents page
1 Introduction
This statistical report presents a range of
information on obesity, physical activity and
diet, drawn together from a variety of
sources. The report primarily uses Body
Mass Index (BMI) as the measurement of
obesity but waist circumference is also
used where available. The data relate to
England unless otherwise specified. Where
figures for England are not available,
figures for Great Britain or the United
Kingdom have been provided.
Chapter 2 reports on trends in obesity
among adults. The relationship between
obesity and various factors such as gender,
socio-economic variables and lifestyle
habits are also explored.
Chapter 3 focuses upon trends in obesity
among children and again, explores the
relationship between obesity and various
factors.
Chapters 4 and 5 present information on
physical activity for adults and children
respectively. Physical activity levels,
according to physical activity guidelines,
and types of physical activity are
considered. Also relationships between
participation in physical activity and factors
such as income and BMI are described.
Chapter 6 presents information on diet, in
particular purchases and consumption of
food and drink and related intake of energy
and nutrients.
Chapter 7 focuses on health outcomes
related to being obese.
The risks of
diseases and death linked to obesity are
discussed in this chapter, as well as
information on hospital Finished Consultant
Episodes with a primary or secondary
diagnosis of obesity and prescriptions for
the treatment of obesity.
A summary highlighting the key findings is
presented at the end of each chapter.
Additionally
throughout
the
report,
references are given to sources for further
information which are provided at the end
of each chapter.
The report also contains five appendices;
the first describes the key sources used in
more detail. The second provides further
details on measurements, classifications
and definitions used in the various sources.
The third appendix covers government
targets and NHS plans related to obesity
whilst the fourth gives editorial notes
regarding the conventions used in
presenting information. The final appendix
lists sources of further information and
useful contacts.
The Health Survey for England (HSE) is a
major source of information for this report.
Wherever possible, the most recent
information available from the HSE is
presented. These figures have been
weighted for non response. Analyses of the
HSE by region and household income for
adults have been age standardised where
possible. This enables groups to be
compared after adjusting for the effects of
any differences in their age distributions.
See Appendix A for further detail on the
HSE
and
Appendix
B
for
age
standardisation.
Chapters 2, 3, 4 and 7 include information
on odds ratios which are created using a
statistical
procedure
called
logistic
regression.
This allows links between
obesity and various lifestyle factors and
health outcomes to be analysed. More
information on odds ratios and logistic
regression can be found in Appendix B.
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2
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2 Obesity among adults
2.1 Introduction
This chapter focuses on the prevalence of
obesity and overweight among adults,
presented mainly by Body Mass Index
(BMI) and also includes some information
on waist circumference. Trends in the
prevalence of overweight and obesity are
presented and relationships between
various economic and lifestyle variables
and obesity are explored.
The main source of data on the prevalence
of obesity and overweight is the Health
Survey for England (HSE). The HSE is an
annual survey designed to monitor the
health of the population of England. Most
of the information presented in this chapter
is taken from the recently published HSE
20061. Where information is not available
from the HSE 2006, this chapter uses
information from the HSE 20032 because of
its large sample size.
Data on obesity and overweight prevalence
among ethnic minority groups are taken
from the HSE 20043. The 2004 survey
focused on the health of ethnic minorities
and is used because of the large sample
size achieved among ethnic minority
groups.
Obesity and overweight prevalence in
Great Britain are provided using information
from the Scottish Health Survey 20034 and
the Welsh Health Survey 2005/065. Other
regional and sub-regional data are
described where available.
This chapter also reports on the prevalence
of overweight and obesity for countries in
the European Union. This data is collected
by Health Interview Surveys over a number
of years and is produced by Eurostat6.
is mainly based on a report published in
October 2007 by The Government Office
for Science: ‘Foresight Tackling Obesities:
Future Choices - Project Report’7 which
forecasted what levels of obesity in
England may be up to 2050 based on
recent trends in obesity prevalence.
2.1.1 Measurement of overweight and
obesity
The calculation of BMI is a widely accepted
method used to define overweight and
obesity.
Guidance published by the
National Institute for Health and Clinical
Excellence (NICE)8 postulates that within
the management of overweight and obesity
in adults, BMI should be used to classify
the degree of obesity and to determine the
health risks. However this needs to be
interpreted with caution as BMI is not a
direct measure of adiposity. NICE
recommends the use of BMI in conjunction
with waist circumference as the method of
measuring overweight and obesity and
determining the health risks, specifically
guidance currently states that assessment
of health risks associated with overweight
and obesity should be based on both BMI
and waist circumference for those with a
BMI of less than 35 kg/m2. Hence this
chapter and subsequent chapters focus on
using BMI and waist circumference in order
to define overweight and obesity in adults.
2.1.2 Measurement of BMI
BMI is defined as weight in kilograms
divided by the square of the height in
metres (kg/m2). Figure 2.1 presents the
various BMI ranges used to define
overweight and obesity throughout this
chapter.
Finally, the chapter focuses on future
forecasts of obesity levels in England. This
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Figure 2.1 BMI definitions
BMI range (kg/m2)
Definition
Under 18.5
Underweight
18.5 to less than 25
Normal
25 to less than 30
Overweight
30 and over
Obese
40 and over
Morbidly obese
25 and over
Overweight including obese
to 74, before decreasing to 69% in those
aged 75 and over. Among women, the
prevalence of overweight including obese
increased with age up to age 65 to 74
(72%), and then remained similar in those
aged 75 and over (69%) (Figure 2.2).
Figure 2.2 Proportion of adults who are overweight
including obese, by age and gender, 2006
Percentages
England
90
Men
Women
80
70
2.1.3 Waist circumference
60
Although BMI allows for differences in
height, it does not distinguish between
mass due to body fat and mass due to
muscular physique, or the distribution of fat.
Therefore, waist circumference is also a
widely recognised measure used to identify
those with a health risk from being
overweight. A raised waist circumference
is defined as greater than 102cm in men
and greater than 88cm in women.
2.2 Overweight and obesity prevalence
50
40
30
20
10
0
16-24
25-34
35-44
45-54
55-64
65-74
75+
Source: Health Survey for England 2006, The Information Centre
Overall, mean BMI in men was similar to
women (27.2 kg/m2 and 26.8 kg/m2
respectively) and as with the prevalence of
overweight including obesity generally
increased with age but fell again in the
oldest age groups (Table 2.1).
2.2.1 BMI
In 2006, 38% of adults were overweight
and 24% were obese. A greater proportion
of men than women were overweight (43%
compared with 32%), and this was true for
all age groups. There was no significant
difference between the genders in the
proportion obese. Although the prevalence
of morbid obesity remains relatively low,
women were more likely to be morbidly
obese than men (3% for women, and 1%
for men).
In 2006, 37% of adults had a raised waist
circumference. The proportion of people
classified as having a raised waist
circumference was higher for women than
for men (41% and 32% respectively) and
this was true for all age groups. (Table
2.2, Figure 2.3).
Figure 2.3 Proportion of adults with a raised waist
circumference, by age and gender, 2006
Percentages
England
70
Men
Women
60
In 2006, men were more likely to be
overweight than women
50
40
30
20
10
Overall, 67% of men and 56% of women
were either overweight or obese in 2006. In
men, overweight including obese increased
with age to 80% for those aged between 55
0
16-24
25-34
35-44
45-54
55-64
65-74
Source: Health Survey for England 2006, The Information Centre
4
75+
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In 2006, women were more likely than
men to have a raised waist
circumference
2.3 Trends in obesity and overweight
2.3.1 BMI
Results from the HSE 2006 show that in
England the proportion of adults with a
normal BMI decreased between 1993 and
2006, from 41% to 32% among men and
from 49% to 42% among women. There
was no significant change overall in the
proportion of adults who were overweight
although there is some fluctuation between
years. However, there was a marked
increase in the proportion that were obese
from 13% in 1993 to 24% in 2006 for men
and from 16% to 24% for women (Table
2.3, Figure 2.4).
Figure 2.4 Prevalence of obesity among adults, by gender,
1993 to 2006
2.3.3 Health risk associated with BMI
and waist circumference
NICE guidelines highlight overweight and
obesity as risk factors for developing other
long-term health problems such as
coronary heart disease, type 2 diabetes,
osteoarthritis and some cancers. It states
that the risk of these health problems
should be identified using BMI and waist
circumference for those with a BMI less
than 35 kg/m2, as explained in Appendix B.
For adults with a BMI of 35kg/m2 or more,
risks are assumed to be very high with any
waist circumference. Table 2.5 shows
these increased health risks associated
with high and very high waist circumference
when
combining
BMI
and
waist
measurement to classify the risks.
Using combined categories of BMI and
waist circumference to assess risk of health
problems, for men 20% were estimated to
be at increased risk, 13% at high risk and
21% at very high risk. For women, 14%
were at increased risk, 16% at high risk and
23% at very high risk.
Percentages
England
30
25
Women
In 2006, around a fifth of men and
almost a quarter of women were at
very high risk of health problems due
to obesity
20
15
10
Men
Data from
2003 are
w eighted
5
0
1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Source: Health Survey for England 2006 - updating of trend tables to include 2006 data.
The Information Centre
Between 1993 and 2006, the proportion of
adults with a raised waist circumference
also increased, from 23% to 37%. The
proportion
with
a
raised
waist
circumference increased from 20% to 32%
among men and from 26% to 41% among
women (Table 2.4).
The proportion of both men and women at
very high risk of the health effects of
obesity increased with age peaking in the
65 to 74 age group, where 30% of men and
34% of women were in this category (Table
2.5).
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2.4 Obesity and socio-economic
variables
2.4.1 Equivalised household income
Among women, the proportion who were
obese was related to equivalised
household income (a measure of
household income that takes account of the
number of people in the household). In the
highest income quintile, 19% were obese
whereas in the lowest income quintile this
rose to 32%.
However,
there
was
no
apparent
relationship between the proportion of men
who were obese and equivalised
household income. The prevalence of
overweight was generally positively related
to income in men (Table 2.6).
In 2006, women in the lowest income
quintile were more likely to be obese
than those in the highest
The proportion of women with a raised
waist circumference was also lowest in the
highest income quintile (36%) and highest
in the lowest income quintile (47%). There
was no observed relationship between
waist circumference and equivalised
household income for men (Table 2.7).
2.4.2 Other socio-economic variables
The ‘Statistics on Obesity, Physical Activity
and Diet: England, 2006’ publication9
includes information on relationships
between obesity and other socio-economic
variables using findings from the 2003
HSE. These include Index of Multiple
Deprivation (IMD)10, National Statistics
Socio-Economic Classification (NS-SEC)
and urbanisation.
professional
households
and
in
intermediate households than in routine
and manual households. For men, the
difference between NS-SEC groups was
less marked.
There was no apparent relationship
between IMD and prevalence of obesity
among men. However, men in the least
deprived IMD quintile had the highest
prevalence of overweight including obese,
while men in the most deprived quintile had
the lowest prevalence. Among women,
those in the most deprived quintile had the
highest prevalence of overweight including
obese while those in the least deprived
quintile had the lowest prevalence.
Similarly, women from the most deprived
areas had the highest prevalence of
obesity9.
2.5 Obesity and demographic
characteristics
2.5.1 Ethnicity
The use of standard BMI cut off points in
measuring obesity and overweight among
certain ethnic groups is under debate. The
relationship between BMI and body fat
varies between ethnic groups, but currently
there are no agreed ethnicity specific BMI
cut off points. The HSE therefore uses the
definition of overweight and obesity as
used for the general population.
The HSE 2004 report, showed that among
minority ethnic groups Bangladeshi and
Chinese men had the lowest prevalence of
overweight including obese (44% and 37%
respectively) and of obesity (both 6%).
Black Caribbean and Irish men had the
highest prevalence of obesity: a quarter of
men in these ethnic groups (25%) were
classified as obese (Figure 2.5).
In 2003, prevalence of obesity among
women was lower in managerial and
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Figure 2.5 Obesity prevalence among adults by
minority ethnic group and gender, 2004
England
Men
Women
Percentages
General Population
Black Caribbean
Black African
Indian
to be overweight including obese. Among
women, those who were widowed were the
most likely to be overweight including
obese9. For both men and women, those
who were single were least likely to be
either obese or overweight including obese.
2.6 Obesity and lifestyle habits
Pakistani
Bangladeshi
2.6.1 Smoking status
Chinese
Irish
0
10
20
30
40
Source: Health Survey for England 2004. The Information Centre
Women from Black African, Black
Caribbean and Pakistani ethnic minority
groups were among those with the highest
(70%, 65% and 62% respectively).
Chinese women had the lowest prevalence
of overweight including obesity (25%).
Obesity prevalence was highest among
women in Black African (38%), Black
Caribbean (32%) and Pakistani (28%)
groups. The lowest prevalence of obesity
was found in Chinese women (8%) (Table
2.8).
The HSE 2004 also presented some
information to show relationships between
ethnic minorities and waist circumference.
Findings were similar to those found for
BMI. Among men, the proportion with a
raised waist circumference was highest
among those with an Irish origin (33%) and
lowest among those with a Chinese origin
(8%). For women, prevalence ranged from
16% of those with a Chinese origin to 53%
of those with a Black African origin3.
2.5.2 Marital status
Information on relationships between
obesity and marital status can be found in
the 2006 Statistics on Obesity, Physical
Activity and Diet publication which uses
findings from the HSE 2003 report and
showed that among men, those who were
married or co-habiting were the most likely
In 2003, men who were current smokers
were less likely to be overweight including
obese (54.7%) and obese (15.1%) than
those who had either never regularly
smoked (64.2% and 21.2% respectively) or
were ex-regular smokers (78.6% and
31.0% respectively).
Figure 2.6 Prevelance of obesity, among adults by
smoking status and gender, 2003
England
Men
Women
10
15
Percentages
Never regular
cigarette smoker
Ex-regular cigarette
smoker
Current cigarette
smoker
0
5
20
25
30
35
Source: Health Survey for England 2003, The Department of Health
Copyright © 2008, re-used w ith the permission of The Department of Health
Among women, those who were current
smokers also had the lowest prevalence of
overweight including obese (50.4%),
increasing to 54.6% among those who had
never regularly smoked and 65.2% among
ex-regular smokers. The proportion of
women who were obese was similar for
those who were current smokers and never
regular smokers (19.9% and 22.2%
respectively) but was higher among exregular smokers (29.1%) (Table 2.9, Figure
2.6).
The HSE 2006 used a statistical procedure
called logistic regression to identify factors
that are independently associated with BMI,
whereas the HSE 2006 carried out a similar
analysis investigating the factors linked with
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raised waist circumference. This latest
analysis found that overall, among both
men and women, the odds of a raised waist
circumference were greater among those
who were ex-regular cigarette smokers
than non-smokers (odds ratios 1.6 in men
and 1.2 in women). More information on
logistic regression can be found in
Appendix B (Table 2.10).
In 2006, ex-regular smokers were
more likely than those who have
never smoked to have a raised waist
circumference
2.6.2 Alcohol consumption
The 2003 HSE found that among women,
those who did not drink in the week prior to
interview or had consumed less than the
maximum daily recommended amount of
alcohol (3 units or less) on their heaviest
drinking day last week had a higher
(61.3% for those who did not drink and
55.9% for those who drank within the
recommendations). This compared with
49.6% for those women who had drunk
between 3 and 6 units and 48.8% for those
who had drunk more than twice the daily
recommendations. For men, those who did
not drink at all in the week prior to interview
were less likely to be overweight including
obese than those who drank at any level
(Table 2.11).
By using logistic regression, the 2006 HSE
analyses however found no significant
relationship between alcohol intake and
raised waist circumference1.
2.6.3 Physical activity
The HSE provides summary measures of
physical activity levels relating to current
physical activity guidelines. This measure is
classified into high, medium and low
activity. High activity levels are the
equivalent to meeting the current physical
activity guidelines for adults: at least 30
minutes of at least moderate intensity
activity, at least five days a week.
The HSE 2003 shows a relationship
between summary activity levels and
prevalence of both overweight and obesity
for both men and women. Among men,
was 71.7% among those with low levels of
activity, falling to 59.7% among those with
high activity levels. The same pattern was
seen for obesity, with 28.3% of those
reporting low activity levels being obese
compared to 17.8% of those with high
activity levels.
A similar pattern was seen among women;
63.0% of women with low activity levels
were overweight including obese and
29.2% were obese. This fell to 47.9% and
16.0% respectively, among women who
reported high levels of activity (Table 2.12,
Figure 2.7).
Figure 2.7 Prevalence of obesity among adults by
summary physical activity levels and gender, 2003
Percentages
England
30
Men
Women
25
20
15
10
5
0
High
Medium
Low
Copyright © 2008, re-used w ith the permission of The Department of Health
Using logistic regression, analysis of the
2006 HSE found that men and women with
medium or low activity levels were more
likely to have a raised waist circumference.
For example those with low physical activity
levels were twice as likely to have a raised
waist circumference than those with high
activity levels (Table 2.10).
8
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In 2006, men and women with low
physical activity levels were twice as
likely to have a raised waist
circumference as those with high
levels of activity
2.7 Geographical patterns in obesity
2.7.1 National comparisons of obesity
The Scottish Health Survey 2003 presented
comparisons of Scotland with England for
obesity
and
waist
circumference
prevalence. The proportion of men who
were overweight including obese was the
same in both Scotland and England
(65.4%); while the corresponding figures for
male obesity were also very similar (22.4%
in Scotland and 22.2% in England).
However, men in Scotland showed
significantly higher rates of morbid obesity
than those in England (1.6% and 1.0%
respectively).
Women in Scotland were more likely to be
overweight including obese than women in
England (59.7% and 55.5% respectively).
The same was true for obesity (26.0% and
23.0% respectively) and morbid obesity
(3.4% and 2.9% respectively) (Table 2.13).
Men in Scotland had a slightly lower
prevalence of raised waist circumference
(28.0%) compared with men in England
(31.1%) (Figure 2.8).
Figure 2.8 Proportion of adults with a raised waist
circumference, by gender, England and Scotland, 2003
Men
45
40
35
30
25
20
15
10
5
0
England
Women
Percentages
There were no significant differences
between Scotland and England for the
proportion of women with a raised waist
circumference
(38.9%
and
41.1%
respectively) (Table 2.14).
Information is available on obesity and
overweight prevalence in Wales from the
Welsh Health Survey 2005/065. However
as the height and weight of respondents in
this survey are self-reported, data are not
directly comparable with England and
Scotland. The limitations of this are
discussed in the report which explains that
there is evidence to show that some people
tend to under-report weight and/or overreport height, resulting in an underestimation of the prevalence of overweight
and obesity.
2.7.2 Obesity by region/ Strategic Health
Authority
Among the different Government Office
Regions (GORs) and Strategic Health
Authorities (SHAs) in England, age
standardised obesity prevalence from the
HSE 2006 varied. For men this ranged from
18% in South Central SHA to 29% in the
West Midlands. For women obesity
prevalence ranged from 21% in London to
29% in the West Midlands (Table 2.15).
2.7.3 Waist circumference by region/
Strategic Health Authority
There was some variation between the
regions for prevalence of raised waist
circumference among adults. Among men,
the age standardised prevalence with a
raised waist circumference ranged from
29% in the South Central SHA to 37% in
the South West. For women it ranged from
37% in the North West to 45% in the South
West (Table 2.16).
Scotland
Source: Scottish Health Survey 2003, The Scottish Executive
Copyright © 2008, re-used w ith the permission of The Scottish Executive
9
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2.7.4 Obesity and sub-regional
comparisons
While survey estimates can provide
information on regional variation, it is not
possible to look at prevalence at a smaller
geographical level due to small sample
sizes. To address this information gap, the
National Centre for Social Research was
commissioned by the IC, to test and
produce model-based estimates for a range
of healthy lifestyle behaviours. Estimates
based on 2003-05 data at Local Authority
(LA) and Medium Super Output Area are
available on the IC website11, and includes
estimates of obesity prevalence. Results
for the whole range of healthy lifestyle
behaviours considered are published on
the
ONS
Neighbourhood
Statistics
website12. Similar estimates based at a
Primary Care Organisation level are
expected be produced in early 2008.
Figure 2.9 Comparison of model based estimated obesity rates of
Local Authorities to the national average, 2003-2005
Just under a fifth of LAs had an obesity rate
significantly higher than the national
average, and 17% of LAs were estimated
to have a significantly lower obesity rate
than the national estimate11. The majority
of these were concentrated in the South of
England (Figure 2.9).
2.7.5 European comparison of BMI
Health Interview Surveys report the
prevalence of obesity and overweight
among European Union (EU) countries.
The most recently available information
shows that the average prevalence of
overweight including obesity among
European countries is 47.5%.
Of the EU countries, prevalence of obesity
ranged from 23.0% in Malta to 8.1% in
Italy. Overweight prevalence ranged from
43.3% in Greece to 27.8% in France. While
overweight including obese prevalence
ranged from 61.0% in the United Kingdom
to 37.1% in France (Table 2.17).
England
2.8 The future
Comparison against national average:
Higher than national average
No difference to national average*
Lower than national average
Forecasts of the future prevalence of
overweight and obesity in England have
been undertaken by various government
departments. In 2006 the Department of
Health published the report, Forecasting
Obesity to 201013. The Statistics on
Obesity, Physical Activity and Diet:
England, 2006 publication describes more
details of this work9.
In October 2007, Foresight at The
Government Office for Science produced
the Tackling Obesities: Future Choices
report. HSE 1994 to 2004 data was used
as a basis for modeling estimates of
obesity prevalence up to 2050.
Data Sources: ONS Boundary Files 2006,
Neighbourhood Statistics Model Based Estimates of Healthy Lifestyle Behaviours.
Reproduced by permission of Ordnance Survey on behalf of HMSO. All rights reserved.
Ordnance Survey Licence Number 100044406.
Crown copyright and database right 2008.
By 2015 the Foresight Report predicts that
if current trends persist, 36% of men and
28% of women aged 21 to 60 living in
England will be obese. By 2025, these
* Prevalence in these LAs are not considered statistically different to the national average.
10
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figures are estimated to rise to 47% and
36% respectively7.
By 2015 over a third of men and
almost three in ten women aged 21 to
60 living in England are predicted to
be obese
11
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Summary: Obesity among adults
In 2006 almost four in ten adults were
classified as overweight and almost a
quarter were obese. Men were more likely
than women to be overweight. Although
there was no difference in proportion of
men and women who were obese, women
were more likely to be morbidly obese. In
general, BMI increased with age among
both men and women.
Almost four in ten adults had a raised waist
circumference. As with BMI, waist
circumference also tended to increase with
age and women were more likely to have a
raised waist circumference than men.
Prevalence of both obesity and raised waist
circumference have shown an overall
increase since 1993, however overweight
prevalence has remained relatively similar.
Using combined categories of BMI and
waist circumference to assess risk of health
problems, just over a fifth of men and
almost a quarter of women were classified
as being in a very high health risk category.
The proportion of women who were obese
was related to income with obesity
increasing as equivalised household
income decreased.
The same pattern
could also be seen when looking at waist
circumference. There was no apparent
pattern with income and obesity among
men, however the proportion overweight
was generally positively related to income
in men.
Among ethnic minority groups, obesity
prevalence was highest among the Black
Caribbean and Irish groups for men and
Black African, Black Caribbean and
Pakistani groups for women.
The proportion of men who were obese
was higher among ex-regular smokers and
non-smokers than current smokers,
whereas for women ex-regular smokers
were most likely to be obese. Ex-regular
smokers also had higher odds of having a
raised waist circumference than nonsmokers.
Both men and women had a higher
prevalence of obesity among those with low
levels of activity, than those with high
activity levels. Adults with low physical
activity levels were twice as likely to have a
raised waist circumference as those with
high physical activity levels.
Scotland reported similar levels of
overweight and obese among men to
England, but a lower waist circumference.
However, men in Scotland were more likely
to be morbidly obese than those in
England. Women in Scotland were more
likely to be overweight including obese,
obese, and morbidly obese than women in
England.
Government predictions have suggested a
rise in the levels of obesity in the future,
such that by 2015 among 21 to 60 year
olds, over a third of men and almost three
in ten women are predicted to be obese.
12
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References
1. Health Survey for England 2006. The
Information Centre, 2008. Available at:
http://www.ic.nhs.uk/pubs/hse06cvdandrisk
factors
2. Health Survey for England 2003:
Department of Health, 2004. Available at:
http://www.dh.gov.uk/assetRoot/04/09/89/1
1/04098911.pdf
3. Health Survey for England 2004: The
www.ic.nhs.uk/pubs/hse04ethnic
4. The Scottish Health Survey 2003: The
Scottish Executive, 2005 Available at:
http://www.scotland.gov.uk/Resource/Doc/7
6169/0019729.pdf
5. Welsh Health Survey 2005/06. Welsh
Assembly Government, 2007. Available at:
http://new.wales.gov.uk/topics/statistics/pub
lications/health-survey200506/?lang=en
6. Health status: indicators from the
national
Health
Interview
Surveys.
European Commission: Eurostat. Available
at:
epp.eurostat.ec.europa.eu/portal/page?_pa
geid=0,1136184,0_45572595&_dad=portal
&_schema=PORTAL
7. Foresight Tackling Obesities: Future
Choices 2nd Edition – Modelling Future
Trends in Obesity & Their Impact on
Health. Foresight, Government Office for
Science, 2007. Available at:
http://www.foresight.gov.uk/Obesity/obesity
_final/17.pdf
8. Obesity: the prevention, identification,
assessment
and
management
of
overweight and obesity in adults and
children. National Institute for Health and
Clinical Excellence (NICE), 2006. Available
at:
http://www.nice.org.uk/guidance/CG43
9. Statistics on Obesity, Physical Activity
and Diet: England, 2006. The Information
Centre, 2006. Available at:
www.ic.nhs.uk/pubs/OPAD06
10.
Indices
of
Deprivation
2004.
Department for Communities and Local
Government. Available at:
http://www.communities.gov.uk/archived/ge
neralcontent/communities/indicesofdeprivation/2
16309/
11.
Neighbourhood Statistics: ModelBased Estimates of Healthy Lifestyles
Behaviours, 2003-05.
The Information
Centre, 2007. Available at:
http://www.ic.nhs.uk/statistics-and-datacollections/population-andgeography/neighbourhoodstatistics/neighbourhood-statistics:-modelbased-estimates-of-healthy-lifestylesbehaviours-2003-05
12. Healthy Lifestyle Behaviours: Model
Based
Estimates,
2003-2005.
Neighbourhood Statistics, Office for
National Statistics, 2007. Available at:
http://www.neighbourhood.statistics.gov.uk/
dissemination/
13.
Forecasting Obesity to 2010.
http://www.dh.gov.uk/en/Publicationsandsta
tistics/Publications/PublicationsStatistics/D
H_4138630
13
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14
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List of tables
2.1
Body Mass Index (BMI) among adults, by age and gender, 2006
2.2
Waist circumference among adults, by age and gender, 2006
2.3
Body Mass Index (BMI) among adults, by gender, 1993 to 2006
2.4
Obesity and raised waist circumference among adults, by age and gender, 1993 and
2006
2.5
Health risk category associated with overweight and obesity in adults based on Body
Mass Index (BMI) and waist circumference, by age and gender, 2006
2.6
Body Mass Index (BMI) among adults, by equivalised household income quintiles and
gender, 2006
2.7
Waist circumference among adults, by equivalised household income quintiles and
gender, 2006
2.8
Body Mass Index (BMI) among adults, by ethnic minority group and gender, 2004
2.9
Body Mass Index (BMI) among adults, by smoking status and gender, 2003
2.10
Estimated odds ratios for raised waist circumference among adults, by associated risk
factors and gender, 2006
2.11
Body Mass Index (BMI) among adults, by units of alcohol drunk on heaviest drinking
day in the week prior to interview and gender, 2003
2.12
Body Mass Index (BMI) among adults, by summary physical activity levels and gender,
2003
2.13
Overweight and obesity prevalence among adults, England and Scotland, 2003
2.14
Waist circumference among adults, England and Scotland, 2003
2.15
Body Mass Index (BMI) among adults, by Government Office Region/Strategic Health
Authority and gender, 2006
2.16
Waist circumference among adults, by Government Office Region/Strategic Health
2.17
Prevalence of overweight and obesity among adults in European Union countries, 2004
15
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1
2
Table 2.1 Body Mass Index (BMI) among adults , by age and gender, 2006
England
Percentages / Numbers
All adults
16-24
25-34
35-44
45-54
55-64
65-74
75+
All adults
Underweight
Normal
Overweight
Obese
1.6
36.8
37.6
23.9
6.0
61.3
22.3
10.5
1.2
43.9
35.4
19.5
0.7
35.7
39.2
24.4
0.4
30.3
41.6
27.7
0.8
26.5
41.1
31.6
0.9
22.9
43.3
32.9
1.6
29.5
45.5
23.4
Morbidly obese
61.6
2.1
32.7
1.1
54.9
1.6
63.6
2.4
69.3
2.4
72.6
3.0
76.2
2.4
68.9
1.0
27.0
24.1
26.3
27.3
27.8
28.3
28.4
27.3
2
Mean BMI (kg/m )
Men
1.2
5.5
0.2
0.4
0.1
0.5
0.4
0.6
Normal
31.7
60.8
37.7
26.5
23.7
19.9
19.2
30.5
Overweight
43.4
24.7
41.3
48.1
48.1
46.6
49.4
51.0
Obese
23.7
9.0
20.7
25.0
28.1
33.0
31.1
17.8
Morbidly obese
67.1
1.5
33.7
0.9
62.0
1.1
73.1
1.6
76.2
1.7
79.6
2.7
80.4
1.2
68.8
0.2
27.2
24.1
26.7
27.8
28.0
28.6
28.3
27.0
Underweight
2
Mean BMI (kg/m )
Women
2.1
6.5
2.2
1.0
0.7
1.2
1.3
2.3
Normal
41.8
61.8
50.3
45.2
36.9
33.0
26.5
28.7
Overweight
31.9
19.7
29.2
30.1
35.2
35.7
37.5
41.6
Obese
24.2
12.0
18.2
23.7
27.2
30.2
34.7
27.4
56.1
31.7
47.5
53.8
62.4
65.9
72.2
69.0
2.7
1.4
2.0
3.1
3.1
3.4
3.6
1.6
26.8
24.0
25.9
26.8
27.6
28.0
28.6
27.5
Underweight
Morbidly obese
2
Mean BMI (kg/m )
Bases (unweighted)
All adults
12,027
1,256
1,697
2,392
2,058
2,092
1,511
1,021
Men
5,523
577
762
1,084
933
986
735
446
Women
6,504
679
935
1,308
1,125
1,106
776
575
Bases (weighted)
All adults
12,088
1,796
1,933
2,454
1,988
1,802
1,236
879
Men
6,014
930
991
1,246
993
888
599
368
Women
6,074
866
942
1,207
996
914
637
511
2
2
1. Using the following BMI definitions: Underweight: less than 18.5 kg/m ; normal: 18.5 to less than 25kg/m ;
2
2
2
overweight: 25 to less than 30 kg/m ; obese 30 kg/m or more; overweight including obese 25 kg/m or more;
2
morbidly obese: 40 kg/m or more
2. Adults aged 16 and over with a valid height and weight measurement
Source:
Health Survey for England 2006. The Information Centre
Health Survey for England 2006 - updating of trend tables to include 2006 data. The Information Centre
16
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Table 2.2 Waist circumference1 among adults2, by age and gender, 2006
England
55-64
65-74
75+
All adults
16-24
25-34
35-44
45-54
All adults
Raised waist circumference
Mean waist circumference (cm)
37
91.5
13
81.6
25
88.4
33
91.6
42
94.0
48
95.8
56
97.2
51
94.8
Men
32
96.8
10
85.6
21
93.5
30
97.7
38
99.5
46
101.8
51
102.8
41
101.0
Women
41
86.4
17
77.4
30
82.9
36
85.4
45
88.5
50
90.1
60
92.1
57
91.0
Bases (unweighted)
All adults
Men
Women
10,128
4,592
5,536
921
415
506
1,298
576
722
1,990
877
1,113
1,725
781
944
1,840
857
983
1,346
651
695
1,008
435
573
Bases (weighted)
All adults
Men
Women
10,128
4,954
5,175
1,460
743
716
1,596
820
777
1,973
990
983
1,631
815
815
1,502
734
768
1,053
504
550
914
349
565
1. Raised waist circumference has been taken to be greater than 102 cm in men and greater than 88cm in women
2. Adults aged 16 and over with a valid waist measurement
Source:
17
1.4
41.0
44.4
13.2
57.6
0.2
1.9
49.5
32.2
16.4
48.6
1.4
Men
Underweight
Normal
Overweight
Obese
Morbidly obese
Women
Underweight
Normal
Overweight
Obese
Morbidly obese
14,679
6,795
7,884
48.7
1.6
2.2
49.1
31.4
17.3
58.1
0.4
1.2
40.7
44.3
13.8
53.1
1.0
1.7
45.2
37.4
15.7
1994
14,436
6,707
7,729
50.4
1.4
2.2
47.4
32.9
17.5
59.3
0.3
1.3
39.5
44.0
15.3
54.5
0.9
1.8
43.7
38.1
16.4
1995
15,061
6,997
8,064
52.0
1.4
2.0
46.0
33.6
18.4
61.0
0.4
1.2
37.7
44.6
16.4
56.2
0.9
1.7
42.2
38.7
17.5
1996
7,939
3,685
4,254
52.5
2.3
1.9
45.6
32.8
19.7
62.2
0.8
1.0
36.9
45.2
17.0
56.9
1.6
1.5
41.6
38.5
18.4
1997
14,330
6,600
7,730
53.3
1.9
2.1
44.6
32.1
21.2
62.8
0.6
1.2
36.0
45.5
17.3
57.7
1.3
1.7
40.6
38.3
19.4
1998
6,903
3,204
3,699
53.9
1.9
1.8
44.3
32.8
21.1
62.5
0.8
1.5
36.0
43.9
18.7
57.9
1.4
1.7
40.4
38.0
20.0
1999
6,963
3,260
3,703
55.1
2.3
1.8
43.1
33.8
21.4
65.5
0.6
1.1
33.4
44.5
21.0
60.0
1.5
1.5
38.6
38.8
21.2
2000
13,681
6,267
7,414
56.4
2.5
1.6
41.9
32.9
23.5
67.7
0.6
1.2
31.1
46.6
21.0
61.6
1.7
1.4
37.0
39.2
22.4
2001
6,478
2,969
3,509
56.5
2.6
1.9
41.6
33.7
22.8
65.5
0.8
1.4
33.1
43.4
22.1
60.6
1.8
1.7
37.7
38.1
22.5
2002
13,056
5,966
7,090
56.8
2.9
1.9
41.3
33.4
23.4
67.4
1.0
5,579
2,444
3,135
58.5
2.6
1.7
39.8
34.7
23.8
69.1
0.9
1.1
29.8
45.5
23.6
63.1
1.8
61.6
2.0
1.2
31.4
44.4
22.9
1.5
35.4
39.4
23.7
2004
(unweighted)3
1.6
36.8
38.4
23.2
2003
(unweighted)3
6,339
2,930
3,409
57.6
2.9
1.6
40.7
32.9
24.8
66.5
1.0
1.3
32.2
43.4
23.1
61.7
2.0
1.5
36.8
37.7
24.0
2005
(unweighted)3
12,027
5,523
6,504
58.0
2.7
1.9
40.1
32.9
25.2
69.5
1.4
0.9
29.5
44.7
24.9
63.3
2.1
1.4
35.2
38.3
25.0
2006
(unweighted)3
13,089
6,519
6,570
55.5
2.9
2.1
42.3
32.6
23.0
65.4
1.0
1.4
33.2
43.2
22.2
60.5
1.9
1.8
37.8
37.9
22.6
2003
(weighted)3
5,584
2,772
2,812
57.1
2.4
1.7
41.2
33.9
23.2
66.5
0.9
1.4
32.1
43.9
22.7
61.8
1.7
1.6
36.7
38.8
22.9
6,328
3,144
3,184
56.3
2.7
1.7
41.9
32.1
24.3
64.7
0.9
1.5
33.8
42.6
22.1
60.5
1.8
1.6
37.9
37.3
23.2
2004
2005
(weighted)3 (weighted)3
Source:
1. Using the following BMI definitions: Underweight: less than 18.5 kg/m2; normal: 18.5 to less than 25kg/m2; overweight: 25 to less than 30 kg/m2; obese 30 kg/m2 or more; overweight including obese 25 kg/m2 or more; morbidly obese: 40 kg/m2 or more
3. Data from 2003 onwards have been weighted for non-response. Unweighted data for 2003 onwards are provided for consistency with previous years which are also unweighted
15,284
7,247
8,037
52.9
0.8
Morbidly obese
Bases
All adults
Men
Women
1.6
45.5
38.0
14.9
1993
All adults
Underweight
Normal
Overweight
Obese
England
Table 2.3 Body Mass Index (BMI)1 among adults2, by gender, 1993 to 2006
12,088
6,014
6,074
56.1
2.7
2.1
41.8
31.9
24.2
67.1
1.5
1.2
31.7
43.4
23.7
61.6
2.1
1.6
36.8
37.6
23.9
Percentages
2006
(weighted)3
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18
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1
2.4 Obesity and raised waist circumference
2,3
among adults, by age and gender, 1993 and 2006
All adults
16-24
25-34
35-44
45-54
55-64
65-74
Percentages
75+
14.9
23.9
6.4
10.5
10.6
19.5
15.8
24.4
17.7
27.7
22.0
31.6
18.6
32.9
13.9
23.4
23
37
7
13
12
25
19
33
26
42
35
48
38
56
39
51
13.2
23.7
4.9
9.0
10.0
20.7
14.3
25.0
16.5
28.1
19.9
33.0
15.2
31.1
10.8
17.8
20
32
4
10
10
21
17
30
24
38
32
46
34
51
32
41
16.4
24.2
7.8
12.0
11.1
18.2
17.1
23.7
18.9
27.2
24.0
30.2
21.5
34.7
15.8
27.4
26
41
9
17
14
30
21
36
28
45
38
50
42
60
44
57
15,284
12,088
2,010
1,796
2,988
1,933
2,772
2,454
2,537
1,988
2,080
1,802
1,832
1,236
1,065
879
7,247
6,014
990
930
1,444
991
1,313
1,246
1,231
993
1,020
888
841
599
408
368
8,037
6,074
1,020
866
1,544
942
1,459
1,207
1,306
996
1,060
914
991
637
657
511
14,004
10,128
1,807
1,460
2,714
1,596
2,549
1,973
2,368
1,631
1,928
1,502
1,642
1,053
966
914
6,656
4,954
881
743
1,306
820
1,223
990
1,158
815
946
734
763
504
379
349
7,348
5,175
926
716
1,408
777
1,356
983
1,210
815
982
768
879
550
587
565
England
All adults
Obese
1993
2006
1993
2006
Men
Obese
1993
2006
1993
2006
Women
Obese
1993
2006
1993
2006
Bases (weighted)
Obese
All adults
1993
2006
Men
1993
2006
Women
1993
2006
All adults
1993
2006
Men
1993
2006
Women
1993
2006
2
1. BMI of 30 kg/m or over
2. Raised waist circumference has been taken to be greater than 102 cm in men and greater than 88 cm in women
3. Figures for raised waist circumference are not available to 1 decimal place for 1993. Figures have therefore been presented to the nearest
whole number for consistency
Source:
19
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Contents page
Table 2.5 Health risk category associated with overweight and obesity in adults based on Body Mass
1
Index (BMI) and waist circumference, by age and gender, 2006
England
2
Waist circumference and BMI
3
4
Health risk category
classification
Percentages
All men
16-24
25-34
35-44
45-54
55-64
65-74
75+
1
-
5
-
-
0
-
-
1
-
0
-
1
-
1
5
-
0
-
1
0
1
29
3
0
61
2
-
37
1
-
23
3
0
20
3
0
16
4
0
14
4
1
20
9
1
32
62
38
27
23
21
20
30
13
19
11
14
7
2
20
16
5
18
21
9
13
23
12
7
25
16
7
22
20
7
23
22
43
23
41
47
49
48
49
52
0
3
15
2
4
0
4
12
4
15
3
18
2
21
1
24
1
14
18
5
17
19
21
24
25
15
Men
Underweight
Low waist circumference
High waist circumference
Very high waist circumference
Not applicable
Not applicable
Not applicable
All underweight
Normal
No increased risk
No increased risk
Increased risk
All normal
Overweight
No increased risk
Increased risk
High risk
All overweight
Obesity I
Increased risk
High risk
Very high risk
All obese I
Obesity II
Very high risk
Very high risk
Very high risk
0
0
4
0
2
0
3
4
0
5
5
5
3
All obese II
Very high risk
4
3
3
4
5
5
5
3
Obesity III
Very high risk
Very high risk
Very high risk
1
1
1
2
1
2
1
0
All obese III
Very high risk
1
1
1
2
1
2
1
0
Not applicable
No increased risk
Increased risk
High risk
Very high risk
1
45
20
13
21
5
76
7
4
8
58
16
9
16
0
44
21
12
21
37
24
15
25
1
27
25
18
29
0
26
23
21
30
1
36
24
23
17
4,274
4,638
394
708
536
765
845
955
734
768
803
687
597
462
365
293
Men - Overall risk
4
Bases
Unweighted
Weighted
1. BMI categories according to NICE guidelines: Underweight: Less than 18.5 kg/m2, Normal: 18.5 to less than 25 kg/m2’,Overweight: 25
2
to less than 30 kg/m2, Obesity I: 30 to less than 35 kg/m2, Obesity II: 35 to less than 40 kg/m2,Obesity III: 40kg/m or more.
2. Waist circumference categories according to NICE guidelines: for men, less than 94cm is low, 94–102cm is high, and more than
102cm is very high. For women, less than 80cm is low, 80–88cm is high, and more than 88cm is very high
3. Percentages and bases in this table are based on those who have a valid measurement for waist circumference, in addition to valid
measurements of weight and height. Therefore subtotals for BMI categories by age and sex in this table are not definitive and may vary
from estimates shown in Table 2.1and 2.3
4. Health risk category according to NICE Guidelines.10 See Appendix B for further information
Source:
20
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Contents page
Table 2.5 continued...
England
2
Waist circumference and BMI
3
4
classification
Health risk category
Percentages
All women
16-24
25-34
35-44
45-54
55-64
65-74
75+
2
0
7
-
1
0
1
-
1
-
1
-
1
-
2
-
2
7
2
1
1
1
1
2
31
9
2
56
5
1
43
7
1
35
9
2
25
11
2
21
10
2
13
11
3
14
11
4
42
61
51
45
38
34
27
29
4
12
15
6
7
6
6
12
11
5
14
12
4
14
16
3
14
20
4
12
22
2
13
27
32
19
29
30
34
37
38
42
0
1
14
1
7
0
1
10
0
1
13
1
15
0
1
17
0
21
2
20
15
9
11
15
16
17
21
21
Women
Underweight
Not applicable
Not applicable
Not applicable
All underweight
Normal
No increased risk
No increased risk
Increased risk
All normal
Overweight
No increased risk
Increased risk
High risk
All overweight
Obesity I
Increased risk
High risk
Very high risk
All obese I
Obesity II
Very high risk
Very high risk
Very high risk
0
6
3
0
5
6
8
7
9
4
All obese II
Very high risk
6
3
5
6
8
7
9
4
Obesity III
Very high risk
Very high risk
Very high risk
0
3
1
2
0
3
3
3
4
0
1
All obese III
Very high risk
3
1
2
3
3
3
4
2
2
45
14
16
23
7
66
8
7
11
1
56
13
12
17
1
49
15
13
22
1
40
16
17
27
1
35
16
20
28
1
27
15
22
34
2
27
17
29
26
5,043
4,722
486
688
676
728
1,044
923
877
754
918
718
617
488
425
423
Women - Overall risk
4
Not applicable
No increased risk
Increased risk
High risk
Very high risk
Bases
Unweighted
Weighted
1. BMI categories according to NICE guidelines: Underweight: Less than 18.5 kg/m2, Normal: 18.5 to less than 25 kg/m2’,Overweight: 25
2
to less than 30 kg/m2, Obesity I: 30 to less than 35 kg/m2, Obesity II: 35 to less than 40 kg/m2,Obesity III: 40 kg/m or more.
2. Waist circumference categories according to NICE guidelines: for men, less than 94cm is low, 94–102cm is high, and more than 102cm
is very high. For women, less than 80cm is low, 80–88cm is high, and more than 88cm is very high
3. Percentages and bases in this table are based on those who have a valid measurement for waist circumference, in addition to valid
measurements of weight and height. Therefore subtotals for BMI categories by age and sex in this table are not definitive and may vary
from estimates shown in Table 2.1 and 2.3
4. Health risk category according to NICE Guidelines.10 See Appendix B for further information
Source:
21
Previous view
Contents page
Table 2.6 Body Mass Index (BMI)1 among adults2, by equivalised household income quintiles
and gender, 2006
England
Highest
2nd
3rd
4th
Lowest
Men
0
1
1
2
2
Normal
32
31
31
32
32
Overweight
47
45
44
39
41
Obese
21
23
24
27
25
68
68
68
66
65
1
2
1
1
2
27.1
27.3
27.3
27.3
27.1
Underweight
Morbidly obese
2
Mean BMI (kg/m )
Women
Underweight
2
2
2
2
3
Normal
48
42
41
37
33
Overweight
31
34
33
31
32
Obese
19
23
24
29
32
50
57
57
60
64
1
3
3
3
4
25.9
26.8
26.9
27.5
27.6
1,079
1,036
1,052
1,117
949
1,135
806
1,152
655
886
1,193
979
1,165
1,061
998
1,047
809
1,035
699
813
Morbidly obese
2
Mean BMI (kg/m )
Bases (unweighted)
Men
Women
Bases (weighted)
Men
Women
2
2
1. Using the following BMI definitions: Underweight: less than 18.5 kg/m ; normal: 18.5 to less than 25 kg/m ; overweight:
2
2
2
25 to less than 30 kg/m ; obese 30 kg/m or more; overweight including obese 25 kg/m or more; morbidly obese: 40
2
kg/m or more
3. Figures presented are age standardised
Source:
22
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1
2
Table 2.7 Waist circumference among adults , by equivalised household
income quintiles and gender, 2006
England
Highest
2nd
3rd
4th
Lowest
31
96.7
32
96.7
31
96.6
35
97.2
35
96.9
36
84.6
41
85.9
41
86.7
45
88.2
47
88.3
Men
906
888
812
699
551
Women
894
971
994
999
763
Bases (weighted)
Men
985
983
822
695
603
Women
826
904
908
912
716
Men
Women
Bases (unweighted)
1. Raised waist circumference has been taken to be greater than 102 cm in men and greater than 88 cm
in women
2. Adults aged 16 and over with a valid waist circumference measurement
Source:
23
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Contents page
Table 2.8 Body Mass Index (BMI)1 among adults2, by ethnic minority group and gender, 2004
England
General
population
Black
Caribbean
Black
African
Indian
Pakistani
Bangladeshi
Chinese
Irish
Men
Underweight
Normal
Overweight
Obese
1
32
44
23
0
32
42
25
1
37
45
17
3
44
39
14
3
41
40
15
4
51
39
6
3
60
31
6
2
31
42
25
Morbidly obese
67
1
67
0
62
0
53
0
55
1
44
0
37
0
67
2
27.1
27.1
26.4
25.8
25.9
24.7
24.1
27.2
Women
Underweight
Normal
Overweight
Obese
2
41
34
23
3
33
32
32
2
29
31
38
3
42
35
20
2
35
34
28
5
44
34
17
5
70
17
8
2
40
37
21
Morbidly obese
57
2
65
4
70
5
55
1
62
2
51
1
25
0
58
2
26.8
28.0
28.8
26.2
27.1
25.7
23.2
26.7
2,444
3,135
317
459
297
332
482
546
346
391
330
353
307
308
420
555
39,244
39,803
380
500
291
344
798
921
336
387
143
153
135
136
1,574
2,008
2
Mean BMI (kg/m )
2
Mean BMI (kg/m )
Bases (unweighted)
Men
Women
Bases (weighted)
Men
Women
2
2
2
1. Using the following BMI definitions: Underweight: less than 18.5 kg/m ; normal: 18.5 to less than 25 kg/m ; overweight: 25 to less than 30 kg/m ;
2
2
2
obese 30 kg/m or more; overweight including obese 25 kg/m or more; morbidly obese: 40 kg/m or more
Source:
24
Previous view
Contents page
1
2
Table 2.9 Body Mass Index (BMI) among adults , by smoking status and
gender, 2003
England
Current cigarette Ex-regular cigarette
smoker
smoker
Percentages
Never smoked
regularly
Men
Underweight
1.8
0.2
1.8
Normal
43.5
21.3
34.0
Overweight
39.5
47.5
43.0
Obese
15.1
31.0
21.2
54.7
78.6
64.2
0.6
1.5
1.0
Morbidly obese
Women
Underweight
Normal
3.4
0.9
2.0
46.3
33.9
43.4
Overweight
30.5
36.0
32.4
Obese
19.9
29.1
22.2
50.4
65.2
54.6
2.6
3.3
2.9
Men
1,529
1,793
2,627
Women
1,777
1,463
3,837
Men
1,751
1,785
2,959
Women
1,651
1,308
3,597
Morbidly obese
Bases (unweighted)
Bases (weighted)
2
1. Using the following BMI definitions: Underweight: less than 18.5 kg/m ; normal: 18.5 to less than
2
2
2
25 kg/m ; overweight: 25 to less than 30 kg/m ; obese 30 kg/m or more; overweight including
2
2
obese 25 kg/m or more; morbidly obese: 40 kg/m or more
Source:
Health Survey for England 2003. The Department of Health
Copyright © 2008, re-used with the permission of The Department of Health
25
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Table 2.10 Estimated odds ratios for raised waist circumference1 among adults2, by associated risk factors3 and
gender, 2006
England
Men
N
Age (p<0.001 men, p<0.001 women)
16-24
25-34
35-44
45-54
55-64
65-74
75 and over
415
576
877
782
857
651
435
4
Women
4
95%
confidence
intervals
N
Odds ratio
95%
confidence
intervals
1.0
2.3 (1.57 - 3.87)
3.8 (2.45 - 5.76)
5.0 (3.29 - 7.75)
6.1 (3.93 - 9.36)
6.7 (4.13 - 10.91)
4.1 (2.51 - 6.55)
506
722
1,113
945
983
695
573
1.0
2.1
2.8
4.1
4.7
6.3
5.1
(1.59 - 2.87)
(2.14 - 3.74)
(3.10 - 5.51)
(3.58 - 6.25)
(4.63 - 8.47)
(3.70 - 7.14)
Odds ratio
Cigarette smoking status (p<0.001 men, p=0.018 women)
Never smoked cigarettes at all
Used to smoke cigarettes occasionally
Used to smoke cigarettes regularly
Current cigarette smoker
1,902
219
1,450
1,022
1.0
0.9
1.6
0.9
(0.62 - 1.24)
(1.36 - 1.90)
(0.78 - 1.13)
2,769
326
1,293
1,149
1.0
0.9
1.2
1.0
(0.69 - 1.12)
(1.06 - 1.42)
(0.86 - 1.18)
Physical activity level (p<0.001 men, p<0.001 women)
High
Medium
Low
Question not answered
1,617
1,286
1,140
550
1.0
1.4
2.1
1.5
(1.17 - 1.66)
(1.71 - 2.48)
(1.10 - 1.95)
1,473
1,798
1,623
643
1.0
1.4
1.9
1.4
(1.19 - 1.64)
(1.59 - 2.22)
(1.05 - 1.77)
906
889
812
699
551
736
1.0
1.1
1.0
1.2
1.3
0.9
(0.88 - 1.41)
(0.81 - 1.33)
(0.96 - 1.59)
(0.98 - 1.67)
(0.70 - 1.21)
894
972
994
999
763
915
1.0
1.4
1.4
1.7
1.9
1.3
(1.16 - 1.78)
(1.13 - 1.67)
(1.38 - 2.06)
(1.49 - 2.37)
(1.05 - 1.61)
Equivalised household income quintile (p=0.219 men, p<0.001)
Highest quintile
2nd quintile
3rd quintile
4th quintile
Lowest quintile
Question not answered
Bases (Weighted)
5,537
4,593
2. All adults aged 16 and over with a valid waist measurement
3. Variables in the model found to be significant in one or both genders are included in the table
Source:
26
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Table 2.11 Body Mass Index (BMI)1 among adults2, by units of alcohol drunk on heaviest
drinking day in the week prior to interview and gender, 2003
England
Did not drink last
3
week
Up to and
including 4/3
4
units
More than 4/3
units, up to and
including 8/6
4
units
More than 8/6
4
units
Men
Underweight
Normal
Overweight
Obese
3.0
37.3
36.9
22.8
0.9
30.5
46.7
22.0
0.6
30.9
46.6
22.0
1.2
34.0
42.4
22.4
Morbidly obese
59.7
1.6
68.6
0.7
68.5
0.6
64.8
0.9
Women
Underweight
Normal
Overweight
Obese
2.3
37.5
32.2
28.0
1.7
42.4
34.6
21.3
2.3
48.1
32.1
17.6
1.8
49.4
28.6
20.2
Morbidly obese
61.3
4.1
55.9
2.2
49.6
1.8
48.8
2.5
Bases (unweighted)
Men
Women
1,335
2,528
2,270
2,773
1,006
1,056
1,296
638
Bases (weighted)
Men
Women
1,475
2,336
2,370
2,522
1,086
984
1,512
632
2
2
1. Using the following BMI definitions: Underweight: less than 18.5 kg/m ; normal: 18.5 to less than 25 kg/m ;
2
2
2
2
3. Includes those who drink nowadays but did not have an alcoholic drink in the seven days prior to interview as well
those who said they never drink alcoholic drinks
4. It is recommended that men drink no more than 4 units a day, and women no more than 3 units a day. Binge
drinking is classed as drinking more than 8 units for men and more than 6 units for women
Source:
27
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Table 2.12 Body Mass Index (BMI)1 among adults2, by summary physical activity
levels3 and gender, 2003
England
High
Medium
Percentages
Low
1.7
1.0
1.5
Normal
38.6
32.6
26.9
Overweight
41.8
44.7
43.4
Obese
17.8
21.6
28.3
59.7
66.3
71.7
0.4
1.4
1.2
Men
Underweight
Morbidly obese
Women
Underweight
2.5
1.8
2.2
Normal
49.6
44.7
34.8
Overweight
31.9
31.9
33.8
Obese
16.0
21.7
29.2
47.9
53.6
63.0
2.0
2.8
3.6
Men
2,157
1,913
1,886
Women
1,797
2,658
2,623
Men
2,458
2,093
1,957
Women
1,689
2,472
2,397
Morbidly obese
Bases (unweighted)
Bases (weighted)
2
2
1. Using the following BMI definitions: Underweight: less than 18.5 kg/m ; normal: 18.5 to less than 25 kg/m ;
2
2
2
2
3. High = 30 minutes or more on at least 5 days a week; medium = 30 minutes or more on 1 to 4 days a week; low
= lower levels of activity
Source:
28
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1
2
2.13 Overweight and obesity prevalence among adults , England
and Scotland, 2003
England and Scotland
Scotland
England
Men
Obese
Mordibly obese
65.4
22.2
1.0
65.4
22.4
1.6
Mean BMI (kg/m )
26.9
27.0
Women
Obese
Mordibly obese
55.5
23.0
2.9
59.7
26.0
3.4
26.7
27.2
5,966
7,090
3,016
3,684
6,519
6,570
3,217
3,458
2
2
Mean BMI (kg/m )
Bases (unweighted):
Men
Women
Bases (weighted)
Men
Women
2
1. Using the following BMI definitions: overweight including obese 25 kg/m or more; obese
2
30 kg/m2 or more; morbidly obese: 40 kg/m or more
Source:
The Scottish Health Survey 2003. The Scottish Executive
Copyright © 2008, re-used with the permission of The Scottish Executive
29
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1
2
2.14 Waist circumference among adults , England and Scotland,
2003
England
Scotland
Men
31.1
96.5
28.0
95.3
Women
41.1
86.4
38.9
86.3
4,962
5,995
2,356
2,850
5,397
5,554
2,532
2,679
Bases (unweighted)
Men
Women
Bases (weighted)
Men
Women
1. Raised waist circumference has been taken to be greater than 102 cm in men and
greater than 88cm in women
2. Adults aged 16 and over with a valid waist circumference and hip measurement
Source:
30
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Table 2.15 Body Mass Index (BMI)1 among adults2, by Government Office Region/Strategic Health Authority3 and gender, 2006
England
North
East
Government Office Region
North Yorkshire
East
West
East
West
and the Midlands Midlands England
Humber
London
South
West
Strategic Health
Authority
South East
South
Coast
Central
South
East
Men
Observed
Underweight
1
2
2
1
1
1
1
0
1
1
1
Normal
38
32
31
33
23
30
40
30
31
31
31
Overweight
Obese
34
27
43
24
41
26
41
25
47
28
48
22
42
17
42
28
47
22
44
24
49
19
Morbidly obese
61
1
66
1
67
2
66
2
76
2
69
1
60
2
70
2
68
1
68
2
68
1
27.2
27.1
27.3
27.3
27.9
27.2
26.5
27.7
27.1
27.2
26.9
Underweight
Normal
1
36
2
32
2
31
1
31
1
23
1
30
1
38
0
32
1
33
1
34
1
32
Overweight
Obese
35
28
43
23
41
26
42
26
47
29
48
22
42
19
41
27
46
20
43
22
48
18
Morbidly obese
62
1
66
1
67
2
68
2
76
2
69
1
61
2
68
2
66
1
65
1
67
1
27.3
27.1
27.3
27.5
27.9
27.2
26.7
27.5
26.8
26.9
26.7
2
Mean BMI (kg/m )
Age standardised
2
Mean BMI (kg/m )
Women
Observed
Underweight
Normal
1
2
3
3
2
2
3
1
2
3
2
39
43
42
37
36
39
51
42
43
45
41
Overweight
32
33
31
34
33
36
26
34
30
30
30
Obese
28
22
24
27
29
24
20
23
24
22
27
60
55
56
61
62
59
46
57
55
52
57
2
2
3
3
4
3
2
3
2
2
3
27.3
26.6
26.8
27.3
27.7
26.9
25.8
27.0
26.6
26.3
26.9
Morbidly obese
2
Mean BMI (kg/m )
Age standardised
Underweight
Normal
1
2
2
3
2
2
3
1
2
3
2
38
44
40
38
36
39
48
42
43
45
42
Overweight
32
33
32
34
33
36
28
34
30
30
30
Obese
28
22
25
26
29
23
21
23
24
22
26
61
54
57
59
62
59
49
57
54
53
57
2
2
3
3
4
2
2
3
2
2
3
27.4
26.5
27.0
27.2
27.6
26.8
26.2
27.0
26.5
26.3
26.8
Morbidly obese
2
Mean BMI (kg/m )
Bases (unweighted)
Men
286
832
577
553
597
646
607
524
901
451
450
Women
360
967
681
661
741
724
651
671
1,048
561
487
Men
297
811
608
547
648
696
861
594
953
480
473
Women
326
840
619
539
677
683
762
659
969
524
Bases (weighted)
2
2
2
445
2
1. Using the following BMI definitions: Underweight: less than 18.5 kg/m ; normal: 18.5 to less than 25kg/m ; overweight: 25 to less than 30 kg/m ; obese 30 kg/m or more;
2
2
overweight including obese 25 kg/m or more; morbidly obese: 40 kg/m or more
3. This table provides data for regional analysis both by Government Office Region (GOR) and the new configuration of Strategic Health Authorities (SHAs) in place from
July 2006. The first eight columns represent GORs and SHAs of the same name, while the South East GOR (column nine) is divided into South East Coast SHA and South
Central SHA, shown in the final two columns
Source:
31
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Table 2.16 Waist circumference1 among adults2, by Government Office Region/Strategic Health Authority3 and gender, 2006
England
North
East
North Yorkshire
East
West
East
West
Humber
London
South
West
South
East
Strategic Health
Authority
South East
South
Coast
Central
Men
Observed
31
95.5
33
97.0
30
97.0
29
96.0
35
98.3
31
97.3
28
94.8
39
98.6
33
97.1
35
97.6
31
96.5
Age standardised
32
95.7
32
96.7
30
97.0
31
96.7
34
98.1
31
97.2
30
95.9
37
97.9
31
96.3
33
96.8
29
95.6
Women
Observed
41
87.0
38
85.8
38
85.9
43
87.0
43
87.3
45
87.4
37
84.7
46
87.7
40
86.2
39
86.2
42
86.2
Age standardised
41
86.7
37
85.4
39
86.2
41
86.4
42
87.2
44
87.2
40
85.9
45
87.4
40
86.0
39
86.0
42
86.1
Men
270
673
509
468
487
545
412
430
798
403
395
Women
326
835
613
557
596
604
466
570
969
521
448
Men
261
645
500
451
521
572
746
464
795
405
390
Women
272
726
524
441
559
563
696
539
855
463
392
Bases (unweighted)
Bases (weighted)
2. Adults aged 16 and over with a valid waist circumference measurement
July 2006. The first eight columns represent GORs and SHAs of the same name, while the South East GOR (column nine) is divided into South East Coast SHA and South
Central SHA, shown in the final two columns
Source:
32
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1
Table 2.17 Prevalence of overweight and obesity among adults in European
2
3
Union countries, 2004
European Union
Overweight and obese
Overweight
Percentages
Obese
EU Average
47.5
34.1
13.4
Austria
Belgium
Bulgaria
Cyprus
Czech Republic
Denmark
Estonia
Finland
France
Germany
Greece
Hungary
Ireland
Italy
Latvia
Lithuania
Malta
Netherlands
Poland
Portugal
Romania
Slovakia
Slovenia
Spain
Sweden
4
United Kingdom
43.5
41.8
46.0
46.1
50.8
41.7
44.2
51.3
37.1
59.7
54.0
52.7
46.2
39.8
45.3
49.0
57.5
42.3
43.2
51.5
41.8
46.7
48.5
49.0
43.8
61.0
34.9
30.8
33.6
33.7
36.4
32.2
30.9
36.7
27.8
39.4
43.3
33.8
33.1
31.7
29.8
32.9
34.5
33.3
31.8
36.8
33.1
32.4
36.2
35.7
33.8
38.3
8.6
11.0
12.4
12.3
14.4
9.5
13.3
14.5
9.3
20.3
10.7
18.8
13.2
8.1
15.5
16.0
23.0
8.9
11.4
14.7
8.6
14.3
12.3
13.3
10.1
22.7
1. Aged 15 and over
2. Data is not available for Luxembourg
3. There is no fixed periodicity in these kinds of health surveys. Very few countries have a yearly
survey on these topics. The Health Interview Survey (HIS) data are collected in different years
depending on the country, going from 1996 to 2003. For more details please see Appendix A
4. UK data only covers England
Source:
Health status: indicators from the national Health Interview Surveys. European Commission:
Eurostat
Copyright © 2008, re-used with the permission of Eurostat
33
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34
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3 Obesity among children
3.1 Introduction
This chapter presents key information
about the prevalence of obesity and
overweight among children aged 2 to 15
living in England, using data from the
Health Survey for England (HSE) 20061. As
described in Chapter 2, this is an annual
survey and has provided information about
the health of children since 1995.
In October 2007, the government published
a new long-term plan to reverse the rising
tide of obesity and overweight in the
population. As part of this a new Public
Service Agreement (PSA) to promote better
health and well being for all was
established. The PSA aims to reduce the
number of obese and overweight children
to 2000 levels by 20202. This replaces the
previous target to ‘halt the year on year rise
in obesity in children under the age of 11 by
2010’. Currently national, progress on
meeting the target is being monitored
through the HSE.
In addition to overall prevalence of obesity
among children, this chapter also presents
relationships between obesity and various
socio-economic variables and other factors
including parental BMI and physical activity
levels, and also provides a geographical
comparison. The final part of this chapter
focuses on future predictions of childhood
obesity by considering two reports;
Forecasting Obesity to 20103 published by
the Department of Health in August 2006
and the more recently published report by
Foresight at the Government Office for
Science, Tackling Obesities: Future
Choices4 published in October 2007.
3.1.1 Measurement of obesity among
children
As with adults, the HSE collects height and
weight measurements to calculate Body
Mass Index (BMI) for each child. BMI
(adjusted for age and gender) is
recommended as a practical estimate of
overweight and obesity in children. The
measurement of obesity and overweight
among children needs to take account of
the different growth patterns among boys
and girls at each age, therefore a universal
categorisation cannot be used to define
childhood obesity as is the case with
adults. Each sex and age group needs its
own level of classification for overweight
and obesity. The data presented in this
chapter uses the UK National BMI
percentile
classification
to
describe
childhood overweight and obesity. This
uses a BMI threshold for each age above
which a child is considered overweight or
obese. The classification estimates were
produced by calculating the percentage of
boys and girls who were over the 85th
(overweight)
or
95th
(obese)
BMI
percentiles based on the 1990 UK
reference population.
3.2 Overweight and obesity prevalence
In 2006, 29.7% of children aged 2 to 15
were classed as overweight or obese.
Equivalent figures for boys and girls among
this age group were 30.6% and 28.7%
respectively. A higher proportion of boys
than girls were obese (17.3% of boys and
14.7% of girls). Among children aged 2 to
10, 29.3% of boys were either overweight
or obese, compared with 25.9% of girls and
17.1% of boys aged 2 to 10 were obese,
compared with 13.2% of girls (Table 3.1
and 3.2).
3.3 Trends in overweight and obesity
Overall, between 1995 and 2006,
prevalence of obesity among both boys and
girls increased. Among boys aged 2 to 15,
the proportion who were obese increased
overall from 10.9% in 1995 to 17.3% in
2006, and among girls from 12.0% in 1995
to 14.7%, over the same period although
35
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there was some fluctuation between years.
The 2006 estimate for girls aged 2 to 15
represents a significant decrease from the
2005 figure of 18.3%. Future years’ data
will show whether this is part of a
downward trend.
In 2006, 17.3% of boys and 14.7% of
girls were obese compared with
10.9% and 12.0% in 1995
The same overall increase was apparent
among both younger children aged 2 to 10
and boys aged 11 to 15. For those aged 2
to 10, the prevalence of obesity increased
overall from 9.6% to 17.1% among boys
and from 10.3% to 13.2% among girls
between 1995 and 2006. In the 11 to 15
age group, obesity increased from 13.5% to
17.7% among boys. For girls aged 11 to 15
the overall increase from 15.4% to 17.0%
was not statistically significant.
3.4 Socio-economic variables
3.4.1 Obesity and income
Table 3.3 presents relationships between
obesity and equivalised household income.
Among boys and girls aged 2 to 15, a
pattern can be seen between obesity
prevalence and income group. Among the
lowest income group 20% of both boys and
girls were obese. In comparison, in the
highest income group, 15% of boys and 9%
of girls were obese (Figure 3.2). The
proportion who were either overweight or
obese also varied among girls from 24% in
the highest income group to 33% in the
lowest, but no such pattern was found
among boys.
Figure 3.2 Prevalence of obesity among children, by
equivalised household income quintiles and gender, 2006
Percentages
England
Boys
25
Girls
20
15
Whilst there have been marked increases
in the prevalence of obesity since 1995, the
prevalence of overweight for children aged
2 to 15 has remained at a similar level
although there has been fluctuation
between years (Table 3.2, Figure 3.1).
Figure 3.1 Obesity prevalence among children aged 2 to 15,
1995 to 2006
Percentages
England
25
20
Boys
15
Girls
10
5
Data w eighted from 2003 - see Appendix A
0
1995 1996 1997
1998 1999 2000 2001 2002 2003
2004 2005 2006
10
5
0
Highest
2nd
3rd
4th
Low est
Logistic regression was used in the HSE
2006 in order to identify factors that are
independently associated with overweight
and obesity among children. The analysis
found girls in the lowest income quintile had
2.5 times higher odds of being overweight
including obese than girls in the highest
quintile. No clear relationship could be
identified for boys nor could a relationship
be seen between obesity and income for
boys and girls (Table 3.4).
36
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Girls in the lowest income quintile
were 2.5 times more likely to be
overweight (including obese) than
those in the highest quintile.
Figure 3.3 Prevalence of obesity among children, by
parental BMI status and gender, 2006
England
30
Percentages
Boys
Girls
25
20
15
10
5
0
3.4.2 Obesity and socio-economic group
Regression analyses also showed that
children in households where the reference
person had a semi-routine or routine
occupation had nearly twice the odds of
being obese compared with those in
managerial and professional households
(boys odds ratio 1.85, girls 1.99) (Table
3.5).
Children in semi-routine and routine
households were nearly twice as
likely to be obese than those in
managerial and professional
households
3.5 Obesity prevalence and other factors
Normal/ household Mother overw eight/ Father overw eight/ Overw eight/ obese
obese, father
obese, mother
household
normal/
normal/
underw eight
underw eight
Logistic regression found that among girls,
parental BMI was a significant predictor of
overweight including obese, and of obesity.
Girls living in overweight or obese
households had over three times the odds
of being overweight or obese compared
with
girls
from
normal/underweight
households. Girls whose mother was
overweight or obese, but whose father was
not, also had higher odds of being
overweight or obese than girls in
normal/underweight households.
There
were no relationships found between
overweight or obesity and parental BMI for
boys. (Tables 3.4 and 3.5)
3.5.1 Relationships between obesity
prevalence and parental BMI
Overweight and obesity prevalence among
children varied by parental BMI status.
Among girls, obesity prevalence was higher
in households where either parents or the
child’s mother, were either overweight or
obese. Twenty-two per cent of girls aged 2
to 15 living in overweight or obese
households were classed as obese
compared with 8% in normal households.
Equivalent figures for those classed as
either overweight or obese were 37% and
16%. No clear relationship could be
identified among boys (Table 3.6, Figure
3.3).
households were over three times as
likely to be overweight or obese than
those living in normal households
3.5.2 Obesity and physical activity
The 2006 HSE, included a set of questions
about a range of children’s physical
activities such as sports and exercise
activities, walking and active play. The
levels of physical activity reported were
then classified into three groups: high,
medium, and low (see Appendix B for more
detail).
37
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For girls aged 2 to 15, a relationship can be
seen between overweight prevalence and
physical
activity
levels:
overweight
prevalence rates ranged from 18% in the
low physical activity group to 12% in the
high physical activity group. No equivalent
difference was identified for those classed
as obese.
There were no significant
patterns found in any category for boys
(Table 3.7).
3.6 Geographical patterns in obesity
3.6.1 National comparisons of obesity
As mentioned in Chapter 2, the Scottish
Health Survey 20035 includes some
comparisons
of
obesity
prevalence
between Scotland and England. Results
for Scotland in 2003 from the Scottish
Health Survey are compared with data for
England from the 2002 HSE6 due to the
boost sample for children included in the
HSE 2002 survey.
Table 3.8 shows that the prevalence of
overweight
including
obesity
was
significantly higher among boys in Scotland
than
England
(34.6%
and
30.3%
respectively). There were no significant
differences for girls.
Overweight and obesity prevalence
was higher among boys in Scotland
than England
3.6.2 Obesity by region
Obesity prevalence varied between the
different Government Office Regions
(GORs) and Strategic Health Authorities
(SHAs). For boys, in 2006, prevalence of
obesity ranged from 24% in London to 13%
in South Central SHA. Among girls values
ranged from 18% in the East Midlands to
10% in East England (Table 3.9).
3.6.3 Obesity and sub-regional
comparisons
The
National
Child
Measurement
Programme (NCMP) is one element of the
government’s
work
programme
on
childhood obesity, and is operated jointly by
the Department of Health (DH) and the
Department for Children, Schools and
Families (DCSF). The NCMP measures
the height and weight among primary
school children in reception year and year
6, and was introduced for academic year
2005/06. Analysis of this data by the
Association of Public Health Observatories7
strongly suggests that results from the
2005/06 academic year significantly
underestimate the prevalence of childhood
obesity. Because of this it has been
decided not to include this data within this
report. The NCMP for academic year
2006/07 has been run by the Information
Centre and the national report is due to be
published in February 2008. This report
will include children’s obesity and
overweight prevalence at sub-national
level, for example at Primary Care Trust
(PCT) and Local Authority (LA) level.
3.7 Children’s perceptions of weight
In the HSE 2006, children aged 8 to 15
were asked ‘Given your age and height,
would you say that you are about the right
weight, too heavy, or too light?’.
Perceptions of weight varied by overweight
and obesity status. Among girls aged 8 to
15 classed as obese, two thirds believed
that they were too heavy while a third said
their weight was about right. The equivalent
figures for boys were 60% and 40% (Table
3.10).
3.8 The future
The DH report, Forecasting Obesity to
2010, uses the HSE and the UK 1990
National BMI percentile classification to
predict future levels of childhood obesity.
38
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The report estimates that 19% of boys and
22% of girls aged 2 to 15 will be obese by
2010, compared with 17% and 16%
respectively in 2003. The proportion of
children likely to be overweight in 2010 is
similar to the estimate in 20033.
Obesity prevalence is predicted to
double by 2025 among young people
The more recently published report by
Foresight at the Government Office for
Science, Tackling Obesities: Future
Choices includes some predictions for the
future prevalence of obesity among young
people under the age of 20. This report
uses a different methodology to define
obesity than that used in the DH report and
throughout the rest of this chapter (UK
1990 National BMI percentile). In this case
the International Obesity Task Force (IOTF)
definition of obesity is used. More
information on the IOTF can be found in
Appendix A. The report’s predictions
suggest a growth in the prevalence of
obesity among people under 20 from
current levels (8% for males and 10% for
females in 2004) to around 15% by 20254.
However, these figures should be viewed
with caution due to the widening confidence
intervals on the extrapolation (Figure 3.4).
Figure 3.4 Percentage of young people predicted to be
obese1, by gender and age
2004
Percentages
2025
Boys
6-10
11-15
All under 20
10
5
8
21
11
15
Girls
6-10
11-15
All under 20
10
11
10
14
22
15
1. Using IOTF criteria. See Appendix A for more information.
Source: Tackling Obesities: Future choices - Project report. Foresight, The
Government Office for Science
Copyright © 2007, re-used with the permission of The Government Office for science
39
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Summary: Obesity among children
This chapter has shown that obesity
prevalence among children has displayed
an overall increase between 1995 and
2006 while the prevalence of overweight
has remained at similar levels. In 2006,
around three in ten children were classed
as either overweight or obese.
households were over three times as likely
to be overweight or obese than those living
in normal or underweight households.
Parental BMI did not appear to effect
overweight or obesity prevalence among
boys.
Girls in the lowest income quintile were two
and a half times more likely than those in
the highest to be overweight including
obese. No clear relationships were found
for boys.
Scotland reported higher levels of
overweight including obesity among boys
than in England. Little difference was
found among girls.
Children in households where the reference
person had a semi-routine or routine
occupations were nearly twice as likely to
be obese compared with those in
managerial and professional households.
Government reports have predicted that
levels of obesity among children and young
people will continue to rise in the future if
action to tackle this trend is not taken.
References
1. Health Survey for England 2006: The
www.ic.nhs.uk/pubs/CVDandriskfactors
2. 2007 Pre-Budget Report and
Comprehensive Spending Review. HM
Treasury, 2007. Available at:
http://www.hmtreasury.gov.uk/media/7/4/pbr_csr07_comp
letereport_1546.pdf
3.
Forecasting
Obesity
to
2010.
http://www.scotland.gov.uk/Resource/Doc/7
6169/0019732.pdf
4. Tackling Obesities: Future Choices –
Modelling Future Trends in Obesity & Their
Impact on Health. Foresight, Government
Office for Science
_final/17.pdf
5. The Scottish Health Survey 2003: The
Scottish Executive, 2005 Available at:
/http://www.scotland.gov.uk/Resource/Doc/
76169/0019729.pdf
6. Health Survey for England 2002:
tistics/PublishedSurvey/HealthSurveyForEn
gland/Healthsurveyresults/DH_4001558
7. Analysis of the National Childhood
Obesity Database 2005/06, a report for the
Department of Health. Available at:
H_063565
40
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List of tables
3.1
Overweight and obesity prevalence among children, by age and gender, 2006
3.2
Overweight and obesity prevalence among children, by year and gender, 1995 to 2006
3.3
Overweight and obesity prevalence among children, by equivalised household income
quintiles and gender, 2006
3.4
Estimated odds ratios for overweight (including obese) among children, by associated
risk factors and gender, 2006
3.5
Estimated odds ratios for obesity among children, by associated risk factors and
gender, 2006
3.6
Overweight and obesity prevalence among children, by parental BMI status and
gender, 2006
3.7
Overweight and obesity prevalence among children, by summary physical activity
levels and gender, 2006
3.8
Overweight and obesity prevalence among children by gender, England, 2002 and
Scotland, 2003
3.9
Overweight and obesity prevalence among children, by Government
Region/Strategic Health Authority and gender, 2006
3.10
Perceived weight among children, by BMI status and gender, 2006
41
Office
1
1
2,822
2,670
Bases (weighted)
Boys
Girls
1,737
1,635
1,875
1,845
13
13
26
12
17
29
Children
aged 2-10
1,085
1,035
1,154
1,105
16
17
33
15
18
33
Children
aged 11-15
145
132
164
153
10
12
22
13
16
29
2
171
181
192
196
16
8
24
13
17
31
3
166
176
187
189
12
9
22
13
16
29
4
198
179
212
197
13
14
27
11
19
30
5
183
178
203
203
9
8
17
9
19
28
6
222
197
234
225
11
14
25
13
6
20
7
176
198
184
235
15
15
30
11
15
26
8
250
201
254
228
10
19
29
14
23
38
9
226
195
245
219
17
18
35
11
21
33
10
198
206
212
232
17
14
31
16
21
38
11
214
196
235
210
16
18
35
15
15
30
12
228
216
252
232
12
18
30
15
23
38
13
Source:
1. Categories are independent, i.e. overweight does not include those who are obese. Overweight was defined as ≥ 85th < 95th UK BMI percentile; obese was defined as ≥ 95th UK BMI percentile
3,029
2,950
14
15
29
13
17
31
Children
aged 2-15
Bases (unweighted)
Boys
Girls
Overweight
1
Obese
Girls
Overweight
1
Obese
Boys
England
Table 3.1 Overweight and obesity prevalence among children, by age and gender, 2006
226
199
229
208
20
19
39
14
13
27
219
218
226
223
17
15
32
15
16
31
Percentages
14
15
Previous view
Contents page
42
1
13.6
14.4
28.1
13.1
11.5
24.5
11-15
4
Overweight
4
Obese
2-15
4
Overweight
4
Obese
13.4
13.5
26.9
13.1
10.9
24.0
11-15
4
Overweight
4
Obese
2-15
4
Overweight
4
Obese
13.9
15.4
29.3
13.1
12.0
25.0
11-15
4
Overweight
4
Obese
2-15
4
Overweight
4
Obese
43
1,261
658
1,918
Boys
2-10
11-15
2-15
1,418
714
2,132
2,783
1,363
4,146
11.8
11.8
23.6
13.5
15.0
28.5
11.0
10.2
21.2
14.1
11.9
26.1
14.9
13.8
28.6
13.8
11.0
24.8
13.0
11.9
24.9
14.2
14.3
28.6
12.4
10.6
23.1
1996
2,007
1,056
3,063
4,089
2,043
6,132
13.1
12.4
25.5
15.4
16.2
31.6
12.0
10.7
22.6
13.0
12.7
25.7
12.7
15.6
28.3
13.1
11.1
24.3
13.0
12.6
25.6
14.0
15.9
29.9
12.5
10.9
23.4
1997
1,336
645
1,981
2,552
1,301
3,853
13.6
13.8
27.4
15.7
17.5
33.2
12.5
11.8
24.3
14.6
13.0
27.6
14.7
16.3
30.9
14.6
11.4
26.0
14.1
13.4
27.5
15.2
16.9
32.1
13.6
11.6
25.2
1998
633
343
977
1,262
665
1,927
13.5
13.7
27.3
13.7
15.2
28.9
13.5
13.0
26.5
14.4
16.4
30.8
14.9
16.9
31.8
14.1
16.1
30.2
14.0
15.1
29.0
14.3
16.1
30.4
13.8
14.6
28.4
1999
570
306
877
1,094
624
1,718
12.7
14.2
26.8
14.4
18.1
32.6
11.6
11.8
23.3
12.4
14.5
26.8
10.0
18.8
28.9
13.6
12.2
25.8
12.5
14.3
26.8
12.3
18.5
30.8
12.6
12.0
24.6
2000
1,035
618
1,653
2,129
1,223
3,352
15.2
14.5
29.7
17.5
17.7
35.2
14.0
12.7
26.7
15.0
15.5
30.5
14.1
18.8
32.9
15.6
13.5
29.1
15.1
15.0
30.1
15.8
18.2
34.1
14.8
13.1
27.9
2001
2,364
1,381
3,745
4,654
2,726
7,381
13.9
17.1
30.9
15.1
19.2
34.3
13.1
15.8
28.9
13.7
16.9
30.6
14.4
19.8
34.2
13.3
15.2
28.5
13.8
17.0
30.8
14.7
19.5
34.2
13.2
15.5
28.7
2002
876
533
1,410
1,774
1,081
2,854
14.4
16.1
30.5
16.0
21.9
37.9
13.4
12.5
25.9
14.6
17.0
31.6
14.4
20.4
34.8
14.7
14.9
29.6
14.5
16.5
31.0
15.2
21.2
36.4
14.0
13.7
27.7
416
230
645
759
465
1,224
16.3
17.8
34.1
19.4
26.2
45.6
14.2
11.9
26.1
13.7
18.9
32.5
12.8
23.7
36.4
14.2
16.2
30.4
14.9
18.3
33.2
16.1
25.0
41.1
14.2
14.3
28.5
695
382
1,077
1,419
794
2,212
12.8
18.1
31.0
14.0
20.6
34.6
12.2
16.7
28.9
15.9
18.0
33.9
14.8
20.5
35.4
16.5
16.6
33.1
14.3
18.0
32.4
14.4
20.5
35.0
14.3
16.7
30.9
1,789
1,007
2,796
3,539
1,999
5,538
13.9
14.7
28.6
16.2
17.1
33.3
12.6
13.3
25.9
13.3
17.1
30.4
14.8
17.6
32.4
12.4
16.8
29.2
13.6
15.9
29.5
15.5
17.4
32.9
12.5
15.1
27.6
2003
2004
2005
2006
2
2
2
2
(unweighted) (unweighted) (unweighted) (unweighted)
Source:
Girls
2-10
1,266
1,365
2,082
1,216
628
523
1,094
2,290
897
343
724
1,750
11-15
635
649
987
656
322
318
605
1,346
547
236
411
992
2-15
1,901
2,014
3,069
1,872
950
841
1,699
3,636
1,444
579
1,135
2,742
1. Data from 1995 to 2006 are weighted for child selection
2. From 2003 data was also weighted for non-response. For consistency with previous years, 2003 to 2006 data shown here are weighted for child selection only
3. Data shown for 2003 to 2006 here is weighted for non-response and child selection
4. Categories are independent, i.e. overweight does not include those who are obese. Overweight was defined as ≥ 85th < 95th UK BMI percentile; obese was defined as ≥ 95th UK BMI percentile
2,527
1,293
3,819
All children
2-10
11-15
2-15
Bases (weighted)
12.6
10.3
22.9
2-10
4
Overweight
4
Obese
Girls
12.9
9.6
22.5
2-10
4
Overweight
4
Obese
Boys
12.8
9.9
22.7
1995
2-10
4
Overweight
4
Obese
All Children
England
Table 3.2 Overweight and obesity prevalence among children, by year and gender, 1995 to 2006
858
535
1,393
878
574
1,452
1,736
1,109
2,845
14.6
16.1
30.7
16.4
22.1
38.5
13.4
12.4
25.8
14.6
17.0
31.6
14.5
20.0
34.5
14.6
15.1
29.7
14.6
16.6
31.2
15.4
21.0
36.4
14.0
13.8
27.8
2003
3
(weighted)
346
235
581
379
245
624
726
480
1,206
16.6
18.5
35.1
19.3
26.7
46.0
14.8
12.8
27.7
13.9
19.2
33.0
12.8
24.2
37.0
14.6
15.9
30.5
15.2
18.8
34.0
16.0
25.4
41.4
14.7
14.5
29.1
2004
3
(weighted)
674
417
1,091
664
438
1,102
1,338
855
2,193
12.9
18.3
31.2
14.1
20.8
34.9
12.2
16.8
29.0
15.7
18.3
33.9
15.0
20.4
35.3
16.1
16.9
33.0
14.3
18.3
32.6
14.5
20.6
35.1
14.2
16.8
31.0
2005
3
(weighted)
1,635
1,035
2,670
1,737
1,085
2,822
3,372
2,120
5,493
14.1
14.7
28.7
16.2
17.0
33.2
12.7
13.2
25.9
13.3
17.3
30.6
15.0
17.7
32.6
12.3
17.1
29.3
13.7
16.0
29.7
15.6
17.4
32.9
12.5
15.2
27.7
2006
3
(weighted)
Percentages
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Table 3.3 Overweight and obesity prevalence among children1, by equivalised
household income quintiles and gender, 2006
England
Percentages
Highest
2nd
3rd
4th
Lowest
14
15
14
15
11
15
15
16
18
20
29
29
29
33
31
15
16
15
13
12
9
12
12
17
20
24
28
26
29
33
Boys
416
510
569
514
602
Girls
363
540
493
526
602
Boys
374
443
517
480
603
Girls
320
448
431
470
597
Boys
Overweight
Obese
2
2
Girls
Overweight
2
2
Obese
Bases (unweighted)
Bases (weighted)
1. Children aged 2 to 15 with a valid BMI measurement
2. Categories are independent, i.e. overweight does not include those who are obese. Overweight was
defined as ≥ 85th < 95th UK BMI percentile; obese was defined as ≥ 95th UK BMI percentile
Source:
44
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Contents page
Table 3.4 Estimated odds ratios for overweight (including obese)1 among children2, by associated risk
factors and gender, 2006
Numbers
England
Boys
Girls
N
Odds ratio
95%
confidence
intervals
141
160
174
186
194
199
211
1
1.34
0.89
1.53
1.76
1.25
1.21
0.82-2.20
0.53-1.49
0.92-2.53
1.07-2.91
0.76-2.06
0.73-2.00
133
162
172
180
180
193
186
1
1.21
0.84
1.48
1.57
1.75
1.88
0.68-2.17
0.47-1.50
0.82-2.67
0.91-2.70
1.01-3.02
1.08-3.25
247
78
230
413
298
1
1.31
0.86
1.32
1.04
0.72-2.35
0.54-1.38
0.90-1.94
0.68-1.59
216
70
197
445
277
1
2.68
1.47
3.03
2.10
1.41-5.10
0.86-2.52
1.94-4.72
1.30-3.40
Equivalised household income quintiles (p=0.375 boys, p=0.014 girls)
Highest
167
1
4th
196
1.09
3rd
212
1.53
2nd
229
1.14
Lowest
302
1.10
Not known
158
1.34
0.66-1.80
0.96-2.45
0.71-1.82
0.71-1.72
0.78-2.28
142
197
193
229
278
167
1
2.37
1.89
2.13
2.50
2.08
1.39-4.04
1.10-3.26
1.24-3.65
1.47-4.25
1.17-3.68
Age (p=0.133 boys, p=0.015 girls)
2-3
4-5
6-7
8-9
10-11
12-13
14-15
N
95%
confidence
Odds ratio
intervals
Parental BMI (p=0.134 boys, p<0.001 girls)
3
Normal household
Mother overweight/obese, father normal
Father overweight/obese, mother normal
Overweight/obese household4
At least 1 natural parent missing BMI / no
natural parent
1. Overweight including obese among children was defined as ≥ 85th UK BMI percentile
3. Both natural parents/lone natural parent has normal BMI
4. Both natural parents/lone natural parent is overweight/obese
5. Weighted bases are 1,265 for boys and 1,204 for girls
6. Only the core sample is used in this table as parental BMI is not available for the boost sample
Source:
45
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Contents page
Table 3.5 Estimated odds ratios for obesity1 among children2, by associated risk factors and gender, 2006
Numbers
England
Boys
Girls
N
Odds ratio
95%
confidence
intervals
141
160
174
186
194
199
211
1
1.13
0.68
1.30
1.72
1.04
0.80
0.63-2.04
0.35-1.34
0.71-2.38
0.96-3.06
0.59-1.83
0.42-1.52
133
162
172
180
180
193
186
1
1.62
1.89
3.70
2.86
3.00
2.55
0.66-4.01
0.81-4.42
1.57-8.73
1.19-6.89
1.28-7.03
1.11-5.88
140
44
147
257
168
1
1.95
1.23
1.37
1.42
0.96-3.98
0.68-2.22
0.86-2.19
0.86-2.35
216
70
197
445
277
1
2.61
0.94
3.36
2.01
1.15-5.93
0.42-2.12
1.95-5.78
1.09-3.71
NS-SEC of household reference person (p=0.017 boys, p=0.017 girls)
Managerial & professional
491
Intermediate
94
Small employers & own account workers
165
Lower supervisory & technical
121
Semi-routine & routine
336
Others/not answered
59
1
1.35
0.96
1.46
1.85
1.58
0.74-2.49
0.57-1.62
0.85-2.52
1.26-2.72
0.63-3.91
473
93
142
119
319
58
1
2.00
1.27
1.52
1.99
3.01
1.10-3.64
0.70-2.30
0.86-2.69
1.30-3.03
1.40-6.49
Age (p=0.037 boys, p=0.040 girls)
2-3
4-5
6-7
8-9
10-11
12-13
14-15
N
95%
confidence
Odds ratio
intervals
Parental BMI (p=0.285 boys, p<0.001 girls)
3
Normal household
Mother overweight/obese, father normal
Father overweight/obese, mother normal
4
Overweight/obese household
At least 1 natural parent missing BMI or no natural parent
1. Obesity among children was defined as ≥ 95th UK BMI percentile
3. Both natural parents/lone natural parent has normal BMI
4. Both natural parents/lone natural parent is overweight/obese
5. Weighted bases are 1,265 for boys and 1,204 for girls
6. Only the core sample is used in this table as parental BMI is not available for the boost sample
Source:
46
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Contents page
Table 3.6 Overweight and obesity prevalence among children1, by parental BMI
2
status and gender, 2006
England
Normal
household
Mother
overweight/
obese, father
normal
Father
overweight/
obese, mother
normal
Percentages
Overweight/
obese
household
Boys
Overweight
Obese
3
3
14
9
10
16
14
24
15
18
28
33
26
34
8
17
14
15
Girls
Overweight
3
3
8
17
6
22
16
34
20
37
Boys
256
82
242
446
Girls
233
75
213
486
Boys
247
78
230
413
Girls
216
70
197
445
Obese
Bases (unweighted)
Bases (weighted)
2. BMI only recorded for adults selected as part of the general population sample, so children from the boost
sample are excluded from this table.
3. Categories are independent, i.e. overweight does not include those who are obese. Overweight was
defined as ≥ 85th < 95th UK BMI percentile; obese was defined as ≥ 95th UK BMI percentile
Source:
47
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Contents page
1
Table 3.7 Overweight and obesity prevalence among children , by
summary physical activity levels2 and gender, 2006
England
High
Medium
Percentages
Low
13
16
13
17
18
18
30
34
31
12
17
18
15
14
15
27
30
33
Bases (unweighted)
Boys
Girls
2,123
1,770
444
527
440
612
Bases (weighted)
Boys
Girls
1,974
1,572
416
495
412
565
Boys
Overweight
Obese
3
3
Girls
Overweight
Obese
3
3
2. High = at least 60 minutes of physical activity on 7 days in the last week; medium = 30 to 59
minutes on 7 days in the last week; low = less active
3. Categories are independent, i.e. overweight does not include those who are obese.
Overweight was defined as ≥ 85th < 95th UK BMI percentile; obese was defined as ≥ 95th UK
BMI percentile
Source:
48
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Contents page
Table 3.8 Overweight and obesity prevalence among children
by gender, England, 2002 and Scotland, 2003
1
Percentages
England
Scotland
14.3
16.7
16.0
18.0
30.3
34.6
14.8
16.1
15.9
13.8
30.7
30.0
4,740
4,672
1,215
1,223
5,442
5,381
1,249
1,191
Boys
Overweight
Obese
2
2
Girls
Overweight
Obese
2
2
Bases (unweighted)
Boys
Girls
Bases (weighted)
Boys
Girls
Overweight was defined as ≥ 85th < 95th UK BMI percentile; obese was defined as ≥
95th UK BMI percentile
Source:
The Health Survey for England 2002. The Department of Health
49
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Contents page
Table 3.9 Overweight and obesity prevalence among children1, by Government Office Region/Strategic Health Authority2
and gender, 2006
England
North
East
North Yorkshire
East
West
East
West
Humber
London
South
West
South
East
Percentages
Strategic Health
Authority
South East
South
Coast
Central
Boys
3
17
14
11
12
14
15
12
14
13
13
12
Obese
20
14
15
19
20
14
24
16
15
18
13
37
29
26
31
34
29
36
30
28
31
25
Overweight
3
Girls
3
14
17
13
14
11
12
16
15
13
14
12
Obese
15
17
14
18
15
10
16
14
13
12
13
28
34
27
32
27
22
32
29
26
27
25
Boys
158
461
356
303
314
323
345
287
482
231
251
Girls
161
487
328
307
310
282
343
266
466
208
258
Boys
143
402
304
242
289
329
380
276
457
216
242
Girls
142
421
273
241
283
264
386
238
423
187
235
Overweight
3
Bases (unweighted)
Bases (weighted)
2. This table provides data for regional analysis both by Government Office Region (GOR) and the new configuration of Strategic Health Authorities (SHAs) in
place from July 2006. The first eight columns represent GORs and SHAs of the same name, while the South East GOR (column nine) is divided into South East
Coast SHA and South Central SHA, shown in the final two columns
3. Categories are independent, i.e. overweight does not include those who are obese. Overweight was defined as ≥ 85th < 95th UK BMI percentile; obese was
defined as ≥ 95th UK BMI percentile
Source:
50
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Contents page
1
Table 3.10 Perceived weight among children , by BMI status and
gender, 2006
Percentages
England
Neither
overweight nor
obese
Overweight
2
Obese
2
Boys
Too light
About right
Too heavy
17
81
2
2
85
13
1
40
60
Girls
Too light
About right
Too heavy
11
81
8
1
72
27
0
34
66
968
827
182
165
229
208
914
749
167
149
210
187
Bases (unweighted)
Boys
Girls
Bases (weighted)
Boys
Girls
Overweight was defined as ≥ 85th < 95th UK BMI percentile; obese was defined as ≥ 95th
UK BMI percentile
Source:
51
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52
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4 Physical activity among adults
4.1 Introduction
The health benefits of a physically active
lifestyle are well documented and there is a
large amount of evidence to suggest that
regular activity is related to reduced
incidence of many chronic conditions.
Physical activity contributes to a wide range
of health benefits and regular physical
activity can improve health outcomes
irrespective of whether individuals achieve
weight loss. Current physical activity
recommendations for adults are, that they
should achieve a total of at least 30 minutes
of at least moderate intensity physical
activity, on five or more days a week1.
Further research suggests that the 30
minutes of physical activity necessary for
health benefits can be built up in bouts of 10
minutes or more. Moderate activity can be
achieved
through
walking,
cycling,
gardening and housework, as well as
various sports and exercise (see Appendix
B for further details).
The main source of data used for adults’
physical activity is the Health Survey for
England (HSE) 20062. The HSE reports on
adults’ physical activity in the four weeks
prior to interview by examining overall
participation in activities that lasted at least
30 minutes and by describing frequency of
participation and type of activity. The HSE is
used as the primary source to measure
progress towards achieving physical activity
guidelines and is used in this chapter to
describe summary levels of physical activity
by a range of demographic and other
factors.
The Taking Part Survey3 (TPS) is a national
survey of private households in England
and began in mid-July 2005. It is a
comprehensive study on how people enjoy
their leisure time. Results from the survey
include estimates on the prevalence of
participation in sport and reasons given for
engagement and non-engagement in
sporting activities. The TPS is used to
monitor the Public Service Agreement 34
(PSA3). Part of this PSA is, by 2008, to
increase the number who participate in
active sport at least twelve times a year by
3%, among those in priority groups (black
and minority ethnic group, limiting disability,
lower socio-economic groups and women).
The TPS is used in this chapter to look at
participation in active sport by a range of
demographic and other factors.
The Active People Survey5 (APS) is the
largest ever survey of sport and active
recreation to be undertaken in Europe. It
surveyed over 360 thousand adults in
England in 2005/06 providing statistics on
participation in sport and active recreation
for Local Authorities and is used in this
chapter to describe participation in sport
and active recreation at a local level.
The National Travel Survey6 (NTS) 2006
provides information on personal travel in
Great Britain, published by the Department
for Transport, and is used in this chapter to
look at the frequency and distances of trips
made by bicycle and on foot.
4.2 Meeting physical activity guidelines
Information on whether current physical
activity guidelines for adults are being met is
obtained from the HSE. The HSE reports on
trends in physical activity for 1997, 1998,
2003, 2004 and 2006. As the 1997 and
1998 results were originally calculated using
a slightly different method, results presented
in this chapter have been recalculated in
order to allow for comparison with more
recent years. For both men and women, the
proportion achieving the physical activity
recommendations (undertaking a minimum
of 30 minutes of at least moderate intensity
activity at least five times a week) has
increased overall, from 32% in 1997 to 40%
in 2006 for men, and from 21% to 28% for
women.
53
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4.3.1 Participation in sport
40% of men and 28% of women met
current physical activity
recommendations in 2006
In 2006, for both men and women, the
proportion
meeting
the
guidelines
decreased with age. For men, over 50% of
16 to 34 year olds met the guidelines
compared to 9% for those aged 75 and
over. The proportion of women meeting the
guidelines remained stable for those
between the ages of 16 and 54 (between
33% and 36%) and decreased thereafter to
4% among those aged 75 and over (Table
4.1).
4.3 Participation in different activities
Participation in different activities is
collected using the long version of the HSE
physical activity questionnaire which was
asked in 2006. Prior to this, the long version
of the questionnaire was last used in 1998.
In 2006, a higher proportion of both men
and women reported participating in
walking, and in sports and exercise
compared to 1998. For men, 32% reported
walking in 1998 compared with 38% in
2006. Likewise, reported participation in
sports and exercise has risen for men from
42% to 46%. For women, 24% reported
walking in 1998 compared with 30% in
2006, while 36% participated in sports and
exercise in 1998 compared with 39% in
2006. There was also a significant increase
(80% in 1998 to 82% in 2006) in
participation in physical activity of any kind
among men (Table 4.2).
Men participated in more hours of
physical activity a week (8.0) than
women (5.4) in 2006
The TPS provides information not only on
the levels of engagement in sporting
activities in the twelve months prior to
interview, but also the reasons for
engagement and non-engagement. Unless
otherwise stated, participation is defined as
engagement in at least one type of active
sport during the past twelve months.
The results showed that, 69%3 of all adults
participated in at least one type of active
sport during the past twelve months (any
active sport excluding utility cycling and
walking). Of those who participated in at
least one type of active sport, enjoyment
and keeping fit were the main reasons given
for
participation
(37%
and
30%
respectively). To take the children and to
meet with friends were the next most
common reasons for participation (9% for
both) (Table 4.3).
In 2005/06, 69% of adults reported
participating in at least one type of
active sport in the past twelve months
The most common type of active sport
adults had participated in during the past
twelve months was swimming or diving
(31%), followed by health, fitness, gym or
conditioning activities (20%) (Figure 4.1).
Figure 4.1 Types of activity participated in by adults, 2005/06
England
Percentages
Swimming or diving (indoors)
Health, fitness, gym
Cycling (not utility)
Swimming or diving (outdoors)
Snooker, pool, billiards (excluding bar billiards)
Tenpin bowling
Keepfit, aerobics, dance exercise
Golf, pitch and putt, putting
Football (including 5 and 6-a-side) (outdoors)
Jogging, cross-country, road running
30.9
20.4
16.4
14.2
14.2
12.0
10.9
10.5
10.3
8.6
Source:
Taking Part: The National Survey of Culture, Leisure and Sport. The
Department for Media, Culture and Sport
Copyright © 2008, re-used with the permission of the Department of Media,
Culture and Sport
54
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4.4 Physical activity and obesity
Analyses from HSE 20037 show physical
activity levels were related to BMI status.
The proportion of men with high physical
activity levels fell from 44% among those
who had a normal BMI (18.5 to less than 25
kg/m2), to 31% among those who were
obese (BMI 30 to less than 40 kg/m2) and
16% among those who were morbidly
obese (BMI of 40 and over kg/m2). The
proportion of women with high activity levels
fell from 30% among those who had a
normal BMI to 18% among those who were
obese and morbidly obese (Table 4.4).
In addition, regression analysis in HSE 2003
showed that relative to those with low levels
of physical activity, both men and women
with medium or high levels were around half
as likely to be obese than those with low
activity levels (odds ratios of 0.58 and 0.50
respectively). Men and women with medium
activity levels were also less likely to be
obese7.
More recent regression analysis from the
HSE 2006 showed a similar pattern
between activity levels and raised waist
circumference. Men and women with low
activity levels were around twice as likely to
have a raised waist circumference
compared to those with high activity levels
(odds ratios of 2.1 and 1.9 respectively)2.
4.5 Physical activity, active sport and
equivalised household income
Equivalised household income is a measure
of household income that takes account of
the number of persons in the household.
The HSE reports on the association
between income and physical activity levels.
The age-standardised prevalence of those
in the ‘high’ category (meeting the current
recommendations for physical activity) was
related to quintile of equivalised income
among men. Between 42% and 45% of men
in the three highest income quintiles met the
recommendations for physical activity in
2006, falling to 35% in the lowest income
quintile. While the pattern was not as clear
in women, those in the second and third
highest income quintiles were more likely to
have met the recommendations compared
to those from the lowest income group.
There is a clear gradient in the prevalence
of low activity levels, across the income
quintiles for both men and women, with
those in the lowest income quintile more
likely to be in the low participation group
than those in the highest income quintile
(Table 4.5, Figure 4.2).
Figure 4.2 Adults with low physical activity levels, by
equivalised household income and gender, 2006
Percentages
England
Men
50
Women
45
40
35
30
25
20
15
10
5
0
Highest
2nd
3rd
4th
Low est
Results from the TPS show those with the
highest income were most likely to
participate in active sport. For those
earnings over £50,000, 89% had done so at
least once in the previous twelve months.
Those whose income was less than
£10,000 were least likely to participate in
active sport (61%)3.
4.6 Physical activity among ethnic
groups
The HSE 20048 focused on the health of
ethnic minorities and is used here to
describe physical activity patterns among
ethnic minority groups. Within minority
ethnic groups, Irish (39%) and Black
Caribbean (37%) men reported the highest
proportion meeting the current physical
55
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activity recommendations, similar to the
proportion of men in the general population
(37%). Among women, Black Caribbean,
Black African and Irish groups reported the
highest rates meeting current physical
activity guidelines (31%, 29% and 29%
respectively), compared with 25% of women
in the general population. Only 11% of
Bangladeshi and 14% of Pakistani women
did the recommended amounts of physical
activity in the four weeks prior to interview
household structure and participation in
active sport, adults living in single adult
households (with no children) had
significantly lower rates of participation
(50%) than any other group in 2005/06.
Adults living in households with adults and
children had the highest observed
participation in active sport with 82%
reporting participating in at least one active
sport in the past twelve months (Figure 4.4).
Figure 4.4 Adults' participation in active sport by household
structure, 2005/06
90
80
Percentages
England
45
Men
40
70
60
50
Women
35
40
30
20
30
25
10
0
20
15
1 adult and no
children
10
5
Adults and children
Lone parent
G
Ir i
en
sh
er
al
po
pu
la
ti o
n
hi
ne
se
C
an
i
Ba
ng
la
de
sh
i
Pa
ki
st
In
di
an
C
ar
ib
be
an
Bl
ac
k
Af
ric
an
2+ adults and no
children
Source: Taking Part Survey 2005/06. 'Taking Part: The National Survey of Culture,
Leisure and Sport. The Department for Culture, Media and Sport
Copyright © 2008. Re-used w ith the permission of The Department for Culture, Media
and Sport
0
Bl
ac
k
Percentages
England
Figure 4.3 Adults achieving the physical activity guidelines,
by ethnic group and gender, 2004
Although Black Caribbean and Irish men
report higher levels of activity compared to
other groups, they are also the most likely to
be obese. Similarly, Bangladeshi women
reported low levels of physical activity but
are among the groups least likely to be
obese as seen in Chapter 2.
Participation rates in any physical activity for
at least 30 continuous minutes in the 4
weeks prior to interview ranged from 54%
among Bangladeshi men to 78% among
Irish men, and from 41% among
Bangladeshi women to 81% among Irish
women (Table 4.7).
4.7 Demographic variables
When comparing patterns between people’s
qualifications and rates of participation in
active sport, TPS results show that
participation rates vary significantly. Those
with no formal qualifications had the lowest
participation rates (41%), compared to
those who had A-levels or above (83%)
(Figure 4.5).
Figure 4.5 Adults' participation in active sport by
qualifications, 2005/06
Percentages
England
A-levels and above
Trade
apprenticeships
Below A-levels
Other qualifications
- Level unknow n
No qualifications
The TPS3 analyses participation in active
sport
by
several
demographic
characteristics, some of which are
highlighted
here.
When
comparing
0
20
40
60
80
100
Copyright © 2008. Re-used w ith the permission of The Department for Culture,
Media and Sport
56
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The TPS also produces a progress report9
on the PSA3. Results show in year 2 (midJuly 06 to mid-July 07) that 53.4% of all
adults participated in at least one active
sport during the past 4 weeks (on average
would have participated 12 times in the last
year). Results focussing on priority groups
show that 51.9% of adults from black and
minority ethnic groups, 31.2% of adults with
limiting disability, 42.2% of adults from lower
socio-economic groups and 46.2% of
women participated in at least one active
sport during the past 4 weeks. When
comparing estimates from year 1 to year 2
(mid-July 05 to mid-July 06), data show that
there has been a statistically significant
decrease in women’s participation in active
sport (Figure 4.6).
Figure 4.6 Adults' participation in active sport during the
past 4 weeks, by priority group
England
Black and minority ethnic
Limiting disability
Lower socio-economic
Women
All adults
Year 1
Percentages
Year 2
53.3
32.3
43.4
47.7
53.7
51.9
31.2
42.2
46.2
53.4
Source:
Taking Part: The National Survey of Culture, Leisure and Sport. The
Department for Media, Culture and Sport
Copyright © 2008, Re-used with the permission of The Department for
Media, Culture and Sport
4.8 Geographical patterns in physical
activity
4.8.1 National comparisons of physical
activity
The Scottish Health Survey10 and the HSE
20037 used similar but not identical methods
to measure adult’s physical activity, which
enabled the Scottish Executive to make a
comparison
between
these
surveys
accounting for these slight differences. A
higher proportion of adults in Scotland had
participated in at least 30 minutes of
continuous physical activity on most days of
the week than in England. Forty per cent of
men in Scotland did 30 minutes or more of
moderate to vigorous physical activity on at
least five days a week, compared with 36%
of men in England. The difference was more
pronounced in women: 29% in Scotland had
been this active compared with 24% in
England (Figure 4.7).
Figure 4.7 Adults achieving the physical activity guidelines, by
country and gender, 2003
England
Percentages
Scotland
Men
36
40
Women
24
29
Source:
The Health Survey for England 2003. The Department of Health
2003 Scottish Health Survey. The Scottish Executive
Copyright 2008 re-used with the permission of The Department of Health
Copyright 2008 re-used with the permission of The Scottish Executive
The Welsh Health Survey11 (WHS) uses a
different approach to arrive at physical
activity levels so results cannot be
compared with England and Scotland (see
Appendix B for more details on how each of
the surveys collect adult’s summary
physical activity data). The WHS shows that
38% of men and 25% of women in Wales
met the physical activity recommendations.
4.8.2 Physical activity and active sport
by region/SHA
Data from the HSE 2006 shows men
participating in high levels of physical
activity varied, ranging from 33% in the
North East to 46% in South Central SHA.
For women, high participation ranged from
24% in East Midlands to 31% in East of
England and South West (Table 4.8).
Similar results are found in the TPS. Figure
4.8, based on the TPS, shows adults living
in the South East had higher rates of
participation in active sport than those living
in all other regions. Adults living in the North
West had lower rates of participation than
those living in all other regions, except
Yorkshire and Humber and the West
Midlands.
57
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Figure 4.8 Adults participation in active sport during the
past 12 months by Government Office Region, 2005/06
England
Percentages
North East
North West
Yorkshire and Humberside
East Midlands
West Midlands
Figure 4.9 shows the level of participation
(at least 30 minutes moderate intensity
activity at least 3 times a week) by Local
Authority. Similar to the Government Office
Regions, results show a varied picture of
activity levels across the country. Detailed
results of activity levels for Local Authorities
maybe found within the APS report5.
East of England
4.9 Early trends in physical activity
London
South East
South West
0
10
20
30
40
50
60
70
Copyright © 2008. Re-used w ith the permission of The Department for Culture,
Media and Sport
4.8.3 Sport and active recreation by
Local Authority
1
Figure 4.9 Adults participation
recreation, 2005/06
in sport and active
England
80
An earlier survey published in 1992 (the
Allied Dunbar National Fitness Survey
199012) measured physical activity patterns
and fitness levels of adults in England.
Similar to the HSE, the survey measured
levels of participation in sport and active
recreation, housework, DIY and gardening
in the previous four weeks. Activities were
classified as either light, moderate or of
vigorous intensity. Physical activity targets
were defined for different age groups based
on varying levels of intensity and activity,
which lasted 20 minutes or more.
The main findings from the survey reported
that 7 out of 10 men and 8 out of 10 women
fell below their age appropriate activity level
necessary to achieve a health benefit.
Furthermore, about 1 in 6 people reported
having done no activities for 20 minutes or
more at a moderate or vigorous level in the
previous four weeks.
Quartile classification:
14.3% - 19.5% (low)
19.6% - 21.2% (low-middle)
21.3% - 23.1% (middle-high)
23.2% - 29.8% (high)
1. Percentage of the adult population participating in at least
30 minutes of sport and active recreation (including walking
and cycling) of at least moderate intensity on at least 3
occasions a week.
Source: The Active People Survey. Sport England
Copyright © 2008 re-used with the permission of Sport
England
The survey also reports declining activity
levels with increasing age, particularly for
men, similar to patterns in the HSE 2006.
Men in the 16 to 24 age group reported the
highest level of activity, similar to current
patterns in HSE. Some further similarities
between the two surveys can be seen in the
patterns of activity between men and
women. Overall, men are generally more
likely to participate in physical activity of
higher intensity than women1.
58
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4.10 Focus on travel
It is widely accepted that active travel such
as cycling or walking can contribute to being
physically active. However, the National
Travel Survey (NTS) 2006 reports that in
Great Britain the average number of walking
trips per person per year fell by 15%
between 1995/97 and 2006 (from 292 trips
to 249). The trend for trips made by bicycle
was similar, although in both cases the
decline has levelled off in recent years
(Table 4.9).
The number of walking trips fell by
15% between 1995/97 and 2006
Overall, women made 26% of their trips on
foot, compared with 22% for men. Children
aged 17 and under, reported the highest
proportion of trips made on foot (34%), with
adults aged 40 to 59 reporting the lowest
proportion (19%). The proportion of trips
made on foot was higher for women than
men in all age groups. Bicycle trips were
more common among men aged 17 to 29,
but even for this age group only 4% of trips
were by bicycle (Table 4.10).
4.11 Non-engagement in active sport and
perceived barriers to increased
participation
The TPS collects reasons for nonparticipation in active sport. The main
reasons given for not participating in active
sports during the last year, were ‘health isn’t
good enough’ (47%), followed by ‘not being
interested’ and ‘difficulty finding the time’
(both 18%) (Table 4.11).
Of those people who reported taking part in
active sports at least once in the past twelve
months, 39% reported that they would
participate more frequently if they were less
busy. Cheaper admission prices were
reported by 11% of people as a factor which
would
encourage
more
frequent
participation (Table 4.12).
59
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Summary: Physical activity among adults
Overall participation in physical activity has
increased among both men and women
since 1997. Men reported higher physical
activity levels than women, with participation
generally decreasing with age. Trends show
that the proportion of people walking and
participating in sports and exercise in 2006
has increased since 1998.
The main reasons for participating in active
sport were enjoyment and the desire to
keep fit, whereas the main reason given for
non-engagement was poor health.
Patterns show physical activity levels were
related to BMI status and raised waist
circumference. Men and women with high
activity levels were half as likely to be obese
than those with low activity levels. Similarly,
men and women with high activity levels
were around half as likely to have a raised
waist circumference.
The proportion meeting the current
recommendations for physical activity was
related to equivalised income among men,
while the pattern was not as clear in
women.
Among minority ethnic groups, Irish and
Black Caribbean men, and Irish, Black
Caribbean and Black African women were
most likely to report high physical activity
levels.
Participation in active sport was also found
to be related to household structure, and
qualifications. Adults living in households
with children and those with qualifications at
A level and above, were more likely to
participate in active sport.
Since 1995/97, the number of walking trips
per person per year has decreased by 15%,
with a similar trend seen for cycling.
References
1.
At least 5 a week: Evidence on the
impact of physical activity and its
relationship to health – A report from the
Chief Medical Officer. The Department of
Health, 2004. Available at:
http://www.dh.gov.uk/en/Publicationsandstat
istics/Publications/PublicationsPolicyAndGui
dance/DH_4080994
2.
Health Survey for England 2006.
The Information Centre, 2008. Available at:
www.ic.nhs.uk/pubs/hse06cvdandriskfactors
3.
Taking Part: The National Survey of
Culture, Leisure and Sport, Annual Report
2005/2006. The Department for Culture,
Media and Sport, 2007. Available at:
http://www.culture.gov.uk/Reference_library/
Publications/archive_2007/tps_annualreport
0506.htm
4.
Spending Reviews 2004 public
service agreements 2005/2008, HMTreasury. Available at:
http://www.hmtreasury.gov.uk/media/3/E/sr04_psa_ch14.p
df
5.
The Active People Survey 2005/06.
Sport England, 2007. Available at:
http://www.sportengland.org/index/get_reso
urces/research/active_people.htm
6.
National Travel Survey 2006. The
Department for Transport, 2007. Available
at:
http://www.dft.gov.uk/pgr/statistics/datatable
spublications/personal/mainresults/nts2006/
60
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7.
The Department of Health, 2004. Available
at:
http://www.dh.gov.uk/en/Publicationsandstat
istics/Publications/PublicationsStatistics/DH
_4098712
8.
The Information Centre, 2006 Available at:
9.
Taking Part: The National Survey of
Culture, Leisure and Sport. Progress report
on PSA3: Final estimates from year two.
The Department for Culture, Media and
Sport, 2007. Available at:
http://www.culture.gov.uk/NR/rdonlyres/13C
1A6B7-9F63-45BB-A734211FE9A97953/0/ProgressreportonPSA3Fi
nalestimatesfromyeartwo.pdf
10.
The Scottish Health Service 2003.
Scottish Executive Health Department, 2005
Available at:
http://www.scotland.gov.uk/Publications/200
5/11/25145024/50251
11.
Welsh Health Survey 2005/06.
National Assembly for Wales, 2007.
Available at:
http://new.wales.gov.uk/topics/statistics/publ
ications/health-survey200506/?lang=en
12.
Allied Dunbar National Fitness
Survey. Sports Council and Health
Education Authority, 1995. Available at:
http://www.dataarchive.ac.uk/findingData/snDescription.asp
?sn=3303
61
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62
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List of Tables
4.1
Proportion of adults achieving the physical activity guidelines, by age and gender, 1997,
1998, 2003, 2004 and 2006
4.2
Average time spent by adults per week participating in physical activity, by gender and
type of activity, 1998 and 2006
4.3
Main reasons for participation by adults in an active sport during the past 12 months,
2005/06
4.4
Adults physical activity levels, by body mass index and gender, 2003
4.5
Adults physical activity level, by equivalised household income and gender, 2006
4.6
Adults physical activity levels, by ethnic minority group and gender, 2004
4.7
Adults participation in physical activity, by minority ethnic group and gender and type of
activity, 2004
4.8
Adults physical activity levels, by Government Office Region/Strategic Health Authority
and gender, 2006
4.9
Average distance travelled by adults, trips taken and time spent travelling, by walking,
cycling and by all modes, 1995/1997 to 2006
4.10
Walking and cycling trips per person per year by age and gender, 2006
4.11
Main reasons for non-participation in active sports during the past 12 months, 2005/06
4.12
Factors that would encourage those who already take part in active sports at least once
a year to do so more often, 2005/06
63
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1,2
Table 4.1 Proportion of adults achieving the physical activity guidelines , by age and gender, 1997,
3
1998, 2003 , 2004 and 2006
England
Percentages
65-74
75+
All ages
16-24
25-34
35-44
45-54
55-64
32
34
35
35
40
36
37
40
49
53
53
56
54
52
56
53
41
45
44
46
53
44
46
52
37
41
41
41
45
41
41
46
32
34
37
37
37
38
37
38
23
30
32
32
35
32
32
35
12
14
17
19
21
17
18
21
7
6
8
9
10
8
8
9
21
21
24
24
30
24
25
28
26
28
30
31
33
30
32
33
26
28
29
31
36
29
30
36
29
28
30
33
35
30
32
35
24
25
30
29
34
31
30
34
19
18
23
19
27
23
20
27
8
9
13
14
16
13
14
16
5
3
3
4
4
3
4
4
Bases
Men 1997
Men 1998
Men 2003 (unweighted)
Men 2003 (weighted)
Men 2004 (weighted)
Men 2006 (weighted)
3,898
7,193
6,581
2,873
5,561
7,177
3,256
6,845
492
875
744
291
649
1,044
485
1,040
739
1,338
1,024
446
860
1,272
556
1,127
740
1,305
1,260
535
1,181
1,412
647
1,354
694
1,289
1,098
439
1,049
1,180
530
1,122
535
987
1,097
508
1,123
1,037
477
1,012
455
837
807
378
415
731
329
694
243
562
551
276
284
501
231
496
Women 1997
Women 1998
Women 2003 (unweighted)
Women 2003 (weighted)
4,684
8,715
8,210
3,818
6,869
7,611
3,436
7,300
560
1,006
886
364
792
1,029
472
1,011
916
1,630
1,279
550
1,146
1,279
563
1,157
833
1,573
1,615
746
1,490
1,437
653
1,375
806
1,484
1,278
626
1,279
1,199
541
1,141
585
1,148
1,304
621
1,269
1,071
491
1,050
545
967
948
482
463
813
364
768
439
907
900
429
430
782
353
798
Men
1997
1998
2003 (unweighted)
2004 (unweighted)
2006 (unweighted)
2003 (weighted)
2004 (weighted)
2006 (weighted)
Women
1997
1998
2003 (unweighted)
2004 (unweighted)
2006 (unweighted)
2003 (weighted)
2004 (weighted)
2006 (weighted)
1. For data comparability across HSE years, only activity sessions that lasted at least 30 minutes were included
2. A minimum of five days a week of 30 minutes or more of moderate-intensity activity
3. Data from 2003 onwards have been weighted for non-response. Unweighted data for 2003 onwards are provided for consistency
Source:
Health Survey for England - updating of trend tables to include 2006 data. The Information Centre
64
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1
Table 4.2 Average time spent by adults per week participating in physical
activity, by gender and type of activity, 1998 and 20062
England
Men
1998
2006
Women
1998
2006
Heavy housework
No time
Any
Less than 1 hour
1, less than 3 hours
7 hours or more
3
Mean number of hours
62
38
19
12
3
1
2
0.8
59
41
20
14
4
2
2
0.8
42
58
21
20
7
3
7
1.7
43
57
21
20
7
3
6
1.6
Heavy manual/gardening/DIY
No time
Any
Less than 1 hour
7 hours or more
3
69
31
7
11
5
2
7
1.5
71
29
6
9
4
2
7
1.9
88
12
4
4
2
1
1
0.4
89
11
4
4
1
1
1
0.3
Walking
No time
Any
Less than 1 hour
7 hours or more
3
68
32
9
9
5
3
6
1.5
62
38
9
11
7
3
8
2.1
76
24
6
7
5
2
4
1.1
70
30
6
9
6
3
6
1.5
Sports and exercise
No time
Any
Less than 1 hour
7 hours or more
3
58
42
13
14
6
3
5
1.3
54
46
13
15
8
4
7
1.6
64
36
13
14
5
2
2
0.8
61
39
13
16
6
2
3
1.0
20
80
11
15
9
6
38
7.2
18
82
10
14
11
7
39
8.0
24
76
14
19
10
8
25
4.8
23
77
12
19
10
9
27
5.4
7,193
..
5,570
6,854
8,715
..
6,877
7,310
4
5
Any physical activity
No time
Any
Less than 1 hour
7 hours or more
3
Bases (unweighted)
6
Bases (weighted)
6
1. Aged 16 and over. To avoid an over-long interview for informants aged 65 and over, in 2006 only half
of these older people were asked the long physical activity module. The weighting used in the analysis
takes this into account
2. Data from 1998 are unweighted, while data from 2006 have been weighted for non-response
3. Mean is based on all informants including those who reported no participation
4. Walking at a 'fairly brisk' or 'fast' pace
5. Includes heavy housework; heavy manual/gardening/DIY; walking; sports and exercise; and
occupational activity (counted as 20 days for full-time workers, 12 days for part time workers)
6. Bases vary: those shown are for the overall sample
Source:
65
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1
Table 4.3 Main reasons for participation by adults in an active sport during the
past 12 months, 2005/06
England
Percentages
Just enjoy it
To keep fit (not just to lose weight)
To take children
To meet with friends
To lose weight
To train/take part in competition
To help with my injury or disability
Holiday activity
To improve my performance
2
Other reasons
37.2
29.7
9.2
8.7
3.5
1.6
1.6
1.5
1.3
5.7
Base
14,281
1. Adults aged 16 and over
2. Other reasons include don't know, to get fresh air and to improve health (no specific mention to fitness/
losing weight)
Source:
Taking Part Survey. 'Taking Part: The National Survey of Culture, Leisure and Sport. The Department for
Culture, Media and Sport
Copyright © 2008, re-used with the permission of The Department for Culture, Media and Sport
66
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Table 4.4 Adults1 physical activity levels2,3, by body mass index4 and gender, 2003
England
Percentages
Morbidly obese
Underweight
Normal
Overweight
Obese excluding
morbidly obese
Men
High
Medium
Low
45
24
31
44
32
24
37
33
30
31
31
38
16
46
38
Women
High
Medium
Low
31
31
37
30
40
30
25
37
38
18
35
47
18
37
45
71
134
1,872
2,924
2,648
2,362
1,305
1,454
60
204
92
138
2,158
2,776
2,814
2,138
1,379
1,317
65
188
Bases (unweighted)
Men
Women
Bases (weighted)
Men
Women
2. High = 30 minutes or more on at least 5 days a week; Medium = 30 minutes or more on 1 to 4 days a week; Low = lower
levels of activity
3. Participation in the last week
2
4. BMI categories are defined as follows: Underweight: less than 18.5, normal:18.5 to less than 25kg/m , overweight: 25 to
2
2
2
less than 30kg/m , obese excluding morbidly obese: 30 to less than 40kg/m , morbidly obese: 40kg/m or more
Source:
Health Survey for England, 2003. The Department of Health
Copyright © 2008, re-used with the permission of the Department of Health
67
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1
2,3
Table 4.5 Adults physical activity levels , by equivalised household income and gender,
2006
England
Highest
2nd
3rd
4th
Percentages
Lowest
Men
High
Medium
Low
42
35
23
45
33
22
44
29
27
38
24
38
35
26
39
Women
High
Medium
Low
28
38
33
31
37
32
31
33
36
28
31
41
26
30
44
1,143
1,175
1,083
1,216
908
1,160
718
1,066
666
942
1,318
1,160
1,270
1,212
1,107
1,213
915
1,212
829
967
Bases (unweighted)
Men
Women
Bases (weighted)
Men
Women
2. High = 30 minutes or more moderate or vigorous activity on at least 5 days a week; Medium = 30 minutes or more
of moderate or vigorous activity on 1 to 4 days a week; Low = lower levels of activity
3. Episode of activity of less than 30 minutes have been excluded, to allow comparison with results from HSE 2003
Source:
68
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Table 4.6 Adults1 physical activity levels2,3, by ethnic minority group and gender, 2004
England
Percentages
Black
Caribbean
Black
African
Indian
Pakistani
Bangladeshi
Chinese
Irish
General
population
Men
Low levels
High levels
34
37
35
35
44
30
51
28
51
26
38
30
33
39
32
37
Women
Low levels
High levels
39
31
43
29
45
23
52
14
68
11
47
17
33
29
39
25
Bases (unweighted)
Men
Women
409
648
386
467
549
634
429
508
408
477
348
375
497
656
2,873
3,818
Bases (weighted)
Men
Women
477
673
373
472
901
1,067
420
499
177
207
151
163
1,776
2,369
46,089
48,643
2. High levels indicate adherence to the physical activity recommendations (30 minutes or more at least moderate activity on at
least five days a week). Low levels indicate inactivity defined as less than one 30-minute moderate or vigorous activity session a
week
3. The 'medium activity levels' category (30 minutes or more at least moderate activity on one to four days a week) is not
presented in this table
Source:
69
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1
Table 4.7 Adults participation in physical activity, by minority ethnic group and gender and type of
activity, 2004
England
Percentages
Irish
General
population
Black
Caribbean
Black
African
Indian
Pakistani
Bangladeshi
Chinese
Men
Heavy housework
2
Any
3
At least once a week
42
22
34
18
35
14
20
7
19
10
34
16
38
20
38
17
Heavy gardening/DIY/building
2
Any
3
18
11
9
3
15
7
10
5
5
3
10
4
24
15
29
16
Walking
2
Any
3
24
18
27
25
19
15
14
11
17
16
21
17
32
23
32
25
Sports exercise
2
Any
3
46
39
43
35
32
26
31
25
26
22
49
39
39
33
41
33
2
Any
3
74
66
75
65
68
56
58
49
54
49
76
62
78
67
79
68
Women
Heavy housework
2
Any
3
50
29
47
27
48
29
49
31
32
19
42
26
63
36
55
31
Heavy gardening/DIY/building
2
Any
3
10
4
4
1
6
2
4
1
4
2
4
1
9
2
11
4
Walking
2
Any
3
24
18
22
17
18
16
12
9
8
7
17
14
33
28
27
22
Sports exercise
2
Any
3
36
27
28
20
27
21
16
13
12
11
34
27
38
29
34
25
2
Any
3
73
61
70
57
68
55
60
48
41
32
67
53
81
67
75
61
409
648
386
467
549
634
429
508
408
477
348
375
497
656
2,873
3,818
477
673
373
472
901
1,067
420
499
177
207
151
163
1,776
2,369
46,089
48,643
Bases (unweighted)
Men
Women
Bases (weighted)
Men
Women
2. Participation for at least 30 minutes in moderate or vigorous activity in the four weeks prior to interview
3. Participation for at least 30 minutes a week on average in moderate or vigorous intensity, i.e. at least four sessions in the four weeks
prior to interview
Source:
Health Survey for England, 2004. The Information Centre
70
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Table 4.8 Adults1 physical activity levels2,3, by Government Office Region/Strategic Health Authority4 and gender, 2006
England
North East North West Yorkshire &
the Humber
East
Midlands
West
Midlands
East of
England
Percentages
London South West South East South East
South
Coast
Central
Men
Observed
High
Medium
Low
33
27
40
39
29
32
42
29
29
38
32
30
35
31
33
39
30
31
42
27
31
43
33
25
42
31
26
39
33
27
45
29
26
Standardised
High
Medium
Low
33
27
40
39
29
32
42
29
29
38
32
30
36
31
32
39
30
30
40
26
33
43
32
24
44
31
25
43
33
25
46
29
25
Women
Observed
High
Medium
Low
26
36
38
29
34
37
29
33
38
25
37
39
24
35
41
30
31
39
29
32
39
31
33
36
29
34
36
29
34
36
29
34
37
Standardised
High
Medium
Low
25
35
40
29
34
37
28
33
39
24
37
39
25
35
40
31
31
38
27
31
42
31
33
36
30
35
36
30
35
35
30
34
36
288
379
828
1,009
591
726
540
665
580
749
640
739
678
765
496
684
920
1,153
455
608
465
545
342
386
910
989
701
746
603
616
717
797
778
797
1,046
983
644
768
1,104
1,218
550
654
554
564
Bases (unweighted)
Men
Women
Bases (weighted)
Men
Women
2. High = 30 minutes or more moderate or vigorous activity on at least 5 days a week; Medium = 30 minutes or more of moderate or vigorous activity on 1 to 4 days
a week; Low = lower levels of activity
3. Episodes of activity of less than 30 minutes have been excluded, to allow comparison with results from HSE 2003
4. This table provides data for regional analysis both by Government Office Region (GOR) and the new configuration of Strategic Health Authorities (SHA) in place
from July 2006. The first eight columns represent GORs and SHAs of the same name, while the South East GOR (column nine) is divided into South East Coast
SHA and South Central SHA, shown in the final two columns
Source:
71
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1
Table 4.9 Average distance travelled by adults , trips taken and time spent travelling, by
walking, cycling and by all modes, 1995/1997 to 2006
Great Britain
2004
2005
Numbers
2006
Miles per person per year
198
201
203
36
37
39
197
36
201
39
7,103
7,208
7,133
19,199
392
19,904
409
Trips per person per year
244
246
246
16
15
16
245
14
249
16
1,026
1,044
1,037
19,199
364
19,904
379
19,490
369
0.7
2.4
0.7
2.4
0.7
2.4
7.0
6.9
6.9
6.9
19,467
370
19,199
364
19,904
379
19,490
369
1995/
1997
1998/
2000
200
43
198
40
6,981
7,164
7,135
7,192
22,861
510
21,868
475
16,886
349
19,467
397
292
18
271
17
1,086
1,071
1,047
1,034
22,861
461
21,868
432
16,886
326
19,467
370
Walk
Bicycle
0.6
2.3
0.6
2.3
Average trip length
0.7
0.7
2.2
2.3
All modes
6.4
6.7
6.8
22,861
461
21,868
432
16,886
326
2
Walk
Bicycle
All modes
Unweighted sample size:
Individuals
3
Stages ('000s)
2
Walk
Bicycle
All modes
Individuals
Stages ('000s) 3
2
Individuals
3
Stages ('000s)
2002
2003
19,490
400
2. Short walks believed to be under-recorded in 2002 and 2003 compared with other years
3. A trip consists of one or more stages. A new stage is defined when there is a change in the form of transport or when
there is a change of vehicle requiring a separate ticket
Source:
The National Travel Survey 2006. The Department of Transport
Copyright 2008, re-used with the permission of the Department of Transport
72
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Table 4.10 Walking and cycling trips per person per year by age and gender, 2006
Great Britain
All adults
Walk
Bicycle
Unweighted sample size
Individuals
Trips ('000s)
Males
Walk
Bicycle
Individuals
Trips ('000s)
Females
Walk
Bicycle
Individuals
Trips ('000s)
Percentages
70+
All trips
(number)
All ages
Under 17
17-20
21-29
30-39
40-49
50-59
60-69
24
2
34
2
27
2
25
2
22
2
19
1
19
1
22
1
25
1
249
16
19,490
369
4,181
72
832
15
1,873
36
2,602
57
2,879
64
2,626
54
2,131
40
2,366
32
.
.
22
2
33
3
26
4
23
4
19
2
16
2
17
1
19
1
23
1
225
23
9,396
175
2,114
37
414
7
867
15
1,262
24
1,404
29
1,256
26
1,049
21
1,030
16
.
.
26
1
34
1
27
1
28
1
24
1
21
1
22
1
24
1
28
-
272
9
10,094
194
2,067
36
418
8
1,006
21
1,340
33
1,475
35
1,370
28
1,082
19
1,336
15
.
.
Source:
Transport Statistics Bulletin, National Travel Survey: 2006, Department for Transport
Copyright © 2008, re-used with the permission of the Department for Transport
73
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1
Table 4.11 Main reasons for non-participation in active sports
during the past 12 months, 2005/06
England
Percentages
Health isn't good enough
Not really interested
It's difficult to find the time
I am too old
It costs too much
I wouldn't enjoy it
Never occurred to me
No one to do it with
I am too lazy
2
Other reasons
47.0
18.4
18.2
2.7
2.1
1.8
1.6
1.1
1.1
5.9
Base
4,523
2. Other reasons include don't know, fear of injury and changing facilities are not good
enough
Source:
Taking Part Survey. 'Taking Part: The National Survey of Culture, Leisure and Sport.
The Department for Culture, Media and Sport
Copyright © 2008, re-used with the permission of The Department for Culture, Media
and Sport
74
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1
Table 4.12 Factors that would encourage those who already take part in
active sports at least once a year to do so more often, 2005/06
Percentages
England
Less busy
Cheaper admission prices
People to go with
If I had more free time
Better playing facilities
Improved transport/access/more cycle lanes
Help with childcare/creche facilities
If there were more/better variety of local facilities
Better facilities e.g. cafes, changing rooms
Longer opening hours
If the weather was better
If I had better health
Better equipment
Support for my specific needs e.g. injury or disability
Safer neighbourhood
Better information on what to do
If I had more motivation/more energy
Other reasons
2
39.3
11.0
8.7
6.4
3.5
3.2
3.1
3.0
2.8
2.7
2.5
1.7
1.6
1.3
1.2
1.0
1.0
5.8
Base
11,530
2. Estimates do not sum to 100% due to multiple responses
Source:
Taking Part Survey. 'Taking Part: The National Survey of Culture, Leisure and Sport. The
Department for Culture, Media and Sport
Copyright © 2008, re-used with the permission of The Department for Culture, Media and Sport
75
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76
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5 Physical activity among children
5.1 Introduction
Physical activity guidelines for children are
different to those for adults. The Chief
Medical Officer (CMO) of England
recommends that children and young
people should achieve a total of at least 60
minutes of at least moderate intensity
physical activity each day1. These
recommendations and their evidence base
build on those published by the Health
Education Authority in 19982. A Public
Service Agreement3 target is in place,
shared by the Department for Children,
Schools and Families and the Department
for Culture, Media and Sport, to enhance
the take-up of sporting opportunities by 5 to
16 year olds so that the percentage of
school children in England who spend a
minimum of two hours each week on high
quality PE and school sport within and
beyond the curriculum increases from 25%
in 2002 to 75% by 2006 and to 85% by
2008.
The main source of data used in this
chapter is the Health Survey for England
(HSE) 20064. The HSE gathers information
on the participation in out-of-school
physical activity and presents information
on the physical activity levels achieved by
children aged 2 to 15. The types of activity
for which data are collected are sports and
exercise, active play and walking. Children
aged 8 and over were also asked questions
about their participation in housework and
gardening. Activity which was part of the
school curriculum was excluded as this
information
is
collected
elsewhere.
Additionally, activities as part of the
curriculum are generally compulsory and
the HSE aims to focus on activity children
do through choice.
Other sources of data used in this chapter
include the School Sports Survey5 and the
National Travel Survey6. The School Sports
Survey collects information about levels of
participation in physical education (PE) and
school sport in schools taking part in the
School Sport Partnership Programme in
England, while the National Travel Survey
is designed to provide a databank of
personal travel information for Great
Britain.
5.2 Meeting physical activity guidelines
As with adults, information on whether
physical activity guidelines are being met is
derived by summarising different types of
activity into a frequency-duration scale, by
taking account of the time spent
participating in physical activities, and the
number of active days in the last week. In
the HSE, the summary levels are divided
between high, medium and low activity.
High activity levels are defined as 60
minutes of moderate intensity physical
activity on all 7 days in the last week.
Medium activity levels are 30 to 59 minutes
of moderate intensity physical activity on all
7 days in the last week and low activity
levels are defined as those that are active
at a lower level or not active at all.
Overall, in 2006, boys were more likely
than girls to achieve the recommended
levels of physical activity, with 70% of boys
and 59% of girls reporting taking part in 60
minutes or more of physical activity on all 7
days in the previous week.
In 2006, 70% of boys and 59% of girls
achieved the recommended level of
physical activity
A further 15% of boys and 19% of girls
participated in physical activity for at least
30 but less than 60 minutes on 7 days in
the week. The proportion of children
reporting low levels of physical activity was
15% for boys and 22% for girls. For girls,
77
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those reporting high levels of physical
activity declined from age 8 onwards, while
for boys, levels remained similar among the
different age groups (Table 5.1, Figure 5.1).
Figure 5.1 Children's physical activity levels, by gender,
2006
In 2006, 99% of both boys and girls
reported doing some type of physical
activity on at least one day in the past
week. Ninety-five per cent of boys and 92%
of girls reported participation in some
activity on 5 or more days in the last week.
Percentages
England
Boys
80
Girls
95% of boys and 92% girls
participated in some physical activity
on 5 or more days the in the last week
in 2006
70
60
50
40
30
20
10
0
High
Medium
Low
The HSE 20027 was the last year the HSE
focused on children, it therefore had a large
sample size, enabling a comparison to be
made with 2006. The proportion of boys
and girls achieving the physical activity
recommendations were similar in 2002 and
2006 (Table 5.2).
5.3 Types of physical activity
Sports and exercise included physical
activities such as swimming, football,
tennis, gymnastics and covered more
organised structured sporting activities.
Active play included activities such as
riding a bike, kicking a ball around, running
about, playing active games and jumping
around. Information on walking was
collected for those children who had done
any continuous walks of at least 5 minutes
duration. Housework and gardening was
collected for those children aged 8 and
over and included activities that involved
pulling or pushing and lasted at least 15
minutes, such as vacuuming or cleaning a
car.
Among boys, the most common physical
activity was active play with 93% reporting
participating at least once in the previous
week, and 70% reporting participation on 5
or more days on the past week. Walking
was the next most common activity, with
90% reporting participating at least once in
the previous week, and 65% on 5 or more
days in the past week. By comparison 22%
of boys took part in sports and exercise on
5 or more days in the past week, with only
4% of boys aged eight and over
participating in housework or gardening on
5 or more days.
For girls, walking was the most common
physical activity, with 91% walking on at
least one day a week and 63% walking on
at least five days in the last week. Only
14% of girls took part in sport and exercise
on 5 or more days in the last week, but
59% participated in active play on 5 or
more days in the last week. As with boys,
the least common activity for girls was
housework/gardening, undertaken by 6% of
girls aged eight and over on 5 or more days
in the previous week (Table 5.3, Figure
5.2).
78
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Figure 5.2 Children's participation on 5 or more days in
last week in different activities, by gender, 2006
Percentages
England
Boys
80
Girls
70
60
50
40
5.5 Socio-economic factors
Equivalised household income has little if
any effect on the level of a child’s
participation in physical activity based on
the evidence seen in Table 5.5. Although
for girls, there was some variation in
physical activity levels but there was no
obvious pattern.
30
20
10
0
Sports & exercise
Active play
Walking
Housework/gardening
5.4 Parental participation
The HSE also collected information on
parental physical activity levels allowing for
analysis of children’s physical activity by
parental physical activity. Parental physical
activity was classified in the same threecategory way as children’s activity levels.
Overall patterns of physical activity were
similar for mothers and fathers.
Parental physical activity levels were
associated with children’s activity levels. In
households where both parents reported
high levels of physical activity, children in
all age and gender groups, were also more
likely to report higher physical activity levels
than children in households where only one
parent had high activity levels4.
Generally, a greater proportion of children
of fathers with low physical activity levels
had either medium or low activity levels
compared with children of fathers with high
activity levels. Almost half (47%) of girls
aged 11 to 15 whose fathers had low
activity levels also had low activity levels.
The same association was found between
children’s and mothers’ activity levels, with
the difference being most pronounced in
girls aged 11 to 15 (35% of girls with
mothers with low activity levels were also in
the low activity category) (Table 5.4).
Although for physical activity overall there
was no obvious pattern, patterns did
emerge
for
sports
and
exercise.
Participation in sports and exercise on at
least one day in the last week increased
with equivalised household income for boys
aged 2 to 10 and girls in both the 2 to 10
and 11 to 15 age groups. Among boys
aged 11 to 15 there was a similar pattern
with lower participation among those in the
lowest two quintiles than in the upper three
(Table 5.6).
5.6 Regional analysis
Among boys, the proportion doing 60 or
more minutes of physical activity on all 7
days ranged from 76% in the East Midlands
to 66% in London, the East of England and
the South Central SHAs.
Among girls, results ranged from 65% in
the North East and the South West SHA to
52% in London (Table 5.7).
Details on the different types of physical
activity by region can be seen in (Table
5.8).
5.7 National comparisons of physical
activity
The latest Scottish Health Survey was
carried out in 20038 and included
information on physical activity levels
among children. In order to compare the
childhood physical activity levels of
England and Scotland, results from the
HSE 2002 were used, which contained a
boost sample of children. These two
79
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surveys used the same methodology and
questionnaire. Unfortunately, information is
not currently available for Wales. However,
data is being collected on children’s
physical activity levels for the 2007 Welsh
Health Survey.
Overall, 74% of boys and 63% of girls from
Scotland reported meeting the physical
activity recommendations, compared to
70% of boys and 61% of girls among
English children. Differences between the
two countries were more notable in boys
aged 2 to 4, 5 to 7 and 8 to 10, and for girls
aged 5 to 7, 8 to 10 and 13 to 15 (Table
5.9, Figure 5.3).
Figure 5.3 Proportion meeting the current physical activity
1
recommendations , England and Scotland, by gender
England
Percentages
Scotland
80
70
86% of pupils in partnership schools
participated in at least 2 hours of high
quality PE and school sport in 2006/07
Among the three types of schools surveyed
(primary, secondary and special), 91% of
pupils in primary schools, 80% of pupils in
secondary schools and 88% in special
schools reported participating in at least
two hours of high quality PE and school
sport in a typical week. Between 2004/05
and 2006/07 the largest observed
improvement in performance has been in
primary schools, particularly for children in
years 1 and 2. The proportion participating
in at least two hours of high quality PE and
school sport in year 1 increased from 51%
in 2004/05 to 87% in 2006/07 (Table 5.10,
Figure 5.4).
60
50
Figure 5.4 Pupils who participated in at least two hours
of high quality PE and school sport in a typical week, by
school type, 2004/05 to 2006/07
40
30
20
England
10
2004/05
2005/06
2006/07
Percentages
100
0
Boys
90
Girls
80
1. 2002 for England and 2003 for Scotland
Source: Health Survey for England 2002. The Department of Health.
2003 Scottish Health Survey
Copyright 2008, re-used w ith the permission of the Department of Health
Copyright 2008, re-used w ith the permission of the Scottish Executive
70
60
50
40
30
20
5.8 Participation in PE and school sport
10
0
5.8.1 Participation in PE
The School Sports Survey aimed to collect
information about levels of participation in
physical education (PE) and school sport in
schools taking part in the School Sport
Partnership Programme in England. In
total, 21,745 schools took part in the survey
between May 2007 and July 2007. The
survey shows that in 2006/07, 86% of
pupils in partnership schools participated in
at least two hours of high quality PE and
school sport in a typical week. This
compares to 80% in 2005/06, 69% in
2004/05 and 62% in the 2003/04 survey4.
All primary
All secondary
All special
Source: 2004/05 School Sport Survey. The Department for Education and Skills
2005/06 School Sport Survey. The Department for Education and Skills
2006/07 School Sports Survey. The Department for Children, Schools and Families
Copyright © 2008, re-used w ith the permission of the Department for Education and
Skills and The Department for Children, Schools and Families
5.8.2 Time spent on PE
The School Sports Survey covers physical
activity both as part of the curriculum and
activities that take part outside of school
hours, for example school sports clubs.
Looking in detail at time spent on PE as
part of the curriculum, pupils in the
partnership schools surveyed spent an
80
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average of almost 2 hours (115 minutes) in
a typical week in 2006/07. Of the year
groups, year 7 spent the most time (126
minutes) and year 11 spent the least time
(94 minutes) participating in curriculum PE
in a typical week. Pupils in special schools
spent an average 133 minutes a week
taking part in curriculum PE compared to
117 minutes for primary school pupils and
112 minutes for secondary school pupils
(Table 5.11).
The survey also shows the importance of
curriculum time spent on PE and school
sport, compared to achieved levels of
participation for children. Overall, 70% of all
children achieved the target through school
curriculum time alone in 2006/07. This
compares to 61% in 2005/064. Year 7 have
the highest proportion achieving the target
through curriculum time alone (84%), while
years 10 and 11 reported the lowest
proportion achieving the target through
curriculum time alone (38% and 35%
respectively) (Table 5.12, Figure 5.5).
5.9 Trips to school
The 2006 National Travel Survey (NTS) is
the latest in a series of household surveys
designed to provide a databank of personal
travel information for Great Britain. In 2006,
just over half (52%) of trips to school by
children aged 5 to 10 years were made on
foot, similar to the proportion in 1995/97
(53%). While the proportion travelling to
school by foot is lower among older
children aged 11 to 16 (41%) the levels
among this age group has also remained
similar since 1995/97 (42%) (Table 5.13,
Figure 5.6).
In 2006, nearly a half of children
reported walking to school
Figure 5.6 Trips to school for children aged 5 to 16 by
mode of transport, 2006
Percentages
Great Britain
50
Figure 5.5 How two hours of PE and school sport target is
achieved by year group, 2006/07
45
England
35
Percentages
Proportion achieving tw o hour PE
40
30
Curriculum time
100
25
90
20
80
15
70
10
60
5
50
-
40
Walk
30
20
Private
bus
Local bus
r1
1
Ye
a
9
8
7
6
5
4
3
2
1
r1
0
Ye
a
Ye
ar
Ye
ar
Ye
ar
Ye
ar
Ye
ar
Ye
ar
Ye
ar
Ye
ar
Ye
ar
pi
ls
0
pu
Bicycle
Rail
Other
Source: The National Travel Survey 2006. The Office for National Statistics
Copyright © 2008, re-used w ith the permission of The Office for National Statistics
10
Al
l
Car/van
Source: 2006/07 School Sport Survey. The Department for Children, Schools and Families
Copyright © 2008, re-used w ith the permission of the Department for Children, Schools
and Families
81
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Summary: Physical activity among children
In 2006, boys were more likely than girls to
meet the recommended levels of physical
activity. Participation levels amongst boys
remained broadly consistent with age while
for girls participation generally decreased
with age. Trends show that physical activity
levels among children are similar to those
in 2002.
Information on participation rates in
different activities, showed that for boys
active play (biking, football, running etc)
was the most common reported activity,
whilst for girls walking was the most
common activity.
Parental physical activity levels were
associated with children’s physical activity
levels. Children with parents who had high
physical activity levels were also more
likely to report high levels of physical
activity themselves.
There was no pattern between equivalised
household income and participation in
physical activity overall, although individual
activity patterns did emerge for sports and
exercise, where participation increased with
equivalised household income.
Comparisons between physical activity
levels in England and Scotland show that
Scottish children were more likely to meet
the physical activity recommendations than
children in England.
The School Sports Survey shows that 86%
of children are achieving at least 2 hours of
high quality PE and school sport in a typical
week, which has shown a gradual increase
since 2003/04. Primary school children
were most likely to achieve at least 2 hours
of high quality PE and school sport.
Seven in ten pupils achieved at least 2
hours of physical activity a week as part of
their curriculum. Those in years 10 and 11
were the least likely to participate in 2
hours of PE as part of the curriculum.
References
1.
At least 5 a week: Evidence on the
impact of physical activity and its
relationship to health – A report from the
Chief
Medical
Officer,
2004.
The
Department of Health. Available at:
tistics/Publications/PublicationsPolicyAndG
uidance/DH_4080994
2.
Young and active? Young people
and health –enhancing physical activity –
evidence
and
implications.
Health
Education Authority, 1998. Available at:
www.nice.org.uk/page.aspx?o=502301
3.
SR 2004 public service agreements
2005/2008, HM-Treasury. Available at:
http://www.hmtreasury.gov.uk/media/3/E/sr04_psa_ch14.
pdf
4.
The Health Survey for England
2006. The Information Centre, 2008.
Available at:
www.ic.nhs.uk/pubs/HSE06CVDandriskfact
ors
82
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Contents page
5.
The 2006/07 School Sport Survey.
The Department for Children, Schools and
Families, 2007. Available at:
https://dservuk.tnsglobal.com/schoolsports2007/Downloadabl
eDocuments/200607%20School%20Sport%20Survey%20Re
port.pdf
6.
Transport
Statistics
Bulletin.
National Travel Survey: 2006. Department
for Transport, 2007. Available at:
http://www.dft.gov.uk/pgr/statistics/datatabl
espublications/personal/mainresults/nts200
6/
7.
The Health Survey for England
2002. The Department of Health, 2003.
Available at:
H_4078027
8.
The Scottish Health Survey 2003.
Scottish Executive, 2005. Available at:
http://www.scotland.gov.uk/Publications/20
05/11/25145024/50251
83
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84
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List of Tables
5.1
Children's physical activity levels, by age and gender, 2006
5.2
Trends in children's physical activity levels, by gender, 2002 and 2006
5.3
Number of days' participation by children in different activities in the last week, by age
and gender, 2006
5.4
Children's physical activity levels by parental physical activity category, by age and
gender, 2006
5.5
Children's physical activity levels, by equivalised household income and gender, 2006
5.6
Number of days’ participation by children in different activities in the last week, by
5.7
Children's physical activity levels, by Government Office Region/ Strategic Health
5.8
Number of days’ participation by children in different activities in the last week, by
Government Office Region/ Strategic Health Authority and gender, 2006
5.9
Proportion of children meeting the current physical activity recommendations, England
and Scotland, by age and gender
5.10
Pupils who participated in at least two hours of high quality PE and out of hour's school
sport in a typical week - by year group, 2004/05 to 2006/07
5.11
Total curriculum time pupils spent taking part in PE in a typical week, by year group,
2004/05 to 2006/07
5.12
How two hours of PE and school sport target is achieved by year group, 2006/07
5.13
Trips to and from school per child by main mode, 1995/97 to 2006
85
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Table 5.1 Children's physical activity levels1, by age and gender, 2006
England
Percentages
14
15
All ages
2
3
4
5
6
7
8
9
10
11
12
13
Boys
2
High
Medium
Low
70
15
15
69
15
16
69
13
18
70
15
16
69
19
12
64
20
16
72
11
17
71
15
14
76
14
10
69
16
16
73
12
15
70
15
15
72
15
13
72
13
15
68
15
16
Girls
2
High
Medium
Low
59
19
22
69
11
20
68
17
15
68
20
13
71
15
14
60
20
19
53
22
25
67
17
17
61
15
24
60
23
17
56
20
24
58
17
25
57
18
25
45
23
32
45
23
31
Bases (unweighted)
Boys
Girls
3,440
3,343
232
199
241
243
213
214
248
221
227
229
255
258
199
262
277
243
264
237
238
260
271
239
270
253
263
242
242
243
Bases (weighted)
Boys
Girls
3,219
3,040
206
171
218
224
191
199
233
203
206
198
244
229
191
222
271
215
244
212
227
232
246
224
244
237
263
234
237
237
1. High = 60 minutes or more on all 7 days; medium = 30-59 minutes on all 7 days; low = lower level of activity
2. Based on the assumption that all activity was of at least moderate intensity, this group represents those who met the physical activity
recommendations for at least an hour of at least moderate intensity activity a day
Source:
86
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Table 5.2 Trends in children's1 physical activity levels2, by gender, 2002 and 2006
England
Percentages
Activity level in the last week
3
2002
2006
Boys
4
High
Medium
Low
70
13
17
70
15
15
Girls
4
High
Medium
Low
61
16
22
59
19
22
Bases (unweighted)
Boys
Girls
3,629
3,504
3,440
3,340
Bases (weighted)
Boys
Girls
4,201
4,058
3,219
3,040
1. Children aged 2-15
3. Children's data from HSE 2002 were weighted for selection probability, as a maximum of two children were
randomly selected from each participating household. Since 2003, children's data have been weighted both for
selection probability and for non-response
4. Based on the assumption that all activity was of at least moderate intensity, this group represents those who met
the physical activity recommendations for at least an hour of at least moderate intensity activity a day
Source:
87
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Table 5.3 Number of days' participation by children in different activities in the last week, by age and gender, 2006
England
Percentages
All ages
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Sports and exercise
None
At least one day
1-2 days
3-4 days
5 days or more
1
Mean number of days
33
67
29
16
22
2.3
61
39
15
6
18
1.5
48
52
27
8
17
1.7
43
57
33
8
17
1.7
43
57
35
9
13
1.7
30
70
40
12
17
2.0
32
68
32
17
19
2.2
29
71
31
21
19
2.3
22
78
29
23
26
2.8
23
77
34
19
24
2.6
26
74
28
19
27
2.7
25
75
25
21
28
2.9
27
73
29
15
29
2.7
29
71
21
20
30
2.9
33
67
25
18
24
2.4
Active play
None
At least one day
1-2 days
3-4 days
5 days or more
1
Mean number of days
7
93
13
11
70
5.2
5
95
2
6
86
6.0
5
95
7
10
78
5.7
3
97
9
10
78
5.8
4
96
10
10
76
5.7
5
95
15
9
71
5.3
8
92
14
8
70
5.2
5
95
14
9
72
5.4
6
94
10
10
74
5.4
6
94
12
12
70
5.2
7
93
15
11
67
5.1
5
95
17
12
65
5.0
9
91
16
17
58
4.7
10
90
16
10
64
4.7
17
83
18
15
50
3.9
Walking2
None
At least one day
1-2 days
3-4 days
5 days or more
1
Mean number of days
10
90
13
13
65
4.8
18
82
14
18
49
4.1
5
95
15
18
62
4.8
8
92
17
19
57
4.5
8
92
14
14
64
4.7
8
92
11
19
62
4.6
14
86
11
12
62
4.5
11
89
17
11
61
4.6
12
88
18
12
58
4.4
10
90
14
11
65
4.8
9
91
14
9
69
4.9
10
90
10
8
72
5.0
9
91
9
10
71
5.0
7
93
9
11
73
5.3
6
94
10
11
73
5.3
Housework / gardening3,4
None
At least one day
1-2 days
3-4 days
5 days or more
1
Mean number of days
70
30
21
5
4
0.7
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
77
23
17
3
3
0.5
79
21
14
3
4
0.6
72
28
20
4
4
0.6
72
28
19
7
3
0.7
67
33
22
7
3
0.7
68
32
22
6
4
0.8
64
36
25
6
5
0.9
63
37
25
7
5
0.9
None
At least one day
1-2 days
3-4 days
5 days or more
1
Mean number of days
1
99
2
3
95
6.7
3
97
1
2
94
6.6
0
100
2
4
94
6.7
1
99
1
2
96
6.7
2
98
1
1
96
6.7
1
99
1
3
94
6.6
0
100
3
3
94
6.7
1
99
1
3
95
6.7
1
99
2
2
95
6.7
0
100
2
4
93
6.7
0
100
2
2
95
6.7
1
99
2
2
95
6.7
1
99
2
2
95
6.7
1
99
1
3
96
6.7
1
99
3
3
93
6.6
3,485
3,261
240
214
244
220
216
194
253
237
230
208
256
245
200
192
281
275
266
246
240
228
272
247
273
246
268
268
246
240
Boys
Bases (unweighted)
Bases (weighted)
1. Means based on all informants
2. Counting activities lasting for at least 5 minutes at a time only
4. For Housework / gardening totals apply only to those aged 8-15
Source:
Copyright © 2008 The Information Centre, Lifestyles Statistics. All rights reserved
88
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Table 5.3 continued…
England
Percentages
14
15
All ages
2
3
4
5
6
7
8
9
10
11
12
13
Sports and exercise
None
At least one day
1-2 days
3-4 days
5 days or more
1
Mean number of days
40
60
32
14
14
1.8
53
47
22
5
19
1.7
52
48
27
10
11
1.4
43
57
32
9
16
1.7
45
55
32
11
12
1.6
41
59
40
11
9
1.4
35
65
38
16
11
1.7
32
68
39
14
15
2.0
34
66
32
19
14
2.0
25
75
38
20
17
2.3
30
70
37
19
14
2.1
34
66
33
17
16
2.1
37
63
33
15
16
1.9
45
55
28
15
12
1.6
55
45
20
14
11
1.4
Active play
None
At least one day
1-2 days
3-4 days
5 days or more
1
Mean number of days
13
87
16
12
59
4.6
7
93
3
9
80
5.9
4
96
5
10
81
5.8
4
96
7
9
80
5.8
4
96
8
7
81
5.8
8
92
12
11
69
5.2
6
94
16
13
64
5.0
5
95
16
14
66
5.0
9
91
18
12
61
4.7
7
93
20
13
61
4.7
12
88
22
16
49
4.1
17
83
25
11
47
3.8
21
79
24
13
42
3.6
33
67
24
15
28
2.6
32
68
23
16
29
2.7
Walking2
None
At least one day
1-2 days
3-4 days
5 days or more
1
Mean number of days
9
91
15
14
63
4.7
11
89
18
20
51
4.3
8
92
14
17
60
4.7
10
90
15
14
61
4.7
7
93
15
13
66
4.9
12
88
15
11
63
4.6
10
90
20
16
54
4.2
9
91
15
13
63
4.7
13
87
14
14
59
4.5
8
92
15
14
63
4.7
9
91
18
10
63
4.6
4
96
15
11
71
5.1
8
92
11
11
70
5.0
7
93
10
13
69
5.0
7
93
12
13
68
5.0
None
At least one day
1-2 days
3-4 days
5 days or more
1
Mean number of days
62
38
26
6
6
1.0
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
70
30
23
3
3
0.7
71
29
23
2
5
0.7
67
33
25
4
5
0.8
61
39
30
4
4
0.8
62
38
26
7
5
0.9
58
42
27
8
8
1.1
55
45
26
9
10
1.3
54
46
27
9
10
1.3
None
At least one day
1-2 days
3-4 days
5 days or more
1
Mean number of days
1
99
2
4
92
6.5
4
96
1
3
92
6.5
2
98
1
3
94
6.7
2
98
0
4
94
6.7
0
100
0
2
97
6.8
2
98
2
5
91
6.5
0
100
4
4
92
6.6
1
99
2
3
94
6.7
2
98
2
4
91
6.5
0
100
2
3
95
6.7
1
99
3
5
91
6.5
1
99
3
7
89
6.5
1
99
2
4
93
6.5
1
99
3
6
90
6.4
2
98
6
6
86
6.2
3,404
3,098
204
178
252
234
220
204
227
208
233
202
260
230
266
226
249
220
238
213
264
236
243
228
255
239
244
236
249
244
Girls
Bases (weighted)
Bases (unweighted)
4. For Housework / gardening totals apply only to those aged 8-15
Source:
89
Previous view
Contents page
1
2
Table 5.4 Children's physical activity levels by parental physical activity category , by age and
gender, 2006
England
Father's physical activity category
High
Medium
Low
Percentages
Mother's physical activity category
High
Medium
Low
Boys 2-10
3
High
Medium
Low
68
19
13
68
17
15
59
25
15
79
12
9
65
18
18
55
22
23
Boys 11-15
3
High
Medium
Low
75
15
10
72
15
12
66
13
21
76
16
8
70
16
14
62
18
20
Girls 2-10
3
High
Medium
Low
67
18
15
60
21
19
56
24
20
73
13
14
62
20
18
49
27
24
Girls 11-15
3
High
Medium
Low
53
26
21
46
18
36
31
22
47
58
14
27
48
23
29
41
24
35
Bases (unweighted)
Boys aged 2-10
Boys aged 11-15
Girls aged 2-10
Girls aged 11-15
255
143
243
142
174
99
195
110
135
94
145
76
327
196
306
128
356
206
381
222
248
142
232
176
Bases (weighted)
Boys aged 2-10
Boys aged 11-15
Girls aged 2-10
Girls aged 11-15
232
136
214
132
174
95
178
104
132
98
137
79
311
139
272
163
355
203
347
218
239
189
222
124
1. Children: high = 60 minutes or more on all 7 days; medium = 30-59 minutes on all 7 days; low = lower level of activity
2. Adults: high = 30 minutes or more activity of at least moderate intensity on at least 5 days a week; medium = 30 minutes or
more of at least moderate intensity on 1 to 4 days a week; low = lower levels of activity
3. Based on assumption that all activity was of at least moderate intensity, this group represents those who met the physical
activity recommendations for at least moderate intensity activity a day
Source:
90
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Contents page
Table 5.5 Children's1 physical activity levels2, by equivalised household income and
gender, 2006
England
Highest
2nd
3rd
4th
Percentages
Lowest
Boys
High
Medium
Low
70
15
15
71
15
14
72
14
13
72
14
14
69
17
15
Girls
High
Medium
Low
60
18
22
62
18
20
64
18
19
60
18
22
56
20
24
Bases (unweighted)
Boys
Girls
460
399
586
618
637
550
572
570
686
698
Bases (weighted)
Boys
Girls
412
350
514
519
580
482
540
512
689
693
Source:
91
Previous view
Contents page
Table 5.6 Number of days’ participation by children in different activities in the last week, by
England
Highest
2nd
3rd
4th
Percentages
Lowest
Boys aged 2-10
Sports and exercise
None
At least one day
1-2 days
3-4 days
5 or more days
1
Mean number of days
28
72
35
18
19
2.4
28
72
38
18
16
2.3
31
69
33
15
21
2.5
43
57
29
11
17
1.9
43
57
25
10
23
2.2
Active play
None
At least one day
1-2 days
3-4 days
5 or more days
1
Mean number of days
3
97
15
10
73
5.4
4
96
9
11
76
5.6
6
94
9
10
75
5.5
4
96
9
8
80
5.8
5
95
11
8
76
5.5
10
90
17
21
51
4.1
12
88
16
16
56
4.3
9
91
17
18
55
4.5
11
89
15
13
62
4.5
10
90
11
10
70
5.1
74
26
22
2
2
0.5
77
23
20
1
2
0.4
77
23
16
3
4
0.6
75
25
19
4
1
0.5
73
27
15
5
7
0.8
Boys aged 11-15
Sports and exercise
None
At least one day
1-2 days
3-4 days
5 or more days
1
Mean number of days
22
78
25
22
31
3.1
20
80
29
18
33
3.1
22
78
27
23
28
2.9
34
66
25
20
20
2.3
35
65
23
16
26
2.5
Active play
None
At least one day
1-2 days
3-4 days
5 or more days
1
Mean number of days
9
91
17
17
57
4.4
9
91
17
14
61
4.6
6
94
18
14
62
4.8
8
92
14
11
67
5.0
13
87
18
12
58
4.5
11
89
15
10
64
4.6
12
88
12
13
63
4.6
7
93
10
10
73
5.2
4
96
11
14
71
5.3
8
92
9
8
75
5.3
69
31
24
3
4
0.7
75
25
20
3
2
0.5
66
34
26
3
4
0.7
64
36
21
8
7
1.0
64
36
25
8
2
0.8
294
170
400
193
416
231
355
224
431
261
265
152
353
167
373
215
331
216
431
264
2
Walking
None
At least one day
1-2 days
3-4 days
5 or more days
1
Mean number of days
Housework / gardening
None
At least one day
1-2 days
3-4 days
5 or more days
1
Mean number of days
3,4
2
Walking
None
At least one day
1-2 days
3-4 days
5 or more days
1
Mean number of days
Housework / gardening
None
At least one day
1-2 days
3-4 days
5 or more days
1
Mean number of days
Bases (unweighted)
Boys aged 2-10
Boys aged 11-15
Bases (weighted)
Boys aged 2-10
Boys aged 11-15
3,4
4. The question about Housework/Gardening was asked of those aged 8-15 only
Source:
92
Previous view
Contents page
Table 5.6 continued...
England
Highest
2nd
3rd
4th
Percentages
Lowest
Girls aged 2-10
Sports and exercise
None
At least one day
1-2 days
3-4 days
5 or more days
1
Mean number of days
21
79
39
24
15
2.4
25
75
44
15
16
2.3
36
64
37
14
13
1.9
44
56
32
11
12
1.7
58
42
23
7
12
1.5
Active play
None
At least one day
1-2 days
3-4 days
5 or more days
1
Mean number of days
5
95
18
14
63
4.8
4
96
12
10
74
5.3
3
97
9
11
78
5.6
4
96
11
13
72
5.4
8
92
11
9
72
5.1
Walking2
None
At least one day
1-2 days
3-4 days
5 or more days
1
Mean number of days
9
91
22
17
52
4.2
8
92
17
17
58
4.5
8
92
19
15
59
4.5
15
85
11
15
60
4.5
10
90
13
13
64
4.8
None
At least one day
1-2 days
3-4 days
5 or more days
1
Mean number of days
79
21
20
1
0.3
74
26
19
1
6
0.7
72
28
24
3
1
0.5
63
37
26
5
6
0.9
65
35
27
4
5
0.8
Girls aged 11-15
Sports and exercise
None
At least one day
1-2 days
3-4 days
5 or more days
1
Mean number of days
24
76
39
22
14
2.2
34
66
31
18
17
2.1
38
62
31
18
13
1.8
42
58
33
15
10
1.6
48
52
26
11
16
1.7
Active play
None
At least one day
1-2 days
3-4 days
5 or more days
1
Mean number of days
17
83
33
9
40
3.4
23
77
26
15
37
3.2
21
79
24
15
40
3.4
26
74
21
14
39
3.4
23
77
21
14
41
3.5
Walking
None
At least one day
1-2 days
3-4 days
5 or more days
1
Mean number of days
11
89
18
14
57
4.5
7
93
15
13
65
4.8
7
93
9
9
75
5.2
4
96
13
12
71
5.1
7
93
12
12
69
5.0
None
At least one day
1-2 days
3-4 days
5 or more days
1
Mean number of days
68
32
22
3
7
0.9
61
39
27
6
6
0.9
55
45
34
8
3
0.9
56
44
28
9
7
1.1
54
46
27
9
10
1.4
270
136
400
226
340
221
385
196
436
278
235
121
332
192
293
199
342
181
417
293
2
Bases (unweighted)
Girls aged 2-10
Girls aged 11-15
Bases (weighted)
Girls aged 2-10
Girls aged 11-15
4. The question about Housework/Gardening was asked of those aged 8-15 only
Source:
93
Previous view
Contents page
Table 5.7 Children's1 physical activity levels2, by Government Office Region/ Strategic Health Authority3 and gender, 2006
England
the Humber
East
Midlands
West
Midlands
East of
England
London South West
Percentages
South East South East
South
Coast
Central
Boys
High
Medium
Low
71
15
14
73
13
14
71
15
15
76
11
13
72
13
15
66
17
17
66
18
16
75
13
12
68
16
16
70
13
17
66
19
16
Girls
High
Medium
Low
65
18
17
60
19
21
61
17
22
64
17
20
58
19
24
55
20
25
52
23
25
65
17
17
61
18
21
62
16
22
60
19
21
Bases (unweighted)
Boys
Girls
177
177
504
528
391
363
328
335
356
357
366
321
425
413
334
295
559
554
270
249
289
305
Bases (weighted)
Boys
Girls
160
155
440
453
333
300
262
263
328
334
376
304
471
458
321
265
528
507
253
226
275
281
3. This table provides data for regional analysis both by Government Office Region (GOR) and the new configuration of Strategic Health Authorities (SHAs) in place
from July 2006. The first eight columns represent GORs and SHAs of the same name, while the South East GOR (column nine) is divided into South East Coast SHA
and South Central SHA, shown in the final two columns
Source:
94
Previous view
Contents page
Table 5.8 Number of days’ participation by children in different activities in the last week, by Government Office
Region/Strategic Health Authority1 and gender, 2006
England
the Humber
East
Midlands
West
Midlands
East of
England
Percentages
South
Coast
Central
Boys aged 2-10
Sports and exercise
None
At least one day
1-2 days
3-4 days
5 days or more
2
Mean number of days
34
66
22
17
27
2.7
29
71
31
11
29
2.7
36
64
35
13
16
2.0
36
64
31
14
20
2.3
42
58
28
11
19
2.1
37
63
33
14
16
2.0
43
57
28
14
15
2.0
36
64
29
17
18
2.3
34
66
33
16
17
2.2
33
67
32
19
16
2.2
34
66
34
14
18
2.2
Active play
None
At least one day
1-2 days
3-4 days
5 days or more
2
Mean number of days
5
95
6
8
81
5.8
5
95
11
9
75
5.5
4
96
9
12
75
5.6
5
95
10
8
77
5.6
4
96
11
6
78
5.6
4
96
8
13
75
5.6
8
92
13
9
70
5.2
7
93
10
9
74
5.5
5
95
11
9
75
5.4
3
97
12
10
75
5.4
6
94
10
8
76
5.5
Walking3
None
At least one day
1-2 days
3-4 days
5 days or more
2
Mean number of days
5
95
8
19
68
5.0
9
91
16
15
60
4.6
10
90
15
13
62
4.6
17
83
10
14
59
4.4
12
88
14
17
57
4.5
11
89
18
20
50
4.1
7
93
11
10
72
5.3
12
88
16
13
59
4.4
12
88
17
14
57
4.4
11
89
11
18
59
4.6
13
87
23
10
54
4.1
None
At least one day
1-2 days
3-4 days
5 days or more
2
Mean number of days
73
27
23
4
0.6
71
29
21
5
3
0.6
79
21
10
5
7
0.7
76
24
20
3
0.5
76
24
20
3
1
0.4
85
15
12
1
2
0.3
78
22
12
4
7
0.7
73
27
21
3
2
0.5
73
27
23
4
0.6
79
21
15
3
3
0.5
69
31
23
4
4
0.7
Sports and exercise
None
At least one day
1-2 days
3-4 days
5 days or more
2
Mean number of days
36
64
30
22
12
1.8
27
73
22
19
33
3.0
29
71
27
13
31
2.7
34
66
23
18
26
2.5
26
74
26
21
27
2.8
28
72
24
24
25
2.7
26
74
22
17
35
3.1
26
74
32
18
24
2.6
28
72
28
19
25
2.6
27
73
25
19
29
2.8
28
72
31
19
22
2.4
Active play
None
At least one day
1-2 days
3-4 days
5 days or more
2
Mean number of days
14
86
15
19
52
4.2
6
94
12
15
67
5.2
9
91
14
8
69
5.0
9
91
10
10
70
5.1
12
88
20
8
61
4.5
15
85
17
13
55
4.2
9
91
20
11
60
4.6
9
91
16
13
62
4.8
8
92
21
20
51
4.3
8
92
24
18
50
4.2
9
91
17
21
52
4.4
Walking3
None
At least one day
1-2 days
3-4 days
5 days or more
2
Mean number of days
7
93
15
8
70
4.9
10
90
9
9
72
5.2
9
91
8
7
76
5.4
8
92
8
7
76
5.4
6
94
12
12
71
5.1
11
89
12
15
63
4.5
6
94
8
6
80
5.6
5
95
11
14
71
5.2
11
89
12
10
66
4.8
9
91
12
16
64
4.9
13
87
13
6
68
4.8
None
At least one day
1-2 days
3-4 days
5 days or more
2
Mean number of days
66
34
29
3
1
0.6
63
37
23
10
4
0.9
69
31
23
5
4
0.8
62
38
25
10
3
0.9
65
35
25
5
5
0.9
76
24
19
2
4
0.6
65
35
20
9
5
0.9
68
32
20
10
1
0.7
65
35
26
4
5
0.8
62
38
29
3
6
0.9
68
32
23
4
5
0.7
Bases (unweighted)
Boys aged 2-10
Boys aged 11-15
111
67
312
196
243
153
207
125
236
126
225
147
276
159
211
127
359
199
150
93
209
106
Bases (weighted)
Boys aged 2-10
Boys aged 11-15
100
61
269
174
207
130
161
104
220
114
229
153
301
181
201
124
530
189
133
86
190
102
Boys aged 11-15
July 2006. The first eight columns represent GORs and SHAs of the same name, while the South East GOR (column nine) is divided into South East Coast SHA and
South Central SHA, shown in the final two columns
3. Counting activities lasting at least 5 minutes at a time only
5. The question about Housework/gardening was asked of those aged 8-15 only
Source:
95
Previous view
Contents page
Table 5.8 continued…
England
the Humber
East
Midlands
West
Midlands
East of
England
Percentages
South
Coast
Central
Girls aged 2-10
Sports and exercise
None
At least one day
1-2 days
3-4 days
5 days or more
2
Mean number of days
37
63
30
18
16
2.6
36
64
32
15
17
2.5
44
56
27
12
17
2.0
41
59
37
11
11
2.1
43
57
34
12
11
2.0
36
64
35
12
17
2.0
56
44
27
9
9
1.8
26
74
42
17
14
2.2
35
65
37
15
13
2.0
34
66
38
16
12
2.0
36
64
37
14
13
1.9
Active play
None
At least one day
1-2 days
3-4 days
5 days or more
2
Mean number of days
3
97
8
16
72
5.5
9
91
15
9
68
5.0
5
95
11
9
75
5.3
6
94
11
6
77
5.5
4
96
14
10
72
5.2
5
95
9
16
69
5.0
8
92
11
11
70
5.1
8
92
11
13
68
5.1
4
96
13
11
72
5.3
3
97
13
10
74
5.3
6
94
12
11
70
5.2
Walking3
None
At least one day
1-2 days
3-4 days
5 days or more
2
Mean number of days
6
94
16
19
58
4.5
11
89
17
13
59
4.6
14
86
14
11
61
4.5
15
85
16
16
54
4.2
10
90
15
16
58
4.4
7
93
18
25
50
4.3
8
92
13
11
68
5.1
11
89
13
9
66
4.9
8
92
16
15
60
4.5
8
92
13
17
61
4.6
8
92
19
14
59
4.5
None
At least one day
1-2 days
3-4 days
5 days or more
2
Mean number of days
57
43
37
5
0.9
71
29
21
3
5
0.7
61
39
27
5
7
0.9
67
33
23
7
3
0.7
83
17
15
1
1
0.3
79
21
17
4
0.5
70
30
19
4
7
0.9
60
40
38
1
1
0.7
57
43
37
5
0.8
69
31
26
2
4
0.6
61
39
28
5
5
0.9
Sports and exercise
None
At least one day
1-2 days
3-4 days
5 days or more
2
Mean number of days
41
59
34
9
15
1.8
38
62
30
15
18
2.0
45
55
26
18
11
1.6
37
63
33
17
13
1.8
37
63
31
15
17
2.0
42
58
36
14
7
1.5
47
53
28
14
12
1.6
38
62
27
21
15
2.0
39
61
29
18
14
1.9
35
65
35
16
14
1.9
44
56
22
21
13
1.9
Active play
None
At least one day
1-2 days
3-4 days
5 days or more
2
Mean number of days
24
76
25
10
40
3.2
23
77
19
18
40
3.5
22
78
23
16
40
3.5
24
76
16
11
49
3.7
27
73
17
14
42
3.3
19
81
26
18
37
3.3
26
74
25
16
33
3.1
22
78
19
17
42
3.5
20
80
36
9
35
3.1
21
79
43
5
31
2.9
19
81
29
12
39
3.4
Walking3
None
At least one day
1-2 days
3-4 days
5 days or more
2
Mean number of days
7
93
15
8
70
4.9
6
94
9
11
75
5.4
6
94
7
11
76
5.4
8
92
17
13
62
4.6
6
94
14
10
70
4.9
6
94
20
12
61
4.5
6
94
10
13
70
5.2
6
94
10
16
68
5.0
11
89
18
11
60
4.5
10
90
19
9
61
4.6
12
88
16
13
59
4.4
None
At least one day
1-2 days
3-4 days
5 days or more
2
Mean number of days
61
39
22
14
4
1.0
52
48
26
7
15
1.6
64
36
23
6
6
0.9
55
45
29
6
9
1.3
57
43
25
10
8
1.2
66
34
27
4
2
0.7
57
43
22
9
11
1.3
50
50
39
9
2
0.9
60
40
30
6
4
0.8
66
34
28
5
2
0.6
55
45
33
7
5
1.0
Bases (unweighted)
Girls aged 2-10
Girls aged 11-15
116
64
334
200
235
134
210
131
227
137
203
123
267
154
198
110
359
202
150
104
209
98
Bases (weighted)
Girls aged 2-10
Girls aged 11-15
101
57
277
183
193
113
157
110
208
131
188
121
291
176
175
101
323
189
133
97
190
92
Girls aged 11-15
July 2006. The first eight columns represent GORs and SHAs of the same name, while the South East GOR (column nine) is divided into South East Coast SHA and
South Central SHA, shown in the final two columns
3. Counting activities lasting at least 5 minutes at a time only
5. The question about Housework/gardening was asked of those aged 8-15 only
Source:
96
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1
2
3
4
Table 5.9 Proportion of children meeting the current physical activity recommendations , England and Scotland , by
age and gender
Total
2-4
5-7
8-10
11-12
Percentages
13-15
Boys
England
Scotland
70
74
72
77
69
75
70
77
74
78
66
66
Girls
England
Scotland
61
63
69
70
66
75
63
75
58
57
48
41
Bases (unweighted)
Boys England
Boys Scotland
Girls England
Girls Scotland
3,629
1,465
3,504
1,468
728
311
730
296
788
312
758
327
804
296
724
299
531
224
529
237
778
322
763
309
Bases (weighted)
Boys England
Boys Scotland
Girls England
Girls Scotland
4,200
1,517
4,058
1,448
834
291
822
280
927
311
895
328
944
319
881
293
621
258
614
239
874
338
846
308
2. At least 60 minutes or more moderate intensity activity on all seven days
3. Based on the 2002 Health Survey for England
4. Based on the 2003 Scottish Health Survey
Source:
2003 Scottish Health Survey. The Scottish Executive
Copyright 2008 re-used with the permission of the Department of Health
Copyright 2008 re-used with the permission of The Scottish Executive
97
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Table 5.10 Pupils who participated in at least two hours of high quality PE and out
1
of hour's school sport in a typical week - by year group, 2004/05 to 2006/07
England
2004/05
2005/06
Percentages
2006/07
All pupils
69
80
86
Year 1
Year 2
Year 3
Year 4
Year 5
Year 6
Year 7
Year 8
Year 9
Year 10
Year 11
51
54
64
68
72
74
87
86
81
63
58
74
77
83
84
87
88
90
89
84
65
60
87
89
91
92
93
94
92
91
86
67
63
All primary
All secondary
2
All special
64
75
69
82
78
82
91
80
88
3,555,553
5,056,155
6,300,142
Base
1. Based on pupils surveyed in 21,745 schools within school sport partnerships in 2006/07
2. A special school is specially organised to make special educational provision for pupils with special
educational needs (SEN) whose needs cannot be fully met from within mainstream provision
Source:
2006/07 School Sport Survey. The Department for Children, Schools and Families
Copyright © 2008. Re-used with the permission of the Department for Education and Skills
Copyright © 2008. Re-used with the permission of the Department for Children, Schools and Families
98
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Table 5.11 Total curriculum time pupils spent taking part in PE in a typical week,
by year group, 2004/05 to 2006/071
England
2004/05
2005/06
Minutes
2006/07
All pupils
107
111
115
Year 1
Year 2
Year 3
Year 4
Year 5
Year 6
Year 7
Year 8
Year 9
Year 10
Year 11
96
96
103
103
104
104
124
123
118
101
98
107
107
111
112
113
112
125
124
120
97
94
115
116
118
119
119
118
126
124
120
97
94
All primary
All secondary
2
All special
101
113
..
110
112
126
117
112
133
3,574,969
5,058,169
6,300,142
Base
1. Based on pupils surveyed in 21,745 schools within school sport partnerships in 2006/07
2. A special school is specially organised to make special educational provision for pupils with special
educational needs (SEN) whose needs cannot be fully met from within mainstream provision
Source:
Copyright © 2008. Re-used with the permission of the Department for Education and Skills
99
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Table 5.12 How two hours of PE and school sport target is achieved by year
group, 2006/07
England
Proportion achieving
two hour PE / School
sport target
Percentages
Curriculum time
All pupils
86
70
Year 1
Year 2
Year 3
Year 4
Year 5
Year 6
Year 7
Year 8
Year 9
Year 10
Year 11
87
89
91
92
93
94
92
91
86
67
63
73
73
78
79
79
79
84
81
74
38
35
6,300,142
6,300,142
Base
Source:
100
1
26
2.1
49
1
28
5
14
1
2
1998/
2000
26
2.5
44
2
32
6
14
1
2
25
2.4
45
1
31
6
14
1
2
27
2.3
46
2
32
5
13
1
1
2004
26
2.3
46
1
32
6
12
1
1
2005
25
2.5
46
2
30
5
14
1
1
2006
3,704
3,426
2,628
3,201
3,183
3,185
2,996
22,948 21,470 15,707 20,307 20,476 20,357 18,508
25
2.1
47
1
29
5
15
2
1995/
1997
Age 5-16
2002
2003
Copyright © 2008. Re-used with the permission of The Office for National Statistics
Source:
Transport Statistics Bulletin, National Travel Survey: 2006. The Office for National Statistics
11
1.4
56
37
3
3
1
1998/
2000
1,955
1,758
12,155 10,608
9
1.3
53
38
3
4
2
1995/
1997
1. Trips of under 50 miles only
2. 1995/97 based on 1995, 1996 and 1997 combined. 1998/2000 uses 1998, 1999 and 2000 combined
3. Short walks believed to be under-recorded in 2002 and 2003 compared with earlier years
individuals
trips
% travelling to school
alone (main stage)
Average length (miles)
Walk
Bicycle
Car/van
Private bus
Local bus
Rail
Other
3
Great Britain
Table 5.13 Trips to and from school1 per child by main mode, 1995/972 to 2006
1,337
7,885
11
1.5
51
1
41
4
2
1
1,572
9,738
8
1.5
51
1
41
3
3
1
Age 5-10
2002
2003
1,572
9,960
10
1.7
49
1
43
4
3
1
2004
1,518
9,449
6
1.5
49
1
43
3
3
1
2005
1,477
9,195
5
1.5
52
1
41
2
3
1
2006
40
2.8
43
2
20
7
24
1
3
1998/
2000
1,749
1,668
10,793 10,862
41
2.9
42
2
20
7
26
1
2
1995/
1997
40
3.2
40
2
23
9
23
1
2
42
2.9
43
3
22
7
22
1
2
44
3.0
44
2
22
9
20
1
2
1,291
1,629
1,611
1,667
7,822 10,569 10,516 10,908
40
3.3
38
2
24
8
25
1
2
1,519
9,313
43
3.4
41
3
20
7
24
2
2
Percentages / Miles / Numbers
Age 11-16
2002
2003
2004
2005
2006
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101
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102
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6 Diet
6.1 Introduction
Poor diet and nutrition are recognised as
major contributory risk factors for ill health
and premature death.
This chapter
describes information available about
purchases and consumption of food and
drink among both adults and children.
Most of this data comes from three major
national surveys; the Expenditure and Food
Survey (EFS), the National Diet and
Nutrition Survey (NDNS) and the Health
Survey for England (HSE). Some data from
a variety of other sources are also included.
The chapter provides dietary information for
adults and children separately. For adults,
purchases and consumption of different
food types are considered. Consumption
among different groups is included, as is
energy intake and which foods that energy
is derived from.
Data on household
expenditure for different food types are also
presented. For children, data sources for
consumption of different food types at
school are considered, fruit and vegetable
consumption among different groups is
presented and consumption of different
food types, fruit and vegetable consumption
and energy and macronutrient intakes
among
children
from
low
income
households are included.
The EFS collects information on the type
and quantity of food and drink purchases
brought into the home and eaten out using
self-reported diaries over a two week
period.
Although this data relates to
households in the United Kingdom,
information from the EFS is presented in
the adults’ diet section of this chapter.
Findings from the survey are published
annually in the Family Food report, by the
Department for Environment, Food and
Rural Affairs (DEFRA), with Family Food
2005/061 being the most recent report.
Data from this report are used here to
present longer time trends in purchase
patterns and expenditure on food.
The NDNS collects data on consumption by
individuals using a weighted intake dietary
record (respondents were required to weigh
all food consumed) over a period of seven
days and so allowing for detailed analysis
of food consumption and average daily
nutrient intakes. The most recent survey of
this type was the NDNS of adults aged 19
to 64 living in Great Britain, which was
conducted in 2000/012 and is used here.
Other NDNS surveys have focused on preschool children3, school-aged children4 and
elderly people5. The NDNS is now moving
to a rolling programme format in which the
survey will run continuously with fieldwork
every year, covering both adults and
children. Between 2003 and 2005 a similar
survey was carried out by the Food
Standards Agency (FSA), which focused on
people found to be from low income and
materially deprived households. This Low
Income Diet and Nutrition Survey (LIDNS)6
included both adults of all ages and
children (aged 2 to 18) and is used in this
chapter to highlight differences in diet and
nutrition between the low income adult
population
and
the
general
adult
population. Key dietary habits and fruit and
vegetable consumption of the low income
adult population and nutritional intakes
among
children
from
low
income
households are also considered.
Data on fruit and vegetable consumption
among both adults and children is taken
from the HSE as this source is used to
monitor the government’s ‘5 a day’ target encouraging people to eat at least five
portions of fruit and vegetables a day. As
described in other chapters of this report,
the HSE is an annual survey designed to
monitor the health of the population of
England. Data presented in this chapter
are taken from HSE 20067 which covers
consumption of fruit and vegetables among
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both adults and children using a 24 hour
dietary recall for the previous day.
6.2 Adults’ diet
6.2.1 Trends in purchases and
expenditure on food and drink
Trends in purchases and expenditure on
food and drink can indicate eating patterns,
although both quantities purchased and
amount spent could be affected by differing
food prices and changing markets.
Although some account is taken of food
which is wasted, these measures do not
strictly represent consumption.
The EFS has estimated both expenditure
on and quantities of food and drink
purchased and brought into the household
since the mid 1970s. Compared to 1974,
we have been buying decreasing amounts
of milk and cream, carcase meat, fats and
oils, sugars and preserves, fresh potatoes,
bread and beverages (excluding soft drinks
and alcoholic drinks). Overall, we have
been buying increasing amounts of noncarcase meat, fish and fruit. Some food
groups have shown a large change since
1974, such as purchases of whole milk,
which have decreased by 82%; purchases
of fruit, which have increased by over three
quarters (77%) and purchases of takeaway
food brought home, which have more than
doubled. Although relatively smaller in
quantity, purchases of rice, pasta and pizza
have generally been increasing since 1974
(Table 6.1).
Since 1974, purchases of fruit have
increased by 77% and purchases of
whole milk have decreased by 82%
EFS data collected between April 2003 and
March 2006 have been pooled together
and averaged to enable a breakdown of
household purchases of the main food and
drink groups by UK country. Respondents
living in England bought the most fish, fruit
and vegetables (excluding potatoes) and
the lowest amount of soft drinks and
confectionary when compared to those
living in Wales, Scotland and Northern
Ireland (Table 6.2, Figure 6.1).
Figure 6.1 Average household purchases of selected food groups
by UK country, April 2003 - March 2006
Grams per person per week
United Kingdom
2,500
England
Wales
Scotland
Northern Ireland
2,000
1,500
1,000
500
0
Vegetables
(excluding potatoes)
Fruit
Soft drinks (millilitres)
Confectionery
Source: Family Food 2005/06. Department for Environment, Food and Rural Affairs
Copyright © 2008, re-used w ith the permission of The Depratment for Environment, Food and Rural
Affairs
The EFS shows that, in 2005/06 the
average weekly expenditure on food and
drink (excluding alcohol) brought home, in
the UK, was £20.91 per person, while
expenditure on food and drink (excluding
alcohol) eaten out was £7.79. Between
1995 and 2005/06, overall expenditure on
food and non-alcoholic drink had risen by
8.6% in real terms mainly due to increased
expenditure on eating out, which increased
by 43% in real terms1 (Table 6.3).
Of the £20.91 spent on food and drink
(excluding alcohol) brought into the home,
24% was spent on meat and meat products
(£4.95), 14% was spent on cereals,
excluding bread (£2.91), 9% each on
vegetables (excluding potatoes) (£1.94)
and fruit (£1.88) and 8% on milk and cream
(£1.64) (Table 6.4).
6.2.2 Consumption of food and drink
As the NDNS focuses on consumption of
different food and drink types, results from
the survey are used here to highlight
patterns of consumption. In 2000/01, milk,
meat (including meat dishes and meat
products), vegetables (including vegetable
dishes, but excluding potatoes) and tea and
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water were consumed in the largest
quantities, in terms of weight. Over 90% of
respondents reported consuming each of
these types of foods during the survey
period. Although consumed in lower
quantities, bread, fats and oils and potatoes
were also consumed by over 90% of
respondents. Comparing 1986/87 NDNS
consumption data to 2000/01 data broadly
reflects the findings on trends in purchases
from the EFS.
The biggest change
between the two NDNS surveys was the
increase in those who drink low calorie soft
drinks (Table 6.5, Figure 6.2).
Figure 6.2 Quantites of selected food groups consumed in
the previous week, 1986/87 and 2000/01
Great Britain
1986/87
Mean number of grams
per consumer
2000/01
2000
1600
consuming these food types remained
similar in each age group (Table 6.6).
Overall, men were more likely than women
to consume fats and oils, meat and meat
dishes/products, sugars and preserves,
non-low calorie soft drinks and alcoholic
drinks.
As might be expected, men
generally consumed larger quantities of
food. Women were more likely to consume
yogurt and fromage frais, fruit (excluding
fruit juice) and low calorie soft drinks, and
consumed larger quantities of fruit than
men (Tables 6.7 and 6.8, Figure 6.3).
Figure 6.3 Percentage consuming selected food groups,
by gender, 2000/01
Great Britain
Men
Women
Percentages
100
80
60
1200
800
40
400
0
20
Pasta, rice,
pizza etc
Fruit
(excluding
fruit juice)
Non-diet soft
drinks
Potatoes
0
Fats and oils
Fats & oils
Meat & meat
products
Yogurt &
fromage frais
Fruit (excluding
fruit juice)
Source: National Diet and Nutrition Survey: adults aged 19 to 64 years old.
The Office for National Statistics
Source: National Diet and Nutrition Survey: adults aged 19 to 64 years
old. The Office for National Statistics
Copyright © 2008, re-used w ith the permission of The Office for National Statistics
Copyright © 2008, re-used w ith the permission of TheOffice for National Statistics
Consumption by age and gender
Consumption by region
Differences in the consumption of food and
drink can be seen by age. In 2000/01,
younger people were more likely to eat
pasta, rice and other miscellaneous cereals
(such as pizza), savoury snacks and drink
non-low calorie soft drinks. Whereas those
in the eldest age group (aged 50 to 64)
were more likely to consume breakfast
cereals, biscuits and cakes, puddings,
yogurts, eggs, and fruit (excluding fruit
juice) than those in other age groups. The
proportion of consumers (and, in most
cases, the mean amount being consumed)
increased with age for the following food
groups: breakfast cereals, biscuits and
cakes, yogurts and fruit (excluding fruit
juice), while for vegetables (excluding
potatoes), sugar and preserves, tea, coffee
and water, mean consumption in grams
increased with age but the proportion
By region in Great Britain, there were few
consistent differences in the proportions
consuming the different types of food or in
the quantities of food consumed, for
example respondents in no one region
were more likely to have consumed cereal
or cereal products and less likely to have
consumed fruit and vegetables than those
in other regions (Tables 6.7 and 6.8).
Consumption among adults from low
income households
The NDNS also collected information on
receipt of certain state benefits. It was
found that there was a wide range of foods
that were less likely to be eaten by
respondents in benefit households, this
included foods such as wholemeal bread,
yogurt, breakfast cereals, shellfish, oily fish
and many types of fruit and vegetables
105
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(see volume 1 of the NDNS report)2. The
number of benefit households in the survey
sample was too small to allow for detailed
analysis but as the NDNS (and other
surveys) provided evidence to suggest that
differences in food consumption exist
between lower and higher socio-economic
groups the FSA carried out a similar survey
between 2003 and 2005 specifically
covering people living in low income and
materially deprived households.
More
information about the Low Income Diet and
Nutrition Survey (LIDNS) can be found in
Appendix A.
There
were
some
methodological
differences between the these two surveys
– for example the LIDNS used a multiple
pass 24 hour dietary recall on four separate
days rather than the seven day weighted
dietary diary method used in NDNS and so
statistical comparisons have not been
drawn between the two survey findings.
For
food
and
drink
consumption
specifically, notable differences between
the two surveys were considered to be
those where the difference in grams
consumed was 25% or more.
When compared to the food consumption
data for the general population from the
2000/01 NDNS, the LIDNS report found
that in general across adults aged 19 to 64,
the low income population were less likely
to consume breakfast cereals, buns, cakes
and pastries, skimmed and semi-skimmed
milk, oily fish and tinned tuna, vegetables,
fruit, nuts and seeds and fruit juice.
Whereas they were more likely to consume
fat spreads, non-diet soft drinks, meat and
meat dishes (beef, veal, lamb and pork),
pizza, processed meats, whole milk and
table sugar (see volume 2 of the LIDNS
report)6.
Among adults in the low income population
white bread, tea and condiments including
sauces, pickles and gravies were the most
commonly consumed, with over 70% of
both male and female respondents
reporting consumption of these food types.
It was found that men were more likely to
consume food such as sausages, table
sugar and beer and lager, whereas women
were more likely to consume food such as
dairy desserts (including yogurt), salad raw
vegetables, tomatoes and fruit, which is not
too dissimilar from the findings for the
general population from the NDNS.
As with the NDNS data, in general, men in
low income households consumed larger
quantities of food, except foods such as
skimmed milk and low calorie carbonated
soft drinks, which were consumed in
greater quantities by women (Table 6.9).
6.2.3 Fruit and vegetable consumption
Data on the consumption of different types
of fruit and vegetables and the number of
portions consumed per day is available
from the HSE, EFS and NDNS. The NDNS
data is based on the 2000/01 survey,
whereas
the
fruit
and
vegetable
consumption data from HSE and EFS is
collected annually.
As the HSE is
specifically concerned with associations of
lifestyle behaviours, socio-demographic
variations and health, it allows for more indepth analysis of fruit and vegetable
consumption data. The HSE data is also
used to monitor the government target of
increasing the proportion of the population
who consume five or more portions of fruit
and vegetables a day and so the HSE data
is therefore the main focus of this section.
In 2006, around three in ten adults
consumed five or more portions of
fruit and vegetables a day
Results from the 2006 HSE show that in
England between 2001 and 2004, the
proportion of men and women consuming
five or more portions of fruit and vegetables
a day remained relatively steady. There
106
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were significant increases in 2005 and
again in 2006 among both men and
women.
Among men, the proportion
consuming five or more portions of fruit and
vegetables a day has increased from 22%
in 2001 to 28% in 2006 and for women
from 25% to 32% over the same period
(Table 6.10).
Figure 6.5 Types of fruit and vegetables most commonly
consumed among adults, by gender, 2006
England
Men
Percentages
Women
80
60
40
20
0
Fruit and vegetable consumption by gender
and age
For both men and women in 2006, those
aged 16 to 24 were least likely to consume
five or more portions of fruit and vegetables
a day (with an average of 3.0 and 3.3
portions per day respectively). The
likelihood of consuming five or more
portions a day increased with age, peaking
at an average of 4.0 portions per day for
men aged 65 to 74 and 4.5 portions a day
for women aged 55 to 64, and then falling
slightly among older respondents (Table
6.11, Figure 6.4).
Figure 6.4 Mean number of portions of fruit and
vegetables consumed per day, by age and gender, 2006
Number of portions
England
Men
5
Women
4
3
2
1
0
16-24
25-34
35-44
45-54
55-64
65-74
75+
Source: Health Survey for England, 2006. The Information Centre
Types of fruit and vegetables consumed
Both men and women were more likely to
have consumed fresh fruit on the previous
day than any other type of food that counts
towards the ‘5 a day’ recommendation, with
62% of men and 71% of women reporting
this in 2006 (Table 6.12, Figure 6.5).
Fresh fruit
Vegetables
Salads
Pulses
Fruit juice
Fruit and vegetable consumption by
Government Office Region / Strategic
Health Authority
Among Government Office Regions
(GORs) and Strategic Health Authorities
(SHAs) in England, the proportion of adults
consuming five or more portions of fruit and
vegetables a day was highest for both men
(38%) and women (42%) in London, with
the other regions ranging from 22% to 30%
for men and 23% to 35% for women (Table
6.13).
Although the 2006 HSE results indicate that
people living in London are more likely to
consume five or more portions of fruit and
vegetables a day, it should be noted that
this region is a very small but densely
populated and diverse area and other
factors are likely to influence estimates of
lifestyle behaviours.
For example the
London region has a higher ethnic minority
population than other regions. As Table
6.14 shows, adults from minority ethnic
groups (with the exception of Irish men) in
2004 were more likely to consume five or
more portions of fruit and vegetables a day
than adults in the general population.
Consuming the recommended portions of
fruit and vegetables a day can be seen to
be related to income. In 2006, both men
and women in the highest income quintile
were more likely to consume five or more
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portions than those in the lowest income
quintile (Table 6.15, Figure 6.6).
8% of men and 9% of women in the
low income population consumed five
or more portions of fruit and
vegetables a day in 2003/05
Figure 6.6 Proportion of adults consuming five or more
portions of fruit and vegetables a day, by equivalised
household income quintile and gender, 2006
England
Men
Women
Percentages
40
Trends in fruit and vegetable purchases
30
20
10
0
Highest
2nd
3rd
4th
Low est
Fruit and vegetable consumption among
adults from a low income household
The LIDNS report found that, in the UK
between 2003 and 2005, among adults in
the low income population, only 8% of men
and 9% of women reported consuming five
or more portions of fruit and vegetables a
day, with the average number of portions
being 2.4 for men and 2.5 for women6. This
was much lower the proportions reported in
the 2006 HSE among adults in the lowest
income quintile, where 22% of men and
23% of women reported consuming five or
more portions of fruit and vegetables a day,
with the mean number of portions being 3.1
and 3.3 per day respectively. However it
should be borne in mind that the two
surveys were carried out over different time
periods, used different dietary recall
methods and cover slightly different age
ranges (Table 6.15, Figure 6.7).
Figure 6.7 Portions of fruit and vegetables consumed per day among
adults from low income households, by gender, 2003/04
United Kingdom
5
Data from the EFS gives a long time series
of household purchases of fruit and
vegetables. This shows that household
purchases of fresh fruit has continued to
increase since 1975, from 511 grams per
person per week to 856 grams in 2005/06
and have consistently been higher than
other types of fruit and vegetables.
Purchases of fresh green vegetables have
steadily decreased since 1975, however
the most recent data indicates that this
decline may have stopped. Other fresh
vegetable purchases have continued to
increase (Table 6.16).
6.2.4 Energy and macronutrients from
food and drink
Definitions
Energy and nutrients are required for the
body to function and be active. Energy is
derived from the intake of macronutrients
(protein, carbohydrates and fat) and
alcohol. There are a number of different
terminologies used to describe the intake of
energy and nutrients and recommendations
pertaining to these, which are defined in
Figure 6.8.
Mean number of portions
Men
Women
4
3
2
1
0
Mean fruit portions
Mean vegetable
Mean fruit and
portions
vegetable portions
Source: Low income diet and nutrition survey, Food Standards Agency, 2007
Copyright © 2008, re-used w ith the permission of The Food Standards Agency
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Figure 6.8 Energy and macronutrient intake definitions
Total Energy
Food Energy
The amount of energy an individual derives from
all food and drink (including alcoholic drinks)
consumed.
The amount of energy an individual derives from
all food and drink (excluding alcoholic drinks)
consumed.
Dietary
Reference
Value (DRV)
A series of estimates of the amount of energy
and nutrients needed by different groups of
healthy people in the UK population.
Estimated
Average
requirement
(EAR)
This is the DRV for energy intake, it is an
estimate of the energy needed to meet the
average requirements of the UK population
(approximately 50% of the group will require less
and 50% will require more).
Reference
This is the DRV for protein, vitamins and
Nutrient Intake minerals and is an estimate of the amount that
(RNI)
should meet the needs of nearly all (97.5%) of
the group to which they apply.
Source:
Nutrient requirements and recommendations. British Nutrition
Foundation webpage, 20048
Copyright © 2008, re-used with the permission of The British Nutrition
Trends in energy intake
Trends in energy intake (based on
household purchases) are available from
the 2005/06 Family Food report1 using data
from the EFS and its predecessor, the
National Food Survey. The trend shows
estimated energy intake from food and
drink (including alcohol) consumed within
the home and eaten out, where data are
available, since 1974. The overall trend
indicated is downwards although some
fluctuations are seen.
However, even
though the combined series from the two
sources gives the best estimate of changes
in energy intake over time, definitions have
varied from year to year and so data from
different years is not strictly comparable
(Table 6.17).
would be expected, men had higher energy
and macronutrient intakes than women in
all age groups.
For both men and women, the average
total energy intakes (which include energy
derived from alcohol) were below the
estimated energy intake needed to meet
the average requirements of the population
(Estimated Average Requirements or
EARs) in all age groups. For instance, the
energy intake among men was on average
92% of the recommended amount of
energy required (as calculated for each
respondent using the appropriate agerelated EAR).
The equivalent energy
intake for women was on average 85% of
Estimated Average Requirements. This
apparent shortfall in energy intake could be
due to a number of reasons such as the
effect of under-reporting on dietary surveys
or respondents modifying their usual diet
during the survey period, it could be also be
a consequence of the EAR being too high
based on individuals’ lifestyles, for example
if physical activity levels are low.
Figure 6.9 Dietary Reference Values for energy, protein,
carbohydrates and fat for adults, by gender
United Kingdom
Nutrient
Energy
Protein
Total carbohydrate
Non-milk extrinsic sugars
Total fat
Saturated fatty acids
Unit
Women
Men
MJ/day (kcal/day)
age 19-50
age 51-59
age 60-64
10.60 (2,550)
10.60 (2,550)
9.93 (2,380)
% of food energy
% of food energy
% of food energy
% of food energy
% of food energy
15
50
11
35
11
8.10
8.00
7.99
(1,940)
(1,900)
(1,900)
Source:
Report on Health and Social Subjects: 41. Dietary Reference Values for Food Energy and
Nutrients for the United Kingdom. Department of Health, 1991
Levels of energy and macronutrient intakes
The 2000/01 NDNS reports on energy and
nutrient intake of adults in Great Britain
aged 19 to 64 derived from dietary records
kept for a seven day period. The intake
data is compared with the Dietary
Reference Values (DRVs)8 for energy and
the different nutrients9. In 2000/01, as
15
50
11
35
11
For both men and women, the proportion of
food energy (excluding energy from
alcohol) derived from carbohydrate was just
under the recommended minimum of 50%
of energy intake and energy from total fat
was around the recommended maximum of
35% of energy intake. However, within
this, intake of non-milk extrinsic sugars
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(NMES, these are sugars not derived from
milk or whole fruit) were 14% for men and
12% for women and intakes of saturated
fats were 13% for both men and women,
which
exceeded
the
maximum
recommendations of 11% of energy intake
for both NMES and saturated fats (Table
6.18, Figure 6.9).
In 2000/01, the average daily intake of
non-milk extrinsic sugars and
saturated fatty acids was above
recommendations among adults
A comparison of energy and macronutrient
intakes from the 1986/87 and the 2000/01
surveys shows that total energy intake,
food energy from total fat and also from
saturated fatty acids had clearly dropped
among both men and women between the
two surveys and food energy from
carbohydrates and proteins had increased
(Table 6.19).
Contributions of food groups to energy and
macronutrient intake
The 2000/01 NDNS report shows the
contribution of different food types to
average daily energy intakes among adults.
Almost a third (31%) of total energy intake
was derived from cereals and cereal
products, 15% from meat and meat
products, 10% from milk and milk products,
10% from drinks (including alcohol) and 9%
from potatoes and savoury snacks (Figure
6.10).
Figure 6.10 Main food group contributors to daily energy
intake among adults, 2000/01
Percentages
Great Britain
Other food
categories
(25%)
Potatoes &
savoury
snacks
(9%)
Drinks
(10%)
Cereals &
cereal
products
(31%)
Meat & meat
products
(15%)
Milk & milk
products
(10%)
National
Diet
and
Nutrition
Survey,
2003. The Office for National
Source:
Statistics
Copyright © 2008, re-used w ith the permission of The Office for National Satistics
Meat and meat products were the main
contributors to the total fat intake (23%),
followed by cereals and cereal products
(19%), milk and milk products (14%), fat
spreads (12%) and potatoes and savoury
snacks (10%). A similar pattern was seen
for saturated fatty acids; however milk was
among the highest contributors along with
meats (24% of milk and milk products and
22% of meat and meat products) when
looking at saturated fatty acids.
The main contributor to the intake of
proteins was meat and meat products,
accounting for 36% of the protein intake.
For total carbohydrates intake the main
source was cereal and cereal products
(45%) (Table 6.20).
In 2000/01, 23% of total fat intake
among adults came from meat and
meat products
Comparison with adults from low income
households
Generally there was little difference in
energy and macronutrient intakes and the
contributing food groups between adults in
the low income population (as reported in
LIDNS)6 and the general population (as
reported in NDNS)2. The main difference
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was that the mean daily total energy intake
among men aged 19 and over was found to
be lower in the low income population than
in the general population.
6.3 Children’s diet
6.3.1 Consumption of food and drink
Data on the consumption of food and drink
among children is much less widely
available than that for adults. The last
National Diet and Nutrition Survey to
include children (aged 4 to 18) was carried
out in 1997/984 and so results are not
included here. A new NDNS covering both
adults and children, as mentioned in the
introduction to this chapter, is planned to be
begin in 200810.
Consumption of food and drink at school
The government has recently launched
initiatives to encourage children to eat more
fruit and vegetables and raise awareness of
healthy eating, such as the School Fruit
and Vegetable Scheme11 (initially launched
as the National School Fruit Scheme in
2004) and the national Healthy Schools
Programme12.
As these initiatives are
relatively new there is little data available to
describe the eating habits of children at
school. In 2004, the former Department for
Education and Skills (DfES) and the Food
Standards Agency (FSA) published a
survey to assess compliance with the 2001
statutory National Nutritional Standards for
school meals and to measure food
consumption among secondary school
pupils13.
In 2006 the government
introduced
new
interim
food-based
nutritional standards for primary and
secondary schools, with the new finalised
food-based and nutrient-based nutrition
standards due to come into force in primary
schools in 2008 and secondary schools in
200914.
Some of the key findings of the 2004
survey, School Meals in Secondary
Schools in England, were that of the
schools involved, the food groups most
commonly served on four or more days a
week were cakes and muffins (95% of
schools), sandwiches (92%), soft drinks
(92%) and fruit (91%). Vegetables and
salads were served in 70% of schools on
four or more days, however 76% of schools
served potatoes cooked in oil (including
chips) and 86% served high fat dishes (for
example, burgers or chicken nuggets) on
four or more days (Table 6.21).
The school meals in secondary schools
survey also collected information on food
consumed from individual pupils selected
randomly during lunchtimes on five
consecutive days. The results showed that
48% of pupils chose high fat main dishes
such as burgers, 48% chose chips or other
potatoes cooked in oil, 45% chose soft
drinks and 24% chose cakes or muffins.
The least popular choices were fruit (2%),
fruit juices (3%) and vegetables and salads
(6%)13.
In 2004, the least popular school meal
choices among children in secondary
schools were fruit, fruit juices,
vegetables and salads
Forty one per cent of total energy intake
from school meals consumed among the
children involved in the survey came from
total fat, with 14% coming from saturated
fatty acids. The targets for school meals in
the 2001 National Nutritional Standards are
that, at most, 35% of total energy intake
should come from fat with 11% or less from
saturated fatty acids13.
6.3.2 Fruit and vegetable consumption
The HSE collects data on the consumption
of fruit and vegetables among children
aged 5 to 15 years. The results show that
the proportion of boys and girls consuming
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five or more portions of fruit or vegetables a
day was relatively stable between 2001 and
2004, as with adults, although there was a
significant increase for both boys and girls
in 2005 and then a further increase among
girls in 2006 (Table 6.22, Figure 6.11).
Figure 6.11 Proportion of children consuming five or more
portions of fruit or vegetables a day, by gender, 2001 to 2006
England
Percentages
25
Girls
20
Boys
15
10
Data w eighted for non-response from 2003
see Appendix A
5
0
2001
2002
2003
2004
2005
2006
In 2006, girls were more likely than boys to
vegetables a day, with 19% of boys and
22% of girls reporting this. There was no
clear pattern of fruit and vegetable
consumption with age (Table 6.23).
Girls were more likely to consume five
or more portions of fruit and
vegetables a day than boys in 2006
Types of fruit and vegetables consumed
Among both boys and girls, as with adults,
fresh fruit was the highest contributor to
fruit and vegetable portions, with 67% of
boys and 71% of girls reporting eating fresh
fruit on the previous day. Fruit juice was
the second highest contributor (55% of
boys and 59% of girls), followed by
vegetables (52% and 54% respectively)
(Table 6.24)
Government Office Region / Strategic
Health Authority
As with adults, consumption of five or more
portions of fruit and vegetables was higher
in London than any other region (30% for
boys and 31% for girls), however the same
issues with regional data and adults
explained in section 6.2.3 above may also
apply to children.
Excluding London,
consumption of five or more portions
ranged from 11% to 22% among boys in
the other GORs/SHAs and from 18% to
24% among girls (Table 6.25)
Again, the same pattern is seen for children
as for adults when considering household
income. Children from households in the
highest income quintile were more likely to
vegetables than those living in households
in the lowest income quintile (28%
compared to 13% among boys and 34%
compared to 17% for girls) (Table 6.26,
Figure 6.12).
Figure 6.12 Proportion of children consuming five or more
portions of fruit and vegetables a day, by gender and
equivalised household income quintile, 2006
England
40
Boys
Girls
Percentages
30
20
10
0
Highest
2nd
3rd
4th
Lowest
6.3.3 Children in low income families
As the Low Income Diet and Nutrition
Survey (LIDNS) covered children as well as
adults, it provides the most recent data on
consumption of different food types, fruit
and vegetable consumption and energy
and macronutrient intake among children
living in low income households. The data
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was collected via dietary recall for four
randomly selected days over a ten day
period (including at least one weekend
day).
Of the children in low income families
surveyed, over 80% consumed white
bread, chips (and other fried or roast potato
products) and crisps and other savoury
snacks during the dietary recall periods.
Boys were more likely to consume foods
such as burgers, kebabs, meat pies and
pastries than girls, whereas girls were more
likely to eat foods such as rice, salad
vegetables, fruit and fruit juice. These
findings are not dissimilar to those for
adults from low income households (Table
6.27).
Between 2003 and 2005, fruit and
vegetable consumption among children
aged 2 to 18 in low income households
across the whole of the UK was very low,
with only 1% of boys and 4% of girls
reporting consuming five or more portions a
day, with the average number of portions
consumed per day being 1.6 for boys and
2.0 for girls (see volume 2 of the LIDNS
report)6.
maximum of 35%. Within this, intakes of
non-milk extrinsic sugars (NMES) (17.1%
and 16.5% respectively) and saturated fats
(14.2% and 14.0% respectively) greatly
exceeded the maximum recommendation
of 11% of energy intake for both
macronutrients (Table 6.28).
The LIDNS report also found that among
children from low income households, the
main contributors to total energy intake
were cereals and cereal products (30%),
meat and meat products (15%), potatoes
and savoury snacks (15%) and milk and
milk products (12%)6.
The main contributing food group to total fat
intake among children from low income
households, was meat and meat products
(22%), closely followed by cereals and
potatoes (both contributing 19% to total fat
intake), milk and milk products (17%) and
then fat spreads which contributed 10% to
children’s total fat intake (Figure 6.13)6.
Figure 6.13 Main food group contributors to fat intake among
children in low income households, 2003/04
Percentages
Meat & meat
products
(22%)
Potatoes &
savoury snacks
(19%)
Only 1% of boys and 4% of girls from
low income households consumed
five or more portions of fruit and
vegetables a day in 2003-05
For both boys and girls, the proportion of
food energy derived from carbohydrates
(50.8% and 51.0% respectively) was just
above the recommended minimum of 50%
and energy from total fat (36.1% and 35.7%
respectively) was above the recommended
Other food
categories
(13%)
United Kingdom
Cereals & cereal
products
(19%)
Fat spreads
(10%)
Milk & milk
products
(17%)
Source: Low income diet and nutrition survey, 2007. The Food Standards
Agency
Copyright © 2008, re-used w ith the permission of The Food Standards Agency
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Summary: Adults’ diet
The first part of this chapter has shown that
while there have been small fluctuations in
the types of foods and drinks that we
purchase over time, there have been some
major changes since the early 1970s in the
amount of some foods such as whole milk,
fruit and takeaways that we purchase.
Eating habits vary with gender and age.
Men tended to eat larger quantities of most
food groups and were more likely to
consume fats, meat dishes, sugars and
preserves and non-diet soft drinks and
alcohol, whereas women were more likely
to consume yogurts, fruit and diet soft
drinks.
A similar pattern was also found among the
low income population, with men from low
income households being more likely to
consume foods such as sausages, beer
and lager and table sugar, and women,
salad vegetables, dairy desserts and fruit.
In many respects the areas of concern
highlighted in the low income survey were
similar to those identified in the general
population, although some were more
marked in the low income population.
In 2006, around three in ten adults
consumed five or more portions of fruit and
vegetables a day. There has been a recent
increase in the number of adults eating five
or more portions of fruit and vegetables;
however younger people and those in lower
income households are least likely to
achieve this. Adults are more likely to eat
fresh fruit than other types of fruit or
vegetables and this is reflected in the
trends in purchases.
In 2000/01, both men and women had
intakes of carbohydrates and total fat
around the recommended levels, while
intakes of non-milk extrinsic sugars and
saturated fatty acids were above the
recommended levels. Between 1986/87
and 2000/01, total energy intake and food
energy from fats and saturated fatty acids
decreased, while food energy intake from
carbohydrates and proteins increased.
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Summary: Children’s diet
The second part of this chapter considered
children’s diet. There is little information
available at a national level on consumption
of food and drink among children.
Research in 2004 found that as well as fruit
and vegetables, less healthy options such
as burgers, chips, cakes and muffins were
regularly served in secondary schools
across the country. These less healthy
options were found to be the most popular
choices among the pupils, with vegetables
and salads, fruit and fruit juices the least
popular.
The research found the total fat and
saturated fat intakes derived from schools
meals to be higher than the recommended
levels from the National Nutrition Standards
set in 2001.
and vegetables a day. As with adults, this
proportion
has
recently
increased.
Although, in 2006, there was no clear
pattern with age, children from lower
income households were less likely to
achieve the ‘5 a day’ recommendation.
Again in line with adults, fresh fruit was also
the main contributor to children’s daily
portions of fruit and vegetables.
The Low Income Diet and Nutrition Survey
reported on consumption of different food
types and energy and macronutrient intake
among children aged 2 to 18. It reports
similar patterns to adults in the general
population, with boys being more likely to
consume foods such as burgers and
kebabs and girls being more likely to
consume foods such as rice, salads and
fruit.
In 2006, around a fifth of children aged 5 to
15 consumed five or more portions of fruit
References
1.
Family Food 2005/06. Department for
Environment, Food and Rural Affairs, 2007.
Available at:
http://statistics.defra.gov.uk/esg/publication
s/efs/default.asp
2.
National Diet and Nutrition Survey of
adults aged 19 to 64: The Food Standards
Agency, 2003. Available at:
http://www.food.gov.uk/science/dietarysurv
eys/ndnsdocuments/
3.
National Diet and Nutrition Survey of
children aged 1½ to 4½: The Food
Standards Agency, 1995, HMSO London.
4.
National Diet and Nutrition Survey:
young people aged 4 to 18: The food
standards Agency, 2000. Available at:
http://www.statistics.gov.uk/ssd/surveys/nat
ional_diet_nutrition_survey_children.asp
5.
National Diet and Nutrition Survey:
people aged 65 and over. Department of
Health, 1998. HMSO, London.
6.
The Low Income Diet and Nutrition
Survey.
The Food Standards Agency,
2004. Available at:
eys/lidnsbranch/
7.
Health Survey for England 2006. The
factors
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8.
Nutrient
requirements
and
recommendations.
British
Nutrition
Foundation. Available at:
http://www.nutrition.org.uk/home.asp?siteId
=43&sectionId=414&subSectionId=320&pa
rentSection=299&which=1#1008
9.
Report on Health and Social Subjects:
41. Dietary Reference Values for Food
Energy and Nutrients for the United
Kingdom. Department of Health, 1991
10. Personal communication, The Food
Standards Agency
12. National
Healthy
Schools
Programme. More information available at:
http://www.healthyschools.gov.uk/
13. School Meals in Secondary Schools
in England. The Food Standards Agency,
2004. Available at:
eys/schoolmealsresearch
14. Revised guide to standards for school
lunches. The School Food Trust, 2007.
Available at:
http://www.schoolfoodtrust.org.uk/doc_item
.asp?DocId=8&DocCatId=9
11. School Fruit and Vegetable Scheme.
Department of Health. More information
available at:
http://www.dh.gov.uk/en/Policyandguidance
/Healthandsocialcaretopics/FiveADay/Five
ADaygeneralinformation/DH_4002149
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List of tables
6.1
Household food and drink purchases, 1974, 1995, 2002/03, 2004/05 and 2005/06
6.2
Average household food and drink purchases, by UK country, April 2003 - March 2006
6.3
Expenditure on food and drink in real terms at 2005/06 prices, 1975, 1985, 1995 and
2002/03 to 2005/06
6.4
Household food and drink expenditure, 2005/06
6.5
Quantities of food consumed in the previous week: among adults, 1986/87 and 2000/01
6.6
Quantities of food consumed in the previous week among adults, by age 2000/01
6.7
Quantities of food consumed in the previous week: men, by region, 2000/01
6.8
Quantities of food consumed in the previous week: women, by region, 2000/01
6.9
Daily quantities of food consumed in the dietary recall period, among adults in low
income households, by gender, 2003-2005
6.10
Fruit and vegetable consumption among adults, by gender 2001 to 2006
6.11
Fruit and vegetable consumption among adults, by age and gender, 2006
6.12
Type of fruit and vegetables consumption on the previous day among adults, by age
and gender, 2006
6.13
Fruit and vegetable consumption among adults (observed and age-standardised), by
Government Office Region / Strategic Health Authority and gender, 2006
6.14
Fruit and vegetable consumption by minority ethnic group and gender, 2004
6.15
Fruit and vegetable consumption among adults (age-standardised), by equivalised
household income quintile and gender, 2006
6.16
Household purchases of fruit and vegetables, 1975 to 2005/06
6.17
Estimates of energy intake, 1974 to 2005/06
6.18
Average daily intake of energy and macronutrients and intakes compared with Dietary
Reference Values (DRVs), by gender and age, 2000/01
6.19
Macronutrient intakes for adults in 1986/87 and 2000/01
6.20
Percentage contribution of food types to average daily energy intakes, 2000/01
6.21
Number and percent of secondary schools offering food from different groups, 2004
6.22
Fruit and vegetable consumption among children, by gender 2001 to 2006
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6.23
Fruit and vegetable consumption among children, by age and gender, 2006
6.24
Type of fruit and vegetables consumption among children, by age and gender, 2006
6.25
Fruit and vegetable consumption among children, by Government Office Region /
Strategic Health Authority and gender, 2006
6.26
Fruit and vegetable consumption among children, by equivalised household income
quintile and gender, 2006
6.27
Daily quantities of food consumed in the dietary recall period among children in low
income households, by gender, 2003-2005
6.28
Macronutrient intakes for children from low income households, by age and gender,
2003-2005
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Table 6.1 Household food and drink purchases, 1974, 1995, 2002/03, 2004/2005 and
2005/06
1
United Kingdom
Milk and cream (millilitres)
Liquid wholemilk
Skimmed milks:
Fully skimmed milk
Semi and other skimmed
Other milks and dairy products2 (millilitres)
Yoghurt and fromage frais
Cream
Cheese
Meat - carcase
Meat - non-carcase
Fish
Eggs (numbers)
Fats and oils
Butter
Margarine
Low fat and reduced fat spreads:
Reduced fat spreads
Low fat spreads
Vegetable and salad oils (millilitres)
Other fats and oils (including lard)
Sugar and preserves
Potatoes - fresh
Potatoes - processed
Vegetables (excluding potatoes)
Fruit
Bread
White bread
Brown bread
Wholemeal bread
Rolls and sandwiches
Other bread
Cereals (excluding bread)
Flour
Cakes and pastries
Buns, scones and tea-cakes
Biscuits
Oatmeal and oat products
Breakfast cereals
Rice
Pasta
Pizza
Other cereals
Beverages
3,4
5
Alcoholic drinks (millilitres)
Confectionery
6
Takeaways
1974
1995
2,978
2,678
5
2
3
238
33
15
105
393
630
123
3.7
316
147
78
1
0
1
22
66
535
1,318
119
1,141
731
1,019
860
65
17
56
21
823
162
158
30
214
13
77
17
31
0
121
107
..
..
..
89
2,245
818
1,127
210
916
137
145
18
108
235
751
147
1.7
227
34
43
75
48
27
52
22
212
810
267
1,150
1,068
818
478
86
102
89
64
834
60
159
40
181
10
127
58
33
51
116
74
1,654
627
124
149
2002/03
2004/05
2005/06
2,006
572
1,085
166
919
167
163
20
112
230
820
155
1.7
190
37
13
70
55
15
56
14
146
617
256
1,101
1,206
757
431
46
100
89
91
914
61
134
41
174
13
132
84
88
66
121
58
1,757
726
126
185
1,996
497
1,133
158
975
159
187
19
110
229
820
158
1.6
182
35
11
68
44
23
55
13
134
570
252
1,106
1,168
695
353
45
120
85
92
882
55
126
47
165
14
131
79
81
69
116
56
1,832
763
131
191
2,027
475
1,167
159
1,008
163
201
21
116
226
821
167
1.6
183
38
20
55
39
16
58
12
129
587
255
1,156
1,292
701
336
41
145
80
99
925
60
130
46
165
19
135
90
89
74
117
57
1,718
739
123
186
1. Unless otherwise stated
2. Includes condensed, infant and instant milks
3. Excluding pure fruit juices which are recorded as fruit products in the 'Fruit' category
4. Concentrated and low calorie concentrated soft drinks converted to unconcentrated equivalent by applying a
factor of 5
5. Average for the whole population
6. Takeaway food bought home
Source:
Family Food 2005/06. Department for Environment, Food and Rural Affairs
Copyright © 2008, re-used with the permission of The Department for Environment, Food and Rural Affairs
119
Previous view
Contents page
Table 6.2 Average1 household food and drink purchases, by UK country, April 2003 - March 2006
2
Scotland
Northern Ireland
United Kingdom
Milk and cream (millilitres)
Cheese
Meat - carcase
Meat - non-carcase
Fish
Eggs (numbers)
Fats and oils
Sugar and preserves
Potatoes
Fruit
Total cereals
Beverages (millilitres)
3,4
Alcoholic drinks (millilitres)
Confectionery
Base (number of households in sample)
England
Wales
2,015
115
228
818
164
2.0
184
133
828
1,145
1,243
1,601
57
1,768
766
125
2,091
106
243
916
146
1.5
199
153
977
1,083
1,113
1,593
55
2,175
852
147
2,000
107
194
852
142
1.6
172
127
780
907
1,104
1,611
50
2,209
785
144
2,151
78
239
817
115
1.5
186
115
1,216
859
977
1,743
46
1,839
519
134
16,199
1,050
1,706
1,676
1. Data collected between April 2003 and March 2006 have been averaged to give grams per person per week with a large
enough base in each country to allow for comparisons
3. Excluding pure fruit juices which are recorded as fruit products in the 'Fruit' category
4. Concentrated and low calorie concentrated soft drinks converted to unconcentrated equivalent by applying a factor of 5
Source:
Family Food 2005/06. Department for Environment, Food and Rural Affairs
Table 6.3 Expenditure on food and drink in real terms at 2005/06 prices, 1975, 1985, 1995 and 2002/03
to 2005/06
United Kingdom
1975
Retail price index (1975 = 100)
Household food and drink
Food and drink eaten out
All food and drink
Household food and drink exc. alcohol
Food and drink eaten out exc. alcohol
All food and drink exc. alcohol
% eaten out
1,2
1985
1,2
1995
1,3
2002/03
£ per person per week/percentages
2003/04
2004/05
2005/06
100
277
436
519
534
550
565
..
..
..
..
..
..
23.26
4
7.36
30.62
23.83
23.99
23.66
23.56
35.79
35.63
35.29
34.97
21.52
..
..
..
19.11
..
..
..
21.00
4
5.44
26.44
21
21.13
7.90
29.03
27
21.19
7.82
29.01
27
20.93
8.00
28.92
28
20.91
7.79
28.70
27
1. Great Britain only
2. Excludes confectionery, soft and alcoholic drinks
3. Estimates on eating out in 1995 are based on National Food Survey which was considered less reliable
4. Whilst National Food Survey household food purchases were adjusted, eating out figures were not
Source:
Family Food 2005/06. The Department for Environment, Food and Rural Affairs (DEFRA)
120
Previous view
Contents page
Table 6.4 Household food and drink expenditure1, 2005/06
United Kingdom
Pence per person per week
Milk and cream
Cheese
Meat and meat products (including carcase meat)
Fish
Eggs
Fats
of which - Butter
Sugars and preserves
Potatoes (fresh and processed)
Fruit
of which - Pure fruit juice
Bread
Cereals (excluding bread)
Beverages
2
Soft drinks
Confectionery
Other food
164
63
495
104
19
38
12
17
101
194
188
30
97
291
41
77
78
124
Total household expenditure on food and drink
2,091
779
Total expenditure on food and drink eaten out
1. Excluding expenditure on alcoholic drinks
2. Concentrated and low calorie concentrated soft drinks converted to unconcentrated equivalent
by applying a factor of 5
Source:
Copyright © 2008, re-used with the permission of The Department for Environment, Food and
Rural Affairs
121
Previous view
Contents page
Table 6.5 Quantities of food consumed in the previous week, among adults, 1986/87 and 2000/01
Great Britain
1
5
Pasta, rice & other miscellaneous cereals
Bread
Breakfast cereals
Biscuits, buns, cakes, pastries & fruit pies
Puddings (including dairy desserts & ice-cream)
Milk (Whole, semi-skimmed, skimmed)
Cheese
Yogurt & fromage frais
Eggs and egg dishes
Fats & oils
Meat, meat dishes & meat products
Fish and fish dishes
Vegetables and vegetable dishes (excluding potatoes)
Potatoes
Savoury snacks
Fruit (excluding fruit juice)
Nuts
Sugars, preserves & sweet spreads
Confectionery
Fruit juice
6
Soft drinks, not low calorie
6
Soft drinks, low calorie
Alcoholic drinks
7
Tea & water
Mean
3
all
1986/87
Mean
4
consumers
%
consumers
Mean
3
all
236
761
143
327
228
1,583
120
81
160
130
1,049
186
956
883
41
501
8
164
74
269
677
131
2,116
6,047
334
766
248
363
343
1,648
148
303
200
134
1,066
245
961
900
81
638
64
199
124
606
1,103
844
3,083
6,080
71
100
58
90
66
96
81
27
80
97
98
76
100
98
51
79
12
82
59
44
61
16
69
100
507
706
203
231
142
1,430
106
153
133
86
1,125
217
943
734
52
666
15
106
82
333
882
653
2,193
4,937
Base (number of respondents)
Grams / Percentages
2
2000/01
Mean
%
4
consumers consumers
585
716
304
277
276
1,522
138
401
197
93
1,186
304
952
753
92
841
71
147
131
742
1,474
1,680
2,974
5,222
2,197
87
99
67
84
51
94
77
38
68
93
95
71
99
97
56
79
20
72
62
45
60
39
74
95
1,724
1. Food consumption data from the 1986/87 Adults Survey has been recalculated, and the data for both surveys restructured into
specific food groups to allow comparisons to be made. Consequently, there may be small discrepancies between the 1986/87 data as
published in 1990. Adults aged 16 to 64
2. Adults aged 19 to 64
3. 'Mean all' is the mean quantity based on total number of respondents, i.e. base shown at bottom of table table
4. 'Mean consumers' is the mean quantity consumed based on only those who reported consuming food in that particular food category
5. Pasta, rice and other miscellaneous cereals includes pizza
6. Figures for low calorie and non-low calorie soft drinks are as consumed, that is concentrated drinks plus dilutent
7. Water includes tap water, bottled water, without added sugar or artificial sweeteners, coffee is excluded from this table as data
between the two surveys on consumption of coffee are not comparable due to differences in dietary recording methodology
Source:
The National Diet & Nutrition Survey: adults aged 19 to 64 years old - Volume 5 , 2003. Office for National Statistics (ONS)
Copyright © 2008, re-used with the permission of The Office for National Statistics
122
1
4
1,522
176
138
401
197
93
1,186
304
952
753
92
841
71
147
131
742
1,474
1,680
2,974
6,959
390
1,430
54
106
153
133
86
1,125
217
943
734
52
666
15
106
82
333
882
653
2,193
6,892
373
1,724
97
56
79
20
72
62
45
60
39
74
99
96
94
31
77
38
68
93
95
71
99
87
99
67
84
51
%
consumers
814
87
283
6
72
111
307
2,193
780
2,607
4,027
281
999
61
91
105
111
80
1,196
137
646
646
660
115
135
107
Mean
2
all
827
126
493
*
101
172
738
2,550
1,797
3,461
4,165
297
1,129
223
141
349
232
89
1,256
257
665
699
674
222
190
271
212
99
70
58
12
72
65
42
86
43
75
97
94
89
27
65
30
48
90
95
53
97
92
98
52
71
40
19-24 years old
Mean
%
3
consumers consumers
690
69
473
16
99
86
287
1,059
1,007
2,562
6,183
353
1,343
48
113
130
121
78
1,140
155
882
630
719
185
201
115
Mean
2
all
709
102
641
76
137
128
628
1,497
2,079
3,395
6,221
372
1,405
175
142
365
188
84
1,226
246
894
686
728
278
245
264
430
97
68
74
21
72
67
46
71
48
75
99
95
96
28
80
36
64
94
93
86
99
92
99
67
82
44
25-34 years old
Mean
%
3
consumers consumers
Aged 19 to 64
'Mean all' is the mean quantity based on total number of respondents, i.e. base shown at bottom of table
'Mean consumers' is the mean quantity consumed based on only those who reported consuming food in that particular food category
Pasta, rice and other miscellaneous cereals includes pizza
Water includes tap water, bottled water, without added sugar or artificial sweeteners. Tea and coffee amounts are as consumed
Includes powdered beverages (except tea & coffee), soups, sauces, condiments & artificial sweeteners
Number of consumers is less than 30 and too small to calculate mean values reliably
585
716
304
277
276
507
706
203
231
142
Mean
2
all
All ages
Mean
3
consumers
Source:
The National Diet & Nutrition Survey: adults aged 19 to 64 years old - Volume 5, 2003. Office for National Statistics (ONS)
1.
2.
3.
4.
5.
6.
*
Base = number of respondents
Bread
Breakfast cereals
Puddings (including dairy desserts & icecream)
Other milk and cream
Cheese
Eggs and egg dishes
Fats & oils
Vegetables and vegetable dishes (excluding
potatoes)
Potatoes
Savoury snacks
Nuts
Confectionery
Fruit juice
Alcoholic drinks
5
Tea, coffee & water
6
Miscellaneous
Great Britain
Table 6.6 Quantities of food consumed in the previous week among adults , by age, 2000/01
713
49
690
16
113
86
342
651
580
2,099
7,456
372
1,551
48
102
161
127
84
1,149
221
986
498
711
197
235
142
Mean
2
all
734
85
844
75
157
129
794
1,168
1,493
2,811
7,503
390
1,631
160
135
409
183
91
1,213
299
993
578
721
286
278
253
570
97
57
82
22
72
67
43
56
39
75
99
95
95
30
76
39
70
92
95
74
99
86
99
69
85
56
35-49 years old
Mean
%
3
consumers consumers
759
25
959
15
117
60
372
446
384
1,818
8,049
429
1,546
63
112
182
160
97
1,057
297
1,069
356
710
263
293
178
Mean
2
all
781
63
1,068
69
162
115
782
1,007
1,327
2,574
8,101
443
1,654
176
138
433
208
103
1,094
357
1,073
443
719
367
329
311
512
97
39
90
22
72
52
47
44
29
71
99
97
93
36
81
42
77
94
96
83
100
80
99
71
89
57
Grams / Percentages
50-64 years old
Mean
%
3
consumers consumers
Previous view
Contents page
123
1
4
661
865
347
315
306
1,609
150
403
223
112
1,430
314
971
837
106
806
81
177
144
795
1,680
1,721
4,345
6,919
413
833
89
99
64
83
49
94
79
33
70
95
98
70
99
98
55
75
21
76
61
43
64
35
81
99
96
%
consumers
500
878
173
216
116
1,512
109
173
131
109
1,441
205
916
811
56
555
11
142
86
287
960
597
4,186
6,750
344
573
881
283
267
270
1,604
145
492
188
114
1,456
297
923
815
103
764
67
201
138
823
1,698
1,823
5,013
6,861
356
234
87
100
61
81
43
94
75
35
70
95
99
69
100
100
54
73
16
71
62
35
56
33
83
98
97
Northern England
Mean
Mean
%
2
3
consumers
all consumers
Aged 19 to 64
Pasta, rice & other miscellaneous cereals includes pizza
Water includes tap water & bottled water, without added sugar or artificial sweeteners. Tea and coffee amounts are as consumed
Includes powdered beverages (except tea and coffee), soups, sauces, condiments & artificial sweeteners
587
856
222
261
149
1,521
118
134
157
106
1,398
218
961
821
58
607
17
134
87
339
1,075
597
3,498
6,842
396
All men
Mean
Mean
2
3
all consumers
Source:
The National Diet & Nutrition Survey: adults aged 19 to 64 years old - Volume 5 , 2003. Office for National Statistics (ONS)
1.
2.
3.
4.
5.
6.
*
Bread
Breakfast cereals
Cheese
Eggs and egg dishes
Fats & oils
Potatoes
Savoury snacks
Nuts
Confectionery
Fruit juice
Alcoholic drinks
5
Tea, coffee & water
6
Miscellaneous
Great Britain
Table 6.7 Quantities of food consumed in the previous week: men , by region, 2000/01
541
897
239
310
174
1,588
115
100
180
120
1,360
212
929
877
62
557
19
152
91
286
1,252
578
3,265
7,070
370
637
909
365
368
325
1,621
150
328
247
125
1,386
311
939
891
100
771
92
187
148
712
1,825
1,637
4,059
7,070
379
294
85
99
65
84
54
98
77
31
73
96
98
68
99
98
62
72
21
81
61
40
68
35
80
100
98
Central, South West and Wales
Mean
Mean
%
2
3
all consumers
consumers
698
781
242
258
153
1,345
132
132
152
87
1,364
229
1,071
742
63
677
21
109
92
456
1,017
558
3,227
6,806
444
738
790
382
316
318
1,485
156
380
226
93
1,428
325
1,087
766
119
855
73
142
152
876
1,522
1,664
4,145
6,966
475
240
95
99
63
82
48
91
84
35
67
93
95
71
99
97
53
79
29
77
61
52
67
34
78
98
93
London and South East
Mean
Mean
%
2
3
all consumers
consumers
695
871
245
213
132
1,894
115
147
166
102
1,544
254
861
895
36
765
15
119
62
327
904
824
3,079
6,276
521
774
887
351
244
283
2,019
147
*
229
110
1,544
346
861
937
*
899
*
182
121
706
1,515
*
3,850
6,276
548
65
91
98
71
88
46
94
78
32
72
94
100
74
100
95
40
86
9
66
52
46
60
43
80
100
95
Grams / Percentages
Scotland
Mean
Mean
%
2
3
consumers
all consumers
Previous view
Contents page
124
4
511
576
267
242
251
1,440
127
399
170
74
943
294
935
674
80
871
62
115
118
697
1,254
1,650
1,444
6,996
369
891
85
98
70
84
54
93
75
43
65
91
92
73
99
97
57
83
20
68
64
47
56
43
67
99
95
%
consumers
389
580
178
187
125
1414
91
198
111
66
851
213
848
659
44
685
6
83
72
265
664
663
1285
7042
390
456
586
252
230
242
1,486
125
459
163
72
920
289
852
664
79
885
46
123
131
598
1,147
1,511
1,957
7,106
402
229
86
99
71
81
52
95
73
43
69
91
93
74
100
100
55
78
14
68
55
45
58
44
66
99
97
Northern England
Mean
Mean
%
2
3
consumers
all consumers
Aged 19 to 64
Pasta, rice & other miscellaneous cereals includes pizza
Water includes tap water & bottled water, without added sugar or artificial sweeteners. Tea and coffee amounts are as consumed
Includes powdered beverages (except tea and coffee), soups, sauces, condiments & artificial sweeteners
433
566
186
204
135
1,345
96
171
111
67
870
216
926
652
45
720
12
79
76
327
702
705
973
6,938
351
All women
Mean
Mean
2
3
all consumers
Source:
The National Diet & Nutrition Survey: adults aged 19 to 64 years old - Volume 5 , 2003. The Office for National Statistics (ONS)
1.
2.
3.
4.
5.
6.
*
Bread
Breakfast cereals
Cheese
Eggs and egg dishes
Fats & oils
Potatoes
Savoury snacks
Nuts
Confectionery
Fruit juice
Alcoholic drinks
5
Tea, coffee & water
6
Miscellaneous
Great Britain
Table 6.8 Quantities of food consumed in the previous week: women1, by region, 2000/01
377
575
181
213
139
1,382
97
163
104
69
904
188
903
703
44
680
10
92
80
318
800
633
879
7,000
317
459
586
262
252
254
1472
129
377
160
75
964
256
920
725
76
801
53
134
118
703
1440
1480
1311
7020
329
327
82
98
69
85
55
94
76
43
65
93
94
73
98
97
58
85
20
68
68
45
56
43
67
100
97
Central, South West and Wales
Mean
Mean
%
2
3
consumers
all consumers
524
556
195
216
134
1,256
94
158
121
68
836
255
1,069
594
47
768
22
64
71
353
613
723
858
6,954
311
605
565
285
250
243
1,365
122
373
190
76
931
359
1,074
622
86
927
78
92
111
708
1,152
1,784
1,247
7,037
335
268
87
99
69
87
55
92
77
43
64
90
90
71
100
96
56
83
28
69
64
50
53
41
69
99
93
London and South East
Mean
Mean
%
2
3
all consumers
consumers
490
511
203
169
162
1,281
107
168
105
58
911
200
727
611
44
847
5
61
90
491
711
1,138
825
6,208
551
Mean
2
all
559
543
266
198
301
1,414
140
*
168
64
966
253
735
663
76
946
*
88
115
910
1,135
2,383
1,186
6,315
593
66
88
94
76
85
53
91
76
41
62
89
94
79
98
92
58
89
12
70
79
53
62
47
70
98
92
Grams / Percentages
Scotland
Mean
%
3
consumers
consumers
Previous view
Contents page
125
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Table 6.9 Daily quantities of food consumed in the dietary recall period1, among adults2 in low income
households, by gender, 2003-2005
United Kingdom
Pasta
Rice
Pizza
Other cereals
White bread
Wholemeal bread
Other breads
Wholegrain and high fibre breakfast cereals
Breakfast cereals not wholegrain or high fibre
Biscuits
Buns, cakes and pastries
Cereal based milk puddings, sponge and other puddings
Whole milk
Semi-skimmed milk
Skimmed milk
Cheese
Yoghurt and other dairy desserts
Ice cream
Eggs and egg dishes
Butter
Soft margarine, not polyunsaturated
Reduced fat spread, not polyunsaturated
Reduced fat spread, polyunsaturated
Low fat spread, not polyunsaturated
Low fat spread, polyunsaturated
Bacon and ham
Beef, veal, lamb and pork and dishes
Coated chicken and turkey
Chicken and turkey dishes
Burgers and kebabs
Sausages
Meat pies and pastries
Other meat and meat products
Liver, liver products and dishes
White fish coated or fried
White fish not coated or fried
Canned tuna and dishes
Oily fish and dishes
Carrots, raw
Salad and other vegetables, raw5
Tomatoes, raw
Peas and green beans, not raw
Baked beans
Leafy green vegetables, not raw
Carrots, not raw
Tomatoes, not raw
Other vegetables and vegetable dishes, not raw
Chips, fried and roast potatoes and fried potato products
Other potatoes, potato salads and dishes, potato products cooked
without fat
Crisps and savoury snacks
Apples and pears not canned
Citrus fruit not canned
Bananas
Other fruit including canned
Table sugar
Preserves, sweet spreads, fillings and icings
Sugar confectionery
Chocolate confectionery
Fruit juice
Soft drinks, not carbonated, not diet
Carbonated soft drinks, not diet
Soft drinks, not carbonated, diet
Carbonated soft drinks, diet
Wine, including fortified, low alcohol and alcohol free
Beers and lager including low alcohol and alcohol free
Coffee (made up)
Tea (made up)
Beverages (dry weight) e.g. drinking chocolate, cocoa, horlicks
Soups
Savoury, sauces, pickles, gravies, condiments
Grams / Percentages
Women
Mean
Mean
%
all3 consumers4 consumers
Mean
all3
Men
Mean
consumers4
%
consumers
18
24
11
5
75
16
15
22
6
14
16
17
87
113
9
13
15
10
5
24
5
1
8
3
1
2
18
74
5
45
9
15
20
8
2
12
6
3
5
1
11
10
16
18
13
9
7
38
51
85
109
91
23
88
70
56
66
24
24
39
75
205
214
138
78
30
65
32
43
17
6
20
17
19
15
31
105
41
81
53
39
58
36
31
51
58
28
37
14
26
27
33
60
34
26
45
59
78
21
22
12
22
85
22
26
34
25
56
40
22
42
53
7
17
50
15
16
55
27
16
38
18
5
13
59
71
11
55
16
39
34
22
6
23
11
11
13
5
41
37
48
30
38
34
16
63
65
19
23
9
5
45
13
11
17
5
11
16
16
62
111
19
6
10
19
4
14
5
1
4
2
1
1
11
54
5
35
5
8
14
4
1
9
6
3
7
1
15
11
14
11
14
9
4
34
37
71
90
68
20
55
45
35
46
18
18
33
55
162
179
180
32
19
66
22
30
15
4
12
11
12
11
21
78
35
57
41
28
47
25
27
42
54
21
42
15
26
23
27
45
32
22
30
51
56
27
25
13
24
82
29
31
37
31
60
48
29
38
62
10
18
55
29
18
48
33
16
34
18
5
13
55
68
14
61
13
27
30
17
5
21
11
13
16
7
56
50
51
24
44
42
12
68
67
69
108
64
59
84
70
6
19
13
18
12
24
5
2
8
33
62
97
24
34
22
17
71
84
59
51
33
17
13
26
159
252
261
282
219
203
34
26
15
31
24
71
30
15
29
21
25
37
8
15
11
5
22
10
18
19
12
4
2
7
37
55
73
28
44
22
14
64
54
49
52
23
15
13
19
124
203
214
243
243
145
36
34
19
38
36
54
31
13
35
30
27
34
11
18
15
290
757
38
44
405
11
221
626
2
452
769
21
49
81
12
205
564
3
402
694
19
51
81
16
25
27
118
35
21
75
23
23
94
30
24
77
Base (unweighted)
946
1,850
1. A repeat 24 hour dietary recall method was used where foods and drinks consumed on the previous day were recalled on four randomly
selected days (including at least one weekend day) over a ten day period
3. 'Mean all' is the mean quantity based on total number of respondents, i.e. base shown at bottom of table
4. 'Mean consumers' is the mean quantity consumed based on only those who reported consuming food in that particular food category
5. Excluding raw tomatoes which are recorded as a separate category
Source:
Low Income Diet & Nutrition Survey: Executive Summary , 2007. The Food Standards Agency
Copyright © 2008, re-used with the permission of The Food Standards Agency
126
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Table 6.10 Fruit and vegetable consumption among adults1, by gender, 2001 to 2006
England
Percentages
2001
Unweighted
2002
2003
2003
Men
None
Less than 5 portions
5 portions of more
8
70
22
8
70
22
9
69
23
9
69
22
Women
None
5 portions of more
6
69
25
6
69
25
6
68
26
Bases (unweighted)
Men
Women
6,966
8,681
3,317
4,077
..
..
..
..
Bases (weighted)
Men
Women
Weighted
2004
2
2005
2006
8
69
23
7
67
26
7
65
28
6
68
26
6
67
27
5
66
30
5
64
32
6,602
8,234
6,602
8,234
2,878
3,825
3,455
4,170
6,321
7,817
..
..
7,202
7,634
3,263
3,441
3,701
3,926
6,850
7,309
1. Aged 16 and over
2. From 2003 data have been weighted for non-response; for 2003 both weighted and unweighted data are shown
Source:
127
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Contents page
Table 6.11 Fruit and vegetable consumption among adults1, by age and gender, 2006
England
65-74 75 and over
All ages
16-24
25-34
35-44
45-54
55-64
Men
None
Less than 1 portion
1 portion or more but less than 2
2 portions or more but less than 3
5 portions or more
7
3
16
17
16
13
28
12
3
21
21
14
10
19
7
2
17
17
17
14
27
9
2
15
17
15
13
29
6
3
16
14
18
13
30
5
3
14
17
15
15
32
3
3
11
17
21
14
31
3
3
14
18
17
15
29
3.6
3.0
3.7
3.5
3.7
3.9
4.0
3.8
Women
None
Less than 1 portion
5 portions or more
5
3
14
16
17
14
32
8
3
17
20
17
13
22
5
2
14
16
17
15
31
6
2
14
16
16
13
33
4
2
14
15
17
13
35
2
2
11
14
16
15
39
2
2
11
17
20
14
33
3
4
14
18
20
17
25
3.9
3.3
3.9
4.0
4.2
4.5
4.1
3.6
Bases (unweighted)
Men
Women
6,321
7,817
649
794
861
1,148
1,182
1,494
1,050
1,279
1,126
1,269
852
933
601
900
Bases (weighted)
Men
Women
6,850
7,309
1,040
1,014
1,128
1,160
1,355
1,379
1,123
1,141
1,015
1,050
694
768
496
797
1. Aged 16 and over
Source:
128
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Contents page
Table 6.12 Type of fruit and vegetable consumption on the previous day among adults1, by age and gender,
2006
England
Percentages
65-74 75 and over
All ages
16-24
25-34
35-44
45-54
55-64
Men
Total fruit and vegetables
Total vegetables (including salad)
Total vegetables (excluding salad)
93
70
58
88
57
47
93
71
58
91
69
55
94
70
58
95
73
61
97
75
65
97
79
71
Total fruit (including fruit juice)
Total fruit (excluding fruit juice)
79
68
73
55
77
61
76
63
79
72
83
75
85
79
87
83
Vegetables (fresh, raw, tinned and frozen)
55
43
54
52
55
58
63
69
Pulses
Salad
Vegetables in composites
Fresh fruit
Fruit in composites
Dried fruit
Frozen fruit
Fruit juice
35
30
7
62
7
9
4
44
33
25
5
52
3
4
2
50
32
33
10
57
6
6
1
51
33
32
7
58
5
11
3
43
36
31
7
67
8
8
3
40
36
31
6
68
9
12
6
42
39
27
5
72
11
14
7
41
39
26
5
72
17
15
13
41
Women
Total fruit and vegetables
Total vegetables (including salad)
Total vegetables (excluding salad)
Total fruit (including fruit juice)
Total fruit (excluding fruit juice)
95
76
62
85
77
92
67
55
79
62
95
77
63
82
72
94
75
60
82
74
96
77
63
85
79
98
82
68
89
85
98
77
63
90
85
97
75
66
89
85
Pulses
Salad
Fresh fruit
Fruit in composites
Dried fruit
Frozen fruit
Fruit juice
59
33
37
7
71
7
15
5
45
51
31
32
7
57
5
7
4
54
60
33
39
9
67
4
11
3
45
55
34
39
9
70
5
15
3
45
60
31
41
8
74
7
16
4
40
65
31
40
7
79
11
20
6
43
60
33
33
6
79
12
19
7
48
65
34
28
3
77
11
17
13
42
Bases (unweighted)
Men
Women
6,321
7,817
649
794
861
1,148
1,182
1,494
1,050
1,279
1,126
1,269
852
933
601
900
Bases (weighted)
Men
Women
6,850
7,309
1,040
1,014
1,128
1,160
1,355
1,379
1,123
1,141
1,015
1,050
694
768
496
797
1. Aged 16 and over
Source:
129
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Contents page
Table 6.13 Fruit and vegetable consumption among adults1 (observed and age-standardised), by Government Office Region/Strategic
Health Authority2 and gender, 2006
England
North East North West
Yorkshire
and the
Humber
East
Midlands
West
Midlands
East
England
London South West South East
Strategic Health
Authority
South East
South
Coast
Central
Men
Observed
None
Less than 1 portion
10
3
20
7
4
17
10
4
18
5
3
13
9
3
17
5
2
17
6
2
14
6
2
18
7
2
14
9
2
14
5
2
14
17
20
20
19
17
16
13
18
18
17
18
13
17
14
19
16
15
16
18
16
14
18
13
11
12
13
12
16
13
15
15
17
13
5 portions or more
24
25
22
27
26
29
37
24
29
27
30
3.3
3.4
3.2
3.6
3.4
3.8
4.2
3.5
3.7
3.7
3.8
Age standardised
None
Less than 1 portion
10
3
8
3
10
4
6
3
9
3
5
2
6
2
7
2
7
2
9
2
5
2
5 portions or more
20
17
14
13
25
17
20
17
11
25
18
20
14
12
22
13
18
19
13
28
17
17
16
12
26
17
16
15
16
29
13
13
17
12
38
18
19
18
14
23
14
18
16
15
28
14
18
14
17
26
14
18
18
13
30
3.3
3.4
3.2
3.6
3.4
3.8
4.3
3.4
3.7
3.6
3.8
Observed
None
Less than 1 portion
5 portions or more
9
4
14
23
16
11
23
6
4
15
16
18
14
28
6
4
17
16
18
13
26
5
2
15
15
17
14
32
5
2
15
20
16
14
29
3
2
13
16
19
14
32
3
1
12
14
15
13
41
3
3
13
15
18
17
31
3
1
11
16
18
16
34
3
2
13
15
18
17
33
4
1
10
17
18
15
35
3.2
3.8
3.5
3.9
3.8
4.0
4.5
4.0
4.1
4.1
4.1
Age standardised
None
Less than 1 portion
5 portions or more
9
4
14
22
16
11
23
6
4
15
16
18
14
28
6
4
16
16
18
13
26
5
2
15
15
17
14
32
5
2
15
20
16
14
29
3
2
14
16
19
14
32
3
1
12
14
14
13
42
4
3
13
15
18
17
31
3
1
11
16
18
16
34
3
2
13
14
17
17
34
4
1
10
17
19
15
35
3.2
3.7
3.6
3.8
3.8
4.0
4.5
4.0
4.1
4.1
4.1
Bases (unweighted)
Men
Women
334
435
945
1,152
647
823
618
774
662
869
733
848
735
833
593
790
1,054
1,293
513
681
541
612
Bases (weighted)
Men
Women
347
392
920
1,002
680
750
605
635
708
792
782
794
1,038
975
667
775
1,104
1,195
540
636
564
560
Women
1. Aged 16 and over
2. This table provides data for regional analysis both by Government Office Region (GOR) and the new configuration of Strategic Health Authorities (SHAs) in place from July
2006. The first eight columns represent GORs and SHAs of the same name, while the South East GOR (column nine) is divided into South East Coast SHA and South Central
SHA, shown in the final two columns
Source:
130
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Contents page
Table 6.14 Fruit and vegetable consumption by minority ethnic group and gender, 20041
England
Irish
General
population
Black
Caribbean
Black African
Indian
Pakistani
Bangladeshi
Chinese
None
Less than one portion
3 portions or more but less that 4
5 portions or more
8
2
16
16
14
12
32
8
3
16
16
13
14
31
4
2
13
15
15
14
37
4
3
13
14
15
17
33
6
2
14
17
14
17
32
3
3
9
15
19
13
36
11
3
18
14
15
14
26
8
4
16
19
16
14
23
3.9
3.7
4.2
4.3
3.8
4.4
3.6
3.3
None
Less than one portion
3 portions or more but less that 4
5 portions or more
7
1
17
18
13
13
31
5
2
18
14
14
15
32
3
1
9
19
17
15
36
4
4
13
17
14
16
32
5
5
14
18
17
13
28
1
1
10
13
15
17
42
5
3
15
17
17
11
32
6
3
16
18
16
14
27
3.9
3.8
4.4
4.0
3.6
4.9
3.9
3.6
Bases (unweighted)
Men
Women
412
652
390
469
550
634
432
508
411
478
348
375
497
656
2,878
3,825
Bases (weighted)
Men
Women
479
675
377
476
903
1,067
422
499
178
208
151
163
1,776
2,369
46,178
48,719
Men
Women
Source:
131
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Contents page
Table 6.15 Fruit and vegetable consumption among adults1 (age-standardised), by
equivalised household income quintiles and gender, 2006
England
4th
Lowest
Highest
2nd
3rd
4
1
6
2
8
2
9
4
11
4
14
15
17
14
14
18
16
16
17
18
15
14
19
18
16
15
20
18
15
10
5 portions or more
36
29
25
20
22
4.2
3.8
3.4
3.2
3.1
None
Less than1 portion
5 portions or more
1
1
10
13
20
17
38
4
2
11
16
15
15
36
5
2
13
16
16
14
33
5
3
18
19
18
13
25
7
4
19
18
17
12
23
4.7
4.2
3.9
3.5
3.3
Bases (unweighted)
Men
Women
1,195
1,219
1,141
1,267
1,054
1,296
933
1,387
779
1,076
Bases (weighted)
Men
Women
1,322
1,163
1,266
1,205
1,104
1,198
932
1,246
827
983
Men
None
Less than1 portion
Women
1. Aged 16 and over
Source:
132
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Contents page
Table 6.16 Household purchases of fruit and vegetables1, 1975 to 2005/06
2
United Kingdom
2002/03
2004/05
2005/06
1975
1990
2000
1,868
2,170
2,336
2,307
2,274
2,448
Fruit
Fresh fruit
Processed fruit
3
Of which - Fruit juices(millilitres)
738
511
228
42
962
624
338
225
1,189
765
424
332
1,206
794
413
333
1,168
805
363
280
1,292
856
437
350
Fresh green vegetables
Other fresh vegetables
Processed vegetables excluding potatoes
341
405
385
287
475
446
246
506
395
231
505
365
225
536
345
235
567
354
1,378
1,999
1,002
873
822
842
Fruit and vegetables excluding potatoes
Fresh and processed potatoes
1. Adjusted National Food Survey data 1975 to 2000, Expenditure and Food Survey data 2001/02 onwards
3. From 2004/05, quantities cannot be compared with previous years due to improvements in product coding. The fall in
purchased quantity may also be partly due to possible shifts in consumer preference towards fruit juice drinks
Source:
Family Food 2005-06. The Department for Environment, Food and Rural Affairs (DEFRA)
Table 6.17 Estimates of energy intake, 1974 to 2005/06
Untied Kingdom
National Food Survey
1
excluding asc
1
including asc
2
Aligned with EFS
NFS eating out
Expenditure on Food Survey
Household
Eating out
Total
Combined series3
Household
Eating out
Total
kcals per person per day
2003/04 2004/05 2005/06
1974
1980
1990
1992
1995
2000
2001/02
2,320
.
2,534
.
2,230
.
2,439
.
1,870
.
2,058
.
1,860
.
2,225
.
1,780
1,881
2,143
240
1,750
1,881
2,152
230
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
2,098
310
2,409
2,079
303
2,381
2,050
288
2,338
2,082
280
2,362
2,534
.
2,534
2,439
.
2,439
2,058
.
2,058
2,225
.
2,225
2,143
240
2,383
2,152
230
2,382
2,089
310
2,409
2,079
303
2,381
2,050
288
2,338
2,082
280
2,362
1. "asc" is alcoholic drinks, soft drinks and confectionery
2. Includes alcoholic drinks, soft drinks and confectionery from 1992 onwards
3. Uses fullest information available each year, however definition changes occuring from year to year means can be used as an
indication of overall trend but not a valid time series
Source:
133
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Table 6.18 Average daily intake of energy and macronutrients and intakes compared with Dietary Reference Values (DRVs),
1
by gender and age , 2000/01
Great Britain
Numbers / Percentages
19-24
25-34
Men
35-49
9.44
89
9.82
93
9.93
94
9.55
92
9.72
92
7.00
86
6.61
82
6.96
86
6.91
87
6.87
85
Protein
Mean (grams)
3
% of RNI
77.8
140
90.6
163
90.1
162
88.8
166
88.2
161
59.9
133
58.7
131
65.1
145
67.4
145
63.7
140
Total carbohydrate4
Mean (grams)
% of food energy
273
49.0
277
47.7
279
47.5
269
47.4
275
47.7
206
49.1
196
48.7
206
48.6
203
48.1
203
48.5
Non-starch polysaccharides
Mean (grams)
% with intakes < 18g
12.3
94
14.6
77
15.7
70
16.4
61
15.2
72
10.6
96
11.6
92
12.8
85
14.0
80
12.6
87
Non-milk extrinsic sugars5
Mean (grams)
% of food energy
96
17.4
80
13.9
78
13.1
70
12.2
79
13.6
60
14.2
49
11.8
51
11.8
48
11.0
51
11.9
Total fat5
Mean (grams)
% of food energy
85.8
36.0
87.1
35.8
88.3
35.9
84.5
35.6
86.5
35.8
63.9
35.5
59.8
35.4
61.9
34.7
61.2
34.5
61.4
34.9
Saturated fatty acids6
Mean (grams)
% of food energy
32.3
13.5
32.2
13.2
33.4
13.5
32.0
13.4
32.5
13.4
23.5
12.9
22.4
13.2
23.6
13.2
23.7
13.3
23.3
13.2
Alcohol
Mean (grams) (all)
% of food energy (all)
20.4
6.0
22.2
6.6
23.1
6.8
21.1
6.4
21.9
6.5
11.4
4.6
9.1
4.0
9.2
3.9
8.6
3.7
9.3
3.9
Mean (grams) (consumers)
7
% of food energy (consumers)
25.6
7.6
27.2
8.1
27.4
8.1
27.5
8.3
27.2
8.1
16.1
6.4
13.2
5.8
13.2
5.6
12.9
5.4
13.5
5.7
Base
108
219
253
253
833
104
210
318
259
891
Total energy intake
Mean (MJ)
% of Estimated Average
2
Requirements
7
50-64
All men
19-24
25-34
Women
35-49
50-64
All women
1. Dietary Reference Values for Food Energy and Nutrients for the United Kingdom. HMSO (London, 1991)
2. Energy intake as a percentage of EAR was calculated for each respondent using the EAR appropriate for gender and age
3. Reference Nutrient Intake values
4. The Dietary Reference Value for total carbohydrate is that the population average intake should contribute no more than 50% to food energy intakes
5. Current recommendation is that intake of non-milk extrinsic sugars should not exceed 11% of food energy intake
6. The Dietary Reference Values for total fat and saturated fatty acids is that the population average intake should not exceed 35% of food energy intake for total fat
and 11% of food energy intake for saturated fatty acids
7. The bases shown here relate to the total sample, not all of which were consumers of alcohol, therefore the alcohol figures for consumers only are different to ones
shown here
Source:
The National Diet & Nutrition Survey: adults aged 19 to 64 years old - volume 5, 2003. Office for National Statistics (ONS)
134
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Table 6.19 Macronutrient intakes for adults in 1986/87 and 2000/01
Great Britain
1
2000/01
10.30
9.72
2,450
2,313
44.7
..
15.2
40.4
16.5
2.2
12.4
0.8
5.4
47.7
13.6
16.5
35.8
13.4
1.2
12.1
1.0
5.4
1,087
833
7.05
6.87
1,680
1,632
44.2
..
15.6
40.3
17.0
2.2
12.2
0.8
5.3
48.5
11.9
16.6
34.9
13.2
1.2
11.5
1.0
5.3
1,110
891
Men
Mean daily total energy intake (MJl)
Mean daily total energy intake (kcal)
3
% food energy from total carbohydrate
% food energy from non-milk extrinsic sugars
% food energy from protein
% food energy from total fat
% food energy from saturated fatty acids
% food energy from trans unsaturated fatty acids
% food energy from cis monounsaturated fatty acids
% food energy from cis n-3 polyunsaturated fatty acids
Base
Women
2
1986/87
3
% food energy from trans unsaturated fatty acids
% food energy from cis monounsaturated fatty acids
Base
Dietary Reference Value
(population average)
10.60 (19-59yrs)
9.93 (60-64yrs)
2,550 (19-59yrs)
2,380 (60-64yrs)
50%
No more than 11%
15%
No more than 35%
No more than 11%
No more than 2%
Population average 13%
.
.
8.10 (19-50yrs)
8.00 (51-64yrs)
1,940 (19-50yrs)
1,900 (51-64yrs)
50%
No more than 11%
15%
No more than 35%
No more than 11%
No more than 2%
13%
.
.
1. Food consumption data from the 1986/87 Adults Survey has been recalculated, and the data for both surveys restructured into specific food
groups to allow comparisons to be made. Consequently, there may be small discrepancies between the 1986/87 data as published in 1990.
Adults aged 16 to 64
2. Adults aged 19 to 64
3. Kcal figures are calculated from the energy intake in MJ using a conversion factor of 4.184 for each individual
Sources:
The National Diet & Nutrition Survey: adults aged 19 to 64 years old - volume 5, 2003. The Office for National Statistics (ONS)
Dietary Reference Values for Food Energy and Nutrients for the United Kingdom. HMSO (London, 1991)
135
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Contents page
Table 6.20 Percentage contribution of food types to average daily energy intakes, 2000/01
Great Britain
Cereals & cereal products
Milk & milk products
Eggs & egg dishes
Fat spreads
Meat & meat products
Fish & fish dishes
Potatoes & savoury snacks
Fruit & nuts
Sugar, preserves & confectionary
1
Drinks
2
Miscellaneous
Average daily intake
3
Base (Total number of respondents)
Total energy
Total
carbohydrate
Protein
Total fat
Saturated fatty
acids
31
10
2
4
15
3
4
9
2
6
10
3
45
6
0
0
5
1
4
12
5
9
10
2
23
16
3
0
36
7
5
4
2
1
2
1
19
14
4
12
23
3
4
10
2
3
0
5
18
24
3
11
22
2
2
7
1
5
1
3
8.38
273
75.3
73.5
27.8
1,724
1,724
1,724
1,724
1,724
1. Includes soft drinks, alcoholic drinks, tea, coffee and water
2. Includes powdered beverages (except tea and coffee), soups, sauces, condiments and artificial sweeteners
3. Average daily intake is measured in MJ for total energy and grams for total carbohydrate, protein, total fat and saturated fats
Source:
The National Diet & Nutrition Survey: adults aged 19 to 64 years old - volume 2, 2003. Office for National Statistics (ONS)
136
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Contents page
Table 6.21 Number and percent of secondary schools offering food1 from different
groups, 2004
England
Food not offered in
2
schools
number of
%
schools
Soft drinks
Milk (including flavoured)
Fruit juice
Soup
Fruit (fresh, tinned, dried)
Sweets and chocolates
Sandwiches, filled rolls and baguettes
Desserts
Cakes and muffins
Chips and potatoes cooked in oil
Potatoes (not fried), plain bread and other starches
Vegetables and salads (e.g. green, mixed, coleslaw)
Baked beans
Main dishes (high fat)
Main dishes (lower fat)
Gravy, butter, cheese and condiments
3
14
22
42
2
13
17
1
5
0
1
0
0
4
0
0
0
Base
79
4
18
28
53
3
16
22
1
6
0
1
0
0
5
0
0
0
Offered 4 or 5 days a
2
week in schools
number of
%
schools
73
58
46
26
72
59
51
73
55
75
60
72
55
64
68
48
77
92
73
58
33
91
75
65
92
70
95
76
91
70
81
86
61
97
79
1. Based on availability of food offered over five consecutive days, where interviewers only collected data on
four days, estimates of availability were determined by dividing the number of days by 0.8
2. In the remaining schools, not shown in this table, the foods were on offer between 1 and 3 days
Source:
School meals in secondary schools in England, research report 557, 2004. Food Standards Agency
Copyright © 2008, re-used with the permission of King's College, London
137
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Contents page
Table 6.22 Fruit and vegetable consumption among children1, by gender, 2001 to 2006
England
Weighted for selection
Percentages
2
Weighted for selection and non response
2
2001
2002
2003
2003
2004
2005
2006
Boys
None
5 portions of more
12
76
11
11
77
12
10
80
10
11
80
10
10
77
13
6
76
18
7
74
19
Girls
None
5 portions of more
10
80
11
8
80
12
9
79
12
9
79
12
8
80
12
5
78
17
6
72
22
Bases (unweighted)
Boys
Girls
1,359
1,404
2,901
2,774
1,298
1,321
1,298
1,321
51
52
1,115
1,100
2,784
2,726
1,498
1,560
3,236
3,236
1,301
1,342
1,350
1,285
599
568
1,070
1,021
2,632
2,480
Bases (weighted)
Boys
Girls
2
1. Aged 5 to 15
2. Data for all years have been weighted to correct for the probability of selection. From 2003 data have also been
weighted for non-response. Two sets of data are shown for 2003: one with selection weighting only, and one with selection
and non-response weighting.
Source:
138
Source:
1. Aged 5 to 15
2,632
2,480
3.4
Bases (weighted)
Boys
Girls
6
3
17
20
19
14
22
Girls
None
Less than 1 portion
5 portions or more
2,784
2,726
3.2
Bases (unweighted)
Boys
Girls
7
3
19
20
18
13
19
All ages
Boys
None
Less than 1 portion
5 portions or more
England
236
208
252
227
3.6
3
1
14
21
23
18
20
3.6
3
4
10
21
20
18
23
5
208
202
230
233
3.3
5
4
13
24
21
14
20
3.2
5
3
15
25
19
13
21
6
245
230
256
260
3.3
5
3
17
18
23
15
20
3.2
4
3
21
21
19
12
20
7
192
226
200
266
3.3
5
3
18
21
19
16
19
3.0
8
4
20
19
16
15
18
8
Table 6.23 Fruit and vegetable consumption among children1, by age and gender, 2006
275
220
281
249
3.5
8
2
15
19
16
16
25
3.3
6
4
16
22
19
14
19
9
246
212
266
237
3.3
4
2
23
20
17
16
20
3.1
6
4
20
22
18
13
18
10
228
235
240
263
3.4
7
2
18
20
19
14
21
2.9
10
1
20
22
18
14
16
11
247
228
272
243
3.3
8
1
16
21
19
12
23
3.2
6
3
24
21
18
7
20
12
246
239
273
255
3.2
5
4
16
20
21
13
21
3.1
10
3
21
20
12
13
21
13
268
236
268
244
3.2
6
4
21
21
12
11
25
3.0
9
3
22
18
20
12
16
240
244
246
249
3.6
6
2
15
21
16
12
28
3.2
9
4
18
16
20
13
19
14
15
Previous view
Contents page
139
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Contents page
1
Table 6.24 Type of fruit and vegetable consumption on the previous day among children , by age and gender, 2006
England
All ages
5
6
7
8
9
10
11
12
13
Percentages
14
15
Boys
Any fruit and vegetables
Any vegetables (and salads)
Any fruit (excludes fruit juice)
93
63
70
97
69
86
95
65
78
96
65
76
92
61
72
94
66
75
94
62
70
90
57
64
94
62
69
90
58
63
91
62
61
91
64
62
Pulses
Salad
52
38
22
61
39
24
56
37
20
57
37
22
48
38
22
57
41
20
52
41
22
48
30
21
49
33
25
47
39
20
48
39
26
49
38
23
Fresh fruit
Fruit in composites
Dried fruit
Frozen fruit
Fruit juice
None
7
67
5
9
3
55
7
5
83
3
20
6
55
3
7
75
4
10
4
56
5
6
74
3
12
1
55
4
7
70
6
10
2
54
8
6
71
7
7
3
56
6
4
67
6
7
1
52
6
5
61
5
9
4
60
10
8
64
7
8
2
60
6
6
57
6
8
4
55
10
7
56
5
7
3
50
9
9
57
5
7
4
56
9
Girls
Any fruit and vegetables
Any vegetables (and salads)
Any fruit (excludes fruit juice)
94
68
75
97
74
85
95
70
78
95
70
80
95
66
76
92
69
80
96
67
79
93
66
70
92
68
73
95
65
71
94
64
65
94
69
70
54
64
58
58
54
56
50
49
55
47
46
57
Pulses
Salad
Fresh fruit
Fruit in composites
Dried fruit
Frozen fruit
Fruit juice
None
34
28
8
71
6
9
3
59
6
41
29
7
81
6
9
2
61
3
35
26
5
76
5
12
3
62
5
36
26
8
76
6
6
4
55
5
37
27
8
72
3
11
5
59
5
25
31
6
75
9
10
3
61
8
35
30
12
74
6
9
4
50
4
33
28
8
67
7
8
4
61
7
32
26
4
69
5
11
2
60
8
37
32
7
65
4
8
4
58
5
33
28
8
63
4
5
1
56
6
33
26
11
65
8
11
3
61
6
Bases (unweighted)
Men
Women
2,784
2,726
252
227
230
233
256
260
200
266
281
249
266
237
240
263
272
243
273
255
268
244
246
249
Bases (weighted)
Men
Women
2,632
2,480
236
208
208
202
245
230
192
226
275
220
246
212
228
235
247
228
246
239
268
236
240
244
1. Aged 5 to 15
Source:
140
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Contents page
Table 6.25 Fruit and vegetable consumption among children1, by Government Office Region/Strategic Health Authority2 and gender,
2006
England
North East North West
Yorkshire
and the
Humber
East
Midlands
West
Midlands
East
England
London South West South East
Strategic Health
Authority
South East
South
Coast
Central
Boys
None
Less than 1 portion
5 portions or more
9
4
24
27
14
12
11
7
5
21
21
16
15
15
10
2
25
17
17
12
17
9
5
21
22
15
11
17
5
4
14
27
24
11
15
9
3
18
21
19
12
17
4
2
14
19
19
13
30
5
3
17
21
21
12
20
5
3
20
17
17
16
22
6
3
18
17
19
15
22
4
3
21
17
16
16
22
2.6
2.9
3.0
2.9
3.0
3.0
3.8
3.3
3.4
3.5
3.4
Girls
None
Less than 1 portion
5 portions or more
9
3
24
19
20
7
19
7
2
19
21
19
14
18
6
5
16
22
17
13
21
6
3
17
23
18
14
20
7
2
18
20
20
14
20
6
4
17
21
17
12
23
3
1
14
18
21
12
31
4
3
15
21
16
19
22
5
2
16
20
17
17
22
5
1
19
19
18
17
20
4
3
14
21
16
18
24
2.8
3.1
3.1
3.2
3.3
3.2
3.9
3.5
3.5
3.3
3.8
Bases (unweighted)
Boys
Girls
148
143
414
438
323
290
264
283
280
294
292
258
339
329
264
250
460
441
216
204
244
237
Bases (weighted)
Boys
Girls
134
125
365
378
279
234
213
225
259
277
304
245
379
366
260
224
440
405
204
184
235
222
1. Aged 5 to 15
2. This table provides data for regional analysis both by Government Office Region (GOR) and the new configuration of Strategic Health Authorities (SHAs) in place from July
2006. The first eight columns represent GORs and SHAs of the same name, while the South East GOR (column nine) is divided into South East Coast SHA and South Central
SHA, shown in the final two columns
Source:
141
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Contents page
Table 6.26 Fruit and vegetable consumption among children1, by equivalised
household income quintiles and gender, 2006
England
4th
Lowest
Highest
2nd
3rd
None
Less than1 portion
5 portions or more
3
3
14
20
17
16
28
6
3
13
22
20
16
21
7
2
19
21
18
14
19
6
5
21
22
19
11
16
11
3
24
20
16
13
13
3.8
3.5
3.2
2.9
2.7
None
Less than1 portion
5 portions or more
3
1
10
17
18
16
34
4
2
12
19
21
16
26
6
4
15
23
16
17
20
6
3
21
21
17
13
19
8
3
22
19
20
11
17
Mean number of units
4.1
3.7
3.2
3.1
3.0
352
311
454
495
522
446
482
468
564
575
319
273
398
411
480
389
456
419
575
579
Boys
Girls
Bases (unweighted)
Men
Women
Bases (weighted)
Men
Women
1. Aged 5 to 15
Source:
142
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1
Table 6.27 Daily quantities of food consumed in the dietary recall period, among children in low income households,
by gender, 2003-2005
United Kingdom
Mean all
Pasta
Rice
Pizza
Other cereals
White bread
Wholemeal bread
Other breads
Wholegrain and high fibre breakfast cereals
Breakfast cereals not wholegrain or high fibre
Biscuits
Buns, cakes and pastries
Cereal based milk puddings, sponge and other puddings
Whole milk
Semi-skimmed milk
Skimmed milk
Cheese
Yoghurt and other dairy desserts
Ice cream
Eggs and egg dishes
Butter
Soft margarine, not polyunsaturated
Reduced fat spread, not polyunsaturated
Reduced fat spread, polyunsaturated
Low fat spread, not polyunsaturated
Low fat spread, polyunsaturated
Bacon and ham
Beef, veal, lamb and pork and dishes
Coated chicken and turkey
Chicken and turkey dishes
Burgers and kebabs
Sausages
Meat pies and pastries
Other meat and meat products
Liver, liver products and dishes
White fish coated or fried
White fish not coated or fried
Canned tuna and dishes
Oily fish and dishes
Carrots, raw
Salad and other vegetables, raw4
Tomatoes, raw
Peas and green beans, not raw
Baked beans
Leafy green vegetables, not raw
Carrots, not raw
Tomatoes, not raw
Other vegetables and vegetable dishes, not raw
Chips, fried and roast potatoes and fried potato products
Other potatoes, potato salads and dishes, potato products
cooked without fat
Apples and pears not canned
Citrus fruit not canned
Bananas
Other fruit including canned
Table sugar
Preserves, sweet spreads, fillings and icings
Sugar confectionery
Chocolate confectionery
Fruit juice
Soft drinks, not carbonated, not diet
Carbonated soft drinks, not diet
Soft drinks, not carbonated, diet
Carbonated soft drinks, diet
Wine, including fortified, low alcohol and alcohol free
Beers and lager including low alcohol and alcohol free
Coffee (made up)
Tea (made up)
Beverages (dry weight) e.g. drinking chocolate, cocoa, horlicks
Soups
Savoury, sauces, pickles, gravies, condiments
2
Boys
Mean % consumers
consumers3
Girls
Mean % consumers
consumers3
31
22
21
5
59
7
8
16
14
17
16
15
141
89
2
19
10
23
11
9
2
1
5
2
0
1
9
42
13
28
13
16
17
3
1
10
2
4
0
1
4
2
9
20
5
6
1
15
72
40
64
76
68
19
65
43
29
34
23
24
31
50
237
212
*
96
19
53
37
27
10
6
12
13
*
10
18
66
34
46
38
34
44
23
*
32
*
23
*
*
13
12
21
48
18
18
*
32
80
64
49
29
31
27
90
17
26
46
60
72
53
31
59
42
2
20
50
43
29
32
21
20
42
15
5
10
50
62
39
59
34
46
40
12
2
32
4
16
2
7
31
20
42
42
25
35
5
48
90
62
28
31
14
6
50
4
8
12
10
16
14
14
105
61
1
15
9
29
10
10
2
1
4
1
0
1
8
38
15
28
8
12
12
5
0
7
3
3
1
1
9
4
8
19
6
5
1
18
57
44
59
79
50
23
55
32
28
29
17
21
25
50
187
118
*
82
17
62
27
28
8
3
9
9
6
9
17
62
36
45
34
28
43
32
*
29
48
20
*
*
18
14
19
49
22
16
*
31
69
66
47
39
29
25
91
11
29
42
61
76
56
27
56
51
2
18
54
47
36
36
20
21
44
17
7
12
46
62
42
64
23
44
28
15
2
24
7
14
4
8
47
29
41
38
27
30
5
57
82
67
17
22
6
14
7
7
3
14
15
47
247
215
96
44
0
22
21
56
37
43
30
11
14
27
26
137
331
315
311
213
*
*
82
39
17
32
23
61
25
50
59
34
75
68
31
21
0
4
18
25
13
14
11
5
3
10
15
59
187
146
114
43
0
3
22
56
52
42
31
9
12
20
23
133
275
237
356
157
*
*
85
44
25
34
36
55
27
50
68
45
68
61
32
27
0
1
11
84
2
*
206
14
6
41
15
15
83
3
159
198
16
10
42
16
5
20
60
25
8
78
10
19
61
25
16
78
Base (unweighted)
1.
3.
4.
5.
*
Mean all
2
439
493
Children aged 2 to 18
Excluding raw tomatoes and raw carrots which are recorded as a separate category
Source:
Low Income Diet & Nutrition Survey: Executive Summary , 2007. The Food Standards Agency
143
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Table 6.28 Macronutrient intakes for children1 from low income households, by age and
gender, 2003-2005
United Kingdom
All ages
Boys
2
2-10
11-18
8.03
1,908
7.07
1,677
9.36
2,224
% of EAR
96
50.8
17.1
13.1
36.1
14.2
98
51.0
17.0
13.1
35.9
14.6
93
50.5
17.2
13.1
36.4
13.7
Base (unweighted)
439
239
200
7.02
1,668
6.40
1,520
7.85
1,866
% of EAR
99
51.0
16.5
13.3
35.7
14.0
100
51.5
16.7
13.2
35.3
14.4
97
50.4
16.3
13.3
36.3
13.5
Base (unweighted)
493
278
215
Girls
2
1. Children aged 2 to 18
2. Kcal figures are calculated from the energy intake in MJ using a conversion factor of 4.184 for each individual
Source:
The Low Income Diet and Nutirtion Survey, 2007 The Food Standards Agency
144
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7 Health outcomes
7.1 Introduction
The link between obesity and increased
risk of many serious diseases and mortality
is well documented and has led to National
Institute for Health and Clinical Excellence
(NICE) developing guidelines in identifying
and treating obesity. This chapter focuses
on the health outcomes related to being
obese. Relationships between selected
diseases and death due to obesity will be
discussed and the associated costs to the
NHS resulting from obesity.
Information from the National Audit Office1
(NAO) and the House of Commons Select
Committee report2 is used to establish the
risk of death and disease associated with
obesity. Data from the Health Survey for
England (HSE) 20033, 20054 and 20065 are
used to provide the latest available
information to look at the prevalence of
selected diseases in relation to BMI and
waist circumference in the population. For
further information please see Appendix B.
Data on Finished Consultant Episodes
(FCEs) in NHS hospitals in England with a
primary diagnosis of obesity are presented
using Hospital Episode Statistics (HES)6
data produced by the Information Centre
for health and social care (the IC). An FCE
is defined as a period of admitted patient
care under one consultant within one
healthcare provider. The figures do not
represent the number of patients, the
number of admissions or the number of
surgical procedures, as a person may have
more than one episode of care within a
year or more than one episode of care
within one visit to hospital and an episode
of care may or may not involve numerous
surgical procedures.
Information on prescription drugs used for
the treatment of obesity are accessed from
the Prescription Pricing Division (PPD) of
the IC7.
Data on the number of adults registered by
GPs on their practices’ obesity register as
part of the Quality Outcomes Framework
(QOF)8 and the resulting prevalence rate is
also shown. Again this data is provided by
the IC.
Finally, an overview of the estimated costs
associated with treating obesity and obesity
related diseases is given. This incorporates
figures from the NAO1 and the House of
Commons Select Committee report2 and
includes predicted future costs to the NHS
linked to obesity produced by the recent
Foresight Tackling Obesities: Future
Choices – Project Report9.
7.2 Relative risks of diseases
Obesity is an important risk factor for a
number of chronic diseases that constitute
the principle causes of death, including
heart disease, stroke and some cancers. It
also contributes to other serious life
shortening conditions such as Type 2
diabetes.
Figure 7.1 shows the extent to which
obesity increases the risks of developing a
number of diseases relative to the nonobese population. For example, it is
estimated that an obese woman is almost
13 times more likely to develop Type 2
diabetes, than a woman who is not obese.
These relative risks are based on a
comprehensive review of international
literature carried out by the NAO1 to provide
the best estimates that could be applied to
England (see Appendix A for more details).
The basis of the estimates varies due to
differences in the methodologies of the
studies selected, but the table gives a
broad indication of the strength of
association between obesity and each of
the diseases.
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Figure 7.1 Relative risk factors for obese people of
developing selected diseases, by gender
7.4 Relationship between obesity
prevalence and selected diseases
England
Guidance published by the National
Institute for Health and Clinical Excellence
(NICE)10 recommends the use of waist
circumference in conjunction with BMI as
the method of measuring overweight and
obesity. NICE have suggested that waist
circumference is a useful measure to
assess health risks in people who have a
BMI less than 35kg/m2.
A raised waist
circumference is defined as greater than
102cm in men and greater than 88cm in
women. Details of health risks associated
with the various combinations of BMI and
raised waist circumference are outlined in
Table 2.5 in Chapter 2.
Numbers
Men
Women
Type 2 diabetes
5.2
12.7
Hypertension
2.6
4.2
Myocardial infarction
1.5
3.2
Cancer of the colon
3.0
2.7
Angina
1.8
1.8
Gall bladder diseases
1.8
1.8
Ovarian cancer
-
1.7
Osteoarthritis
1.9
1.4
Stroke
1.3
1.3
Source:
National Audit Office, NAO
Copyright © 2006. UK National Audit Office
7.3 Relative risks of death
In addition to increasing the risk of ill
health, obesity also increases the risk of
mortality. Evidence suggests that for young
adults, the risk of mortality for an obese
person with a BMI of 30 kg/m2 is about
50% higher than for someone with a normal
BMI (BMI between 18.5 kg/m2 to less than
25 kg/m2) and with a BMI of 35 kg/m2 or
more the risk is more than doubled1.
Young adults with a BMI of 35 or more
have double the risk of death
compared to those with a normal BMI
1
The NAO estimated that in 1998 over
30,000 deaths a year in England were
attributable to obesity, approximately 6% of
all deaths in that year. Around 9,000 of
these were premature deaths (i.e. occurred
before state retirement age). In 2004,
research by a House of Commons Select
Committee2, estimated that 34,100 deaths
were attributable to obesity by applying
latest available obesity prevalence rates.
This equates to 6.8% of all deaths in
England.
This section reports on the relationships
found between BMI, waist circumference
and with selected diseases. Analyses for
BMI have previously been carried out using
HSE 2003 data and are presented in the
2006 Statistics on Obesity, Physical Activity
and Diet: England 200611. Additional
analysis is presented in this chapter for
raised waist circumference and uses the
latest available HSE data in which the
sample size of the general population was
large enough to comment upon. For further
information please see Appendix B.
7.4.1 Blood pressure
Data from the HSE 20033 shows that
overweight men and women (BMI between
25 to less than 30) and obese men and
women (BMI 30 or more) both had higher
prevalence of high blood pressure than
those with a normal BMI.
When comparing prevalence of high blood
pressure with waist circumference, the
20054 HSE showed that high blood
pressure was over twice as prevalent in
men (50.5%) and women (41.6%) with a
raised waist circumference compared with
those who did not record a raised waist
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circumference (24.4% for men and 16.4%
for women) (Table 7.1, Figure 7.2).
Figure 7.2 High blood pressure by waist circumference
and gender, 2005
Percentages
England
60
Non raised w aist circumference
Raised w aist circumference
50
30
20
10
0
Women
7.4.2 Cardiovascular disease
Data from the HSE 20033 shows that a
relationship
between
cardiovascular
disease (CVD) and BMI can also be seen
for both men and women where prevalence
of CVD was lowest among those with a
normal BMI, increased for those classified
as overweight and was highest among
obese women and men.
Using HSE 2003 data, prevalence of CVD
is higher for both men (19.8%) and women
(17.1%) with a raised waist circumference
in comparison to those recorded as not
having a raised waist circumference (11.2%
for men and 11.1% for women) (Table 7.2,
Figure 7.3).
Figure 7.3 Cardiovascular disease by waist
circumference and gender, 2003
Percentages
England
25
20
15
10
5
0
Men
7.4.4 Limiting longstanding illness
Using HSE 20033 data, men and women
categorised as obese reported a higher
prevalence of limiting longstanding illness
(whereby a longstanding illness limits their
activity in some way). The prevalence for
both limiting and non-limiting longstanding
illness was lower among men and women
categorised with a normal BMI.
40
Men
As might be expected prevalence of
Ischemic Heart Disease (IHD) shows a
similar relationship with both BMI and waist
circumference as CVD shown in the HSE
2003 (Table 7.3).
Women
This pattern was reflected in analysis using
waist circumference data from HSE 20054
where 30.4% of men and 34.5% of women
with a raised waist circumference reported
having a limiting longstanding illness
compared to 18.7% of men and 21.0% of
women who did not have a raised waist
circumference (Table 7.4).
7.4.5 General health
The general health questionnaire (GHQ12),
consisting of 12 questions measuring
general levels of happiness, depression,
sleep disturbance and ability to cope, was
completed by respondents of the HSE.
The prevalence of a high GHQ12 score (4
or more) is indicative of possible psychiatric
disorder. When considering GHQ12 by
BMI, results from the 2003 HSE3 showed
that among women, those who were in the
morbidly obese category (BMI of 40 or
more) had a significantly higher prevalence
of high GHQ12 score than all groups apart
from those who are underweight. No such
pattern was apparent amongst men.
Waist circumference results from HSE
20054 showed that for men, those with a
raised waist circumference were more likely
to record a high GHQ12 score (12.6%)
compared to those without (9.4%). No such
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distinctions were apparent among women
(Table 7.5).
Figure 7.4 Prevalence of doctor diagnosed diabetes by
waist circumference and gender, 2006
7.4.6 Diabetes
14
Percentages
England
12
The HSE reports on the prevalence of
doctor diagnosed diabetes and associated
risk factors. The survey reports on both
type 1 and type 2 diabetes. Type 1
diabetes (also known as insulin-dependent
and in the past as juvenile diabetes) is the
result of an autoimmune destruction of the
cells of the pancreas which produces
insulin. It is treated with regular insulin
injections. Type 2 diabetes (also known as
non insulin-dependent or late-onset) is
characterised by insulin resistance and is
controlled with diet and sometimes insulin
therapy. This is the most common form of
diabetes in the UK accounting for over 90%
of all diabetes in UK5.
Using the 2003 HSE3 data the relationship
between BMI and type 2 diabetes was
considered. It was found that prevalence of
diabetes increased with increasing BMI for
both men and women.
The most recent data available on diabetes
prevalence and waist circumference is
available from the 2006 HSE5 which found
that diabetes prevalence (type 1 and type 2
combined) was over four times greater in
men and women with a raised waist
circumference (11.5% and 8.5%) than
those recorded as not having a raised waist
circumference (2.7% and 1.5%) (Table 7.6,
Figure 7.4).
10
8
6
4
2
0
Men
Women
The HSE 20065 used logistic regression to
examine the association between a number
of risk factors and type 2 diabetes among
adults aged 35 and over. After adjusting
for other factors, men and women who
were obese had approximately double the
odds of having type 2 diabetes compared
to those who had a BMI of less than 25.
Similarly men with a raised waist
circumference had more than double the
odds of having type 2 diabetes than those
without a raised waist circumference.
Results for women were even more
pronounced; those with a raised waist
circumference were four times more likely
to have type 2 diabetes than those without
a raised waist circumference (Table 7.7).
Women with a raised waist
circumference aged 35 and over are
four times more likely to have type 2
diabetes than those without a raised
waist circumference.
7.5 Hospital Episodes Statistics
7.5.1 Hospital admissions with a
diagnosis of obesity
Table 7.8 shows that in 2006/07 there were
4,068 FCEs with a primary diagnosis of
obesity. This is five times as high as the
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number in 1996/97 (787) and 50% higher
than in 2005/06 (2,749).
FCEs with a primary diagnosis of
obesity were five times higher in
2006/07 compared with 10 years
earlier
Over the period 1996/97 to 2006/07 results
show that women were consistently more
than twice as likely to have an FCE with a
primary diagnosis of obesity than men
(Figure 7.5).
Figure 7.5 Finished Consultant Episodes with a primary
diagnosis of obesity, by gender, 1996/97 to 2006/07
Numbers
England
3,500
3,000
2,500
Females
2,000
1,500
1,000
Figure 7.6 Finished Consultant Episodes with a secondary
diagnosis of obesity, by gender, 1996/97 to 2006/07
/0
7
/0
6
20
06
/0
5
20
05
/0
4
20
04
/0
3
20
03
/0
2
20
02
/0
1
20
01
/0
0
20
00
/9
9
19
99
19
98
19
97
/9
8
0
/9
7
Focusing now on FCEs where there was a
secondary diagnosis of obesity, in 2006/07
there were 80,113 FCEs, with a secondary
diagnosis of obesity compared with 21,257
in 1996/97. The results indicate that obesity
is much more likely to be recorded as a
secondary diagnosis than a primary
diagnosis. Females are again more likely
than males to have an FCE with a
secondary diagnosis of obesity but not to
the same extent. More than twice as many
females than males had an FCE with a
primary diagnosis of obesity but about a
third more females than males are had an
FCE with a secondary diagnosis of obesity
Males
500
19
96
However in North West the proportions of
such FCEs were more even between males
and females (42% and 58% respectively)
(Table 7.10). Note that FCE figures cannot
be used to compare prevalence of obesity
between areas as people travel for
treatment and/or treatment is concentrated
in some areas.
Source: Hospital Episode Statistics, HES. The Information Centre
Numbers
England
50,000
45,000
40,000
35,000
Among Government Office Regions
(GORs) in 2006/07, Yorkshire and the
Humber and London recorded the highest
number of FCEs with a primary diagnosis
of obesity (666 and 654 respectively), while
the East of England had the lowest (300
FCEs). Similar gender patterns shown
nationally emerged amongst the regions
with women more likely than men to have
an FCE with a primary diagnosis of obesity.
30,000
25,000
20,000
Females
15,000
10,000
5,000
Males
0
19
96
/9
7
19
97
/9
8
19
98
/9
9
19
99
/0
0
20
00
/0
1
20
01
/0
2
20
02
/0
3
20
03
/0
4
20
04
/0
5
20
05
/0
6
20
06
/0
7
In 2006/07, the 35 to 44 age group were
the most likely to be admitted with a
primary diagnosis of obesity. Indeed this
age group has consistently accounted for
around a quarter of all the FCEs with a
primary diagnosis of obesity since 1996/97
(Table 7.9).
Source: Hospital Episode Statistics, HES. The Information Centre
Different patterns in age are seen when
focusing on obesity as a secondary
diagnosis. Adults aged 55 to 64 had the
highest number of FCEs (19,650) with a
secondary diagnosis of obesity in 2006/07,
followed by those aged 65 to 74 years with
16,781 FCEs (Table 7.12).
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Results for FCEs with a secondary
diagnosis of obesity among GORs differed
considerably from those with a primary
diagnosis. The North West showed the
largest number of FCEs (14,590) but had
the third lowest figure when considering
primary diagnosis. The North East reported
the least number of FCEs (4,389) followed
by Yorkshire and the Humber (4,881) which
interestingly had the highest number of
primary diagnosed FCEs. However, the
consistency of reporting diagnoses needs
to be kept in mind when considering these
data (Table 7.13).
7.5.2 Bariatric surgery
Bariatric surgery consists of two types of
surgery (adjustable gastric banding and
gastric bypass) performed on the stomach
and/or intestines to limit the amount of food
an individual can consume. This surgery is
used in the treatment of obesity for people
with a BMI above 40, or on people with a
BMI between 35 and 40 who have health
problems like type 2 diabetes or heart
disease.
FCEs for bariatric surgery are identified
using a primary diagnosis of obesity and a
main procedure code for bariatric surgery.
These are recorded using the Office of
Population, Censuses and Surveys:
Classification
of
Interventions
and
Procedures, 4th Revision (OPCS4) codes.
An updated version of these codes was
introduced in 2006/07. Results based on
the old coding system (OPCS 4.2) cannot
be compared with results based on the
revised system (OPCS 4.3), and so are
presented separately here. See Appendix B
for further details.
OPCS 4.2
There was a year on year increase in the
number of FCEs for bariatric surgery from
121 in 1996/97 to 997 in 2005/06.
Annually the ratio of these FCEs between
men and women remained relatively
constant with around eight in ten of FCEs
involving female patients. The actual
number of procedures for males has
remained quite small, in 1996/97 there
were 19 FCEs for bariatric surgery
compared with 187 FCEs in 2005/06. In
comparison the figures for women were
100 in 1996/97 and 780 in 2005/06 (Table
7.14).
OPCS 4.3
Using this new classification, in 2006/07
there were 1,890 FCEs for bariatric surgery
(362 males and 1,520 females). While
unable to compare actual figures to earlier
years it is interesting to note that the ratio
of FCEs between males and females have
remained similar to that which was
apparent using OPCS 4.2 codes (Table
7.14).
7.6 Prescribing
The two main drugs prescribed for the
treatment of obesity by GP practices in
England, were Orlistat (Xenical) and
Sibutramine (Reductil). Orlistat is a capsule
that prevents the absorption of some fat in
the intestine, while Sibutramine works in
the brain by altering the chemical
messages that control how the person
taking it feels and thinks about food. In
2006 there were 1.06 million prescription
items for drugs for the treatment of obesity.
Overall, the number of prescriptions in
2006 was more than eight times the
number prescribed in 1999, when there
were 127 thousand prescription items for
drugs for the treatment of obesity. The Net
Ingredient Cost (NIC) increased from £4.9
million to £47.5 million over the same
period, while the NIC per item increased
from £38 to £45.
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In 2006, over a million drugs for the
treatment of obesity were prescribed.
During the latest period for which data are
available (January to June 2007), there
were 613 thousand prescriptions for drugs
used for the treatment of obesity in
England. This is around 25% more than the
same period in 2006 (490 thousand
prescriptions) (Table 7.15).
Considering the two main drugs which are
prescribed, around 73% of prescriptions
were for Orlistat and 25% of prescriptions
were for Sibutramine in 2006 (Figure 7.8).
Figure 7.8 Number of prescription items for obesity
dispensed in primary care, 1999 to 2006
Thousands
England
900
800
700
Orlistat
600
500
400
300
Sibutramine
200
100
0
1999
2000
2001
2002
2003
2004
2005
2006
Source: Prescribing Analyses and Cost Tool (PACT) from the Prescription Pricing
Division of the Business Services Authority (PPD of the BSA). Copyright © 2008,
re-used w ith the permission of the Prescription Pricing Devision
Among SHAs, North West SHA had the
greatest number of prescriptions of Orlistat
and of Sibutramine (135 thousand and 45
thousand respectively). This compares with
43 thousand prescription items of Orlistat in
South Central SHA and 11 thousand
prescription items for Sibutramine in North
East SHA (Table 7.16).
7.7 GP recording of BMI
The Quality and Outcomes Framework
(see Appendix A) for 2006/078 includes an
indicator which rewards practices for
maintaining an obesity register of patients
(aged 16 and over) with a BMI greater than
or equal to 30 recorded in the previous 15
months. The recording of BMI for the
register takes place in the practice as part
of routine care.
The underlying data
includes the number of patients on the
obesity register and number of obese
patients registered as a proportion of the
practice list size. In this report, an adjusted
prevalence rate is used based on an
estimate of practice list sizes for the 16 and
over age group.
In England, in 2006/07, nearly 4 million
people aged 16 and over had been
recorded by GPs on obesity registers8.
Using this information it was calculated that
the prevalence rate based on GPs obesity
registers was 9.1% much less than the
24% derived from the HSE. While perhaps
not able to demonstrate the complete
extent of obesity prevalence, QOF can be a
useful indicator of the number of people
whose health is being monitored due to
their obesity.
At a regional level prevalence rates based
on GP obesity registers ranged from 10.6%
in the North East to 8.0% in London.
Although the national prevalence rates
derived from these two sources are not
comparable, the regional patterns seen are
similar with London having one of the
lowest prevalence rates from the HSE and
from the obesity register while the North
East had one of the higher rates (Table
7.17).
7.8 Financial costs
7.8.1 Previous estimates
Illness associated with obesity gives rise to
costs to the NHS. Costs of obesity arise
from NHS consultations, drugs and
treatments of diseases attributable to
obesity. It was estimated by the NAO1 that
in 1998 these costs amounted to
approximately £480 million or about 1.5%
of NHS expenditure for that year. Of this
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the cost of treating obesity itself was £9.5
million while approximately £470 million
was spent on treating the consequences of
obesity. The most significant costs by far
were related to treating hypertension,
coronary heart disease and type 2
diabetes.
7.8.2 Present and future predictions
More recent figures, produced for a House
of Commons Select Committee report2,
suggest the cost of treating obesity itself
was between £46 and £49 million in 2002,
a large increase compared to the £9.5
million estimated in 1998, largely due to the
increase in drug costs and in particular the
licensing of orlistat. Estimated costs of
treating the consequences of obesity were
estimated to be between £945 million and
£1,075 million in 2002. The increase in the
estimate is due to a number of reasons,
including higher NHS and drugs costs,
more detailed and accurate data becoming
available, the inclusion of more comorbidities and the increased prevalence of
obesity.
In October 2007, Foresight at The
Government Office for Science produced
the Tackling Obesities: Future Choices
report9. The Foresight report predicts future
trends in obesity prevalence amongst
adults and children, details of which have
been described in Chapter 2 (section 2.7)
and Chapter 3 (section 3.7) of this report.
The report also models current and future
costs of obesity and obesity related
diseases to the NHS. Foresight used the
2002 Health Select Committees2 findings
and uses £1 billion as the baseline for
obesity attributable healthcare costs in the
modeling exercise. The model used
forecasted costs solely on the basis of
anticipated additional morbidity arising from
the increasing prevalence of obesity.
Factors other than BMI, including costs of
treating disease were fixed at current
levels. As BMI is the only variable in the
model all the additional costs predicted by
the model are attributable to obesity.
Estimated costs of treating the
consequences of obesity were
approximately £1 billion in 2002.
It is predicted that by 2025, the NHS
cost of obesity could rise to £5.3
billion.
Combining these costs gives an estimate
between £990 million and £1,225 million
(between 2.3% and 2.6% of NHS
expenditure), more than double the figure
estimated in 1998. These figures are still
considered to be an underestimate.
Using the increasing levels of BMI
predicted, the Foresight model estimates
that the NHS cost attributable to obesity
could rise to £5.3 billion9 by 2025.
152
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Summary: Health outcomes
The link between obesity and increased
risk of many serious diseases and mortality
is clear. For example for young adults, the
risk of mortality for an obese person is
about 50% higher than someone with a
normal BMI.
Prevalence rates for certain diseases vary
significantly depending on BMI status or
waist circumference or a combination of
both. For example the prevalence of
diabetes was over four times greater in
men and women with a raised waist
circumference than those recorded as
having a raised waist circumference.
Similar relationships were found with other
health problems including high blood
pressure and cardiovascular disease.
In 2006/07, there were over four thousand
FCEs with a primary diagnosis of obesity,
five times greater than the number 10 years
earlier. The number of FCEs with a
secondary diagnosis of obesity has more
than doubled in the same period.
In 2006 there were over a million
prescription items for drugs for the
treatment of obesity in England.
It is predicted that the cost of obesity to the
NHS will continue to rise in the future and
could exceed £5 billion by 2025.
References
1.
Tackling Obesity in England.
National Audit Office, 2001. Available at:
http://www.nao.org.uk/publications/nao_rep
orts/00-01/0001220.pdf
2.
Obesity.
House of Commons
Health Committee, 2004. Available at:
http://www.publications.parliament.uk/pa/c
m200304/cmselect/cmhealth/23/23.pdf
3.
Health Survey for England 2003:
http://www.dh.gov.uk/assetRoot/04/09/89/1
1/04098911.pdf
4.
Health Survey for England 2005:
The Information Centre, 2007. Available
at:
www.ic.nhs.uk/pubs/hse05olderpeople
5.
The Information Centre, 2008. Available at:
factors
6.
Hospital Episode
data included in this
routinely published, but
request. Available at:
www.hesonline.org.uk
Statistics (HES).
2007. The HES
bulletin are not
are available on
7.
The prescription data available in
this bulletin are not routinely available.
National prescription data may be available
on request. Available at:
http://www.ic.nhs.uk/statistics-and-datacollections/primary-care/prescriptions
8.
Quality and Outcomes Framework
Information (QOF). The Information Centre
2007. Available at:
http://www.ic.nhs.uk/ourservices/improving-patient-care/the-qualityand-outcomes-framework-qof-2006/07/qof2006-07-data-tables
153
Previous view
Contents page
9.
Tackling Obesities: Future Choices
– Modelling Future Trends in Obesity &
Their Impact on Health 2nd Edition.
Foresight, Government Office for Science.
Available at:
_final/17.pdf
11.
Statistics on Obesity, Physical
Activity and Diet: England, 2006: The
http://www.ic.nhs.uk/statistics-and-datacollections/health-andlifestyles/obesity/statistics-on-obesityphysical-activity-and-diet-england-2006
10.
Obesity:
the
prevention,
identification,
assessment
and
management of overweight and obesity in
adults and children. National Institute for
Health and Clinical Excellence (NICE),
2006. Available at:
154
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List of Tables
7.1
Blood pressure level by waist circumference and gender, 2005
7.2
Cardiovascular disease (CVD) by waist circumference and gender, 2003
7.3
Ischaemic Heart Disease (IHD) or stroke by waist circumference and gender, 2003
7.4
Longstanding illness by waist circumference and gender, 2005
7.5
GHQ12 score by waist circumference and gender, 2005
7.6
Prevalence of doctor diagnosed diabetes by waist circumference and gender, 2006
7.7
Adults estimated odds ratios for type 2 diabetes, by associated risk factors and gender,
2006
7.8
Finished Consultant Episodes with a primary diagnosis of obesity, by gender, 1996/97
to 2006/07
7.9
Finished Consultant Episodes with a primary diagnosis of obesity, by age, 1996/97 to
2006/07
7.10
Finished Consultant Episodes with a primary diagnosis of obesity, by Government
Office Region of residence and gender, 2006/07
7.11
Finished Consultant Episodes with a secondary diagnosis of obesity, by gender,
1996/97 to 2006/07
7.12
Finished Consultant Episodes with a secondary diagnosis of obesity, by age, 1996/97
to 2006/07
7.13
Finished Consultant Episodes with a secondary diagnosis of obesity, by Government
Office Region of residence and gender, 2006/07
7.14
Finished Consultant Episodes for Bariatric Surgery by gender, 1996/97 to 2005/06 and
2006/07
7.15
Number of prescription items, net ingredient cost and average net ingredient cost per
item of drugs for the treatment of obesity prescribed in Primary Care and dispensed in
the community, 1999 to 2007
7.16
Number of prescription items, net ingredient cost and average net ingredient cost per
item of drugs for the treatment of obesity prescribed in Primary Care and dispensed in
the community, by Strategic Health Authority 2006
7.17
Prevalence of obesity using the Quality Outcomes Framework by Strategic Health
Authority, 2006/07
155
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Table 7.1 Blood pressure level1,2 by waist circumference3 and gender, 20054
England
5
Non raised waist circumference
Percentages
66.7
75.6
49.5
7.4
4.7
12.6
6.8
4.4
11.4
19.0
33.3
15.3
24.4
26.4
50.5
72.7
83.6
58.4
7.9
4.3
12.8
8.1
3.8
13.3
11.4
8.3
15.4
27.3
16.4
41.6
Total
Men
Normotensive untreated
Hypertensive controlled
6
Hypertensive uncotrolled
Hypertensive untreated
6
All with high blood pressure7
Women
Normotensive untreated
Hypertensive controlled
6
Hypertensive uncotrolled
Hypertensive untreated
6
All with high blood pressure7
Bases (unweighted)
Men
1,916
1,206
673
Women
2,392
1,322
1,032
Bases (weighted)
Men
8
Women
2,035
1,333
663
2,208
1,241
925
1. See Appendix B for explanations of categories
2. All figures are based on those with a valid blood pressure measurement
3. A raised waist circumference has been taken to be greater than 102 cm in men and greater than 88 cm in women
5. Total includes those without a valid waist measurement recorded. See Appendix B for further details
6. Those who take drugs that lower blood pressure, irrespective of the reason they were prescribed
7. Those who are hypertensive (BP >=140/90 mmHg) or on treatment that lowers blood pressure
8. Different weighting is used for these with a valid waist cirumference measurement and the total - see Appendix B for further details
Source:
156
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Table 7.2 Cardiovascular disease (CVD)
1,2
3
4
by waist circumference and gender, 2003
5
Percentages
Men
13.6
11.2
19.8
Women
13.0
11.1
17.1
England
Total
Bases (unweighted)
Men
6,594
3,291
1,671
Women
8,224
3,484
2,505
7,194
3,728
1,671
7,626
3,282
2,265
Bases (weighted)
Men
6
Women
1. Not including diabetes or high blood pressure
2. All figures are based on those with a valid answer for whether they have had a CVD condition or not
5. Total includes those without a valid waist measurement recorded. See appendix B for further details
Source:
Table 7.3 Ischaemic Heart Disease (IHD)1 or stroke by waist circumference2 and gender, 20033,4
5
Percentages
Men
7.9
5.8
12.9
Women
5.8
3.8
9.3
Men
6,600
3,293
1,673
Women
8,232
3,490
2,507
7,200
3,730
1,672
7,632
3,288
2,267
England
Total
Bases (unweighted)
Bases (weighted)
Men
Women
1.
2.
3.
4.
5.
6
Angina or heart attack
A raised waist circumference has been taken to be greater than 102 cm in men and greater than 88 cm in women
All figures are based on those with a valid answer for whether they have had IHD or stroke
Adults aged 16 and over
Total includes those without a valid waist measurement recorded. See Appendix B for further details
6. Different weighting is used for those with a valid waist cirumference measurement and the total - see Appendix B for further details
Source:
157
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1
2
3
Table 7.4 Longstanding illness by waist circumference and gender, 2005
Total4
Percentages
Men
Limiting Longstanding Illness
Non limiting Longstanding Illness
No Longstanding Illness
22.4
19.8
57.8
18.7
19.9
61.4
30.4
25.5
44.1
Women
Limiting Longstanding Illness
Non limiting Longstanding Illness
No Longstanding Illness
26.6
18.2
55.2
21.0
18.5
60.4
34.5
20.5
45.0
Men
3,455
1,561
813
Women
4,175
1,618
1,283
3,701
1,760
806
3,931
1,532
1,159
England
Bases (unweighted)
Bases (weighted)
Men
Women
5
1. All figures are based on those with a valid answer for whether they have a longstanding illness or not.
3. Adults aged 16 or over
Source:
158
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1,2
Table 7.5 GHQ12 score
3
4
by waist circumference and gender, 2005
Total4
Percentages
67.3
21.9
10.8
67.4
23.3
9.4
66.5
20.9
12.6
62.1
23.0
14.9
62.4
22.4
15.2
61.9
23.1
15.1
3,079
3,796
1,489
1,557
772
1,202
3,280
3,557
1,669
1,466
766
1,077
England
Men
score 0
score 1-3
score 4+
Women
score 0
score 1-3
score 4+
Bases (unweighted)
Men
Women
Bases (weighted)
Men
Women
6
1. See Appendix B for explanation of GHQ12
2. All figures are based on those with a valid GHQ12 score
Source:
159
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Table 7.6 Prevalence of doctor diagnosed diabetes1 by waist circumference and gender, 20062
England
Percentages
Men
Non raised waist
circumference
Raised waist
circumference
Women
Non raised waist
circumference
Raised waist
circumference
All ages
2.7
11.5
1.5
8.5
16 to 24
25 to 34
35 to 44
45 to 54
55 to 64
65 to 74
75 and over
0.7
1.2
1.1
2.5
4.7
9.1
7.9
[2.3]
1.1
4.9
10.5
13.3
24.6
18.0
1.0
1.0
0.8
1.5
1.0
4.1
4.2
1.5
1.7
5.1
10.9
16.3
17.7
Bases (unweighted)
All ages
16 to 24
25 to 34
35 to 44
45 to 54
55 to 64
65 to 74
75 and over
2,975
379
454
615
485
470
317
255
1,617
36
122
262
296
387
334
180
3,168
417
496
713
522
491
280
249
2,368
89
226
400
422
492
415
324
Bases (weighted)
All ages
16 to 24
25 to 34
35 to 44
45 to 54
55 to 64
65 to 74
75 and over
3,371
672
647
691
502
399
252
208
1,578
71
173
299
313
335
249
138
3,077
593
545
625
445
381
243
246
2,100
124
232
359
370
386
303
326
1. Figures presented are for both type 1 and type 2 diabetes combined
2. Aged 16 and over with a valid waist measurement
[ ] Figure should be viewed with caution due to small base
Source:
160
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Table 7.7 Adults1 estimated odds ratios for type 2 diabetes, by associated risk factors and gender, 2006
England
Men
N Odds ratio 95% Confidence Interval
Lower
Upper
Age (p<0.001 men, p<0.001 women )
35-44
45-54
55-64
65-74
75+
1,348
1,120
1,011
691
496
Alcohol Consumption (p<0.001 men, p<0.001 women)
No alcohol in the last 12 months
436
No alcohol in the last week or ≤ 4 units on
2
heaviest drinking day in last week
Alcohol >4 and ≤ 8 units on heaviest
drinking day in last week
Alcohol >8 units on heaviest drinking day
in last week
1
2.92
3.49
4.55
3.98
1.75
2.07
2.57
2.19
4.88
5.87
8.06
7.25
1
Numbers
Women
N Odds ratio 95% Confidence Interval
Lower
Upper
1,373
1,126
1,047
768
793
1
2.76
6.10
8.39
7.51
735
1
1.34
3.13
3.90
3.39
5.70
11.90
18.05
16.67
2,541
0.55
0.37
0.82
2,862
0.62
0.43
0.90
792
0.39
0.24
0.64
903
0.23
0.12
0.43
896
0.36
0.22
0.59
608
0.18
0.07
0.45
Body Mass Index (p<0.001 men, p<0.018 women)
2
BMI <25kg/m
987
2
BMI ≥25 to 29.9 kg/m (overweight)
1,974
2
BMI ≥30 kg/m (obese)
1,117
Not measured
588
1
1.46
2.32
2.36
0.85
1.33
1.33
2.53
4.05
4.17
1,589
1,477
1,161
881
1
1.01
1.87
1.48
0.56
1.03
0.83
1.81
3.39
2.64
1,961
1
Waist circumference (p<0.001 men, p<0.001 women)
Waist circumference ≤102 cm men, ≤88
cm women
2,077
Waist circumference ≥ 102 cm men, ≥ 88
cm women
1,363
Not measured
1,227
2.26
1.42
1.56
0.80
3.29
2.49
1,734
1,413
4.08
2.31
2.24
1.15
7.43
4.63
Physical activity (p<0.001 men, p<0.437 women)
Low
2,195
Medium
1,082
High
1,389
1
0.46
0.54
0.30
0.37
0.72
0.77
2,644
1,320
1,145
1
0.78
0.70
0.48
0.38
1.28
1.26
Blood pressure (p=0.002 men, p=0.116 women)
3
Not hypertensive
1,794
4
Hypertensive
1,177
Not measured
1,695
1
2.00
1.46
1.36
0.87
2.95
2.45
2,108
1,179
1,820
1
1.61
1.48
1.02
0.81
2.53
2.70
Index of multiple deprivation (p=0.375 men, p=0.004 women)
Least deprived quintile
1,006
1
Second Quintile
1,064
1.13
Third Quintile
1,023
1.05
Fourth Quintile
868
1.19
Most deprived quintile
706
1.52
0.77
0.71
0.78
0.98
1.66
1.57
1.82
2.35
1,096
1,176
1,131
959
746
1
1.53
1.26
1.72
2.88
0.93
0.76
1.08
1.76
2.51
2.09
2.77
4.69
Bases (weighted)
1
4,666
5,108
1. The analysis is restricted to those aged 35 and over due to the small numbers of people with diabetes aged under 35
2. Includes 14 cases (men), 18 cases (women) where the information was not given
3. Not hypertensive: systolic blood pressure (BP)<140 mmHg , diastolic BP <90 mmHg, and not taking medication to control blood pressure.
4. Hypertensive: Systolic BP ≥140mmHg, diastolic BP ≥90mmHg or on medication for hypertension
Source:
Health Survey for England 2006, The Information Centre
161
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1
2
3
Table 7.8 Finished Consultant Episodes with a primary diagnosis of obesity ,
4
by gender, 1996/97 to 2006/07
England5
6
Males
Numbers
Females
787
781
1,049
1,073
1,170
1,121
1,406
1,856
2,185
2,749
4,068
243
221
298
303
343
314
467
560
636
811
1,117
538
557
749
770
823
802
939
1,296
1,545
1,906
2,943
All
1996/97
1997/98
1998/99
1999/00
2000/01
2001/02
2002/03
2003/04
2004/05
2005/06
2006/07
1. An FCE is defined as a period of admitted patient care under one consultant within one healthcare
provider. Figures do not represent the number of patients or the number of admissions as a person may
have more than one episode of care within a year or more than one episode of care within one visit to
hospital
2. The primary diagnosis is the first of up to 14 (7 prior to 2002/03) diagnosis fields in the Hospital
Episode Statistics (HES) data set and provides the main reason why the patient was in hospital
3. Figures have been determined using ICD-10 code of E66-Obesity- in the primary diagnosis field in a
HES record
4. The data are ungrossed ie the figures have not been adjusted for shortfalls in data. Note that earlier
HES records are sometimes adjusted for shortfalls, however over time there have been ongoing
improvements in quality and coverage in the data collected from the NHS
5. Excludes patients with residence outside England, no fixed abode and residence not known
6. Includes people where gender was not known or not specified
7. The data include private patients in NHS Hospitals (but not private patients in private hospitals)
Source:
Hospital Episode Statistics (HES). The Information Centre
162
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1
2
3
Table 7.9 Finished Consultant Episodes with a primary diagnosis of obesity , by age, 1996/97 to
2006/074
England5
6
Under 16
16-24
25-34
35-44
45-54
55-64
65-74
Numbers
75 and over
787
781
1,049
1,073
1,170
1,121
1,406
1,856
2,185
2,749
4,068
139
152
209
221
226
243
402
579
550
583
657
27
32
40
34
49
41
65
71
110
96
189
139
117
172
189
164
139
151
187
305
357
479
176
194
259
250
284
264
325
422
520
672
1,118
127
139
188
189
237
218
246
294
398
599
915
102
67
101
102
112
116
113
192
208
314
517
44
41
48
58
75
68
70
71
51
102
136
33
39
32
30
21
27
34
40
42
24
57
All ages
1996/97
1997/98
1998/99
1999/00
2000/01
2001/02
2002/03
2003/04
2004/05
2005/06
2006/07
1. An FCE is defined as a period of admitted patient care under one consultant within one healthcare provider. Figures do not
represent the number of patients or the number of admissions as a person may have more than one episode of care within a
year or more than one episode of care within one visit to hospital
2. The primary diagnosis is the first of up to 14 (7 prior to 2002/03) diagnosis fields in the Hospital Episode Statistics (HES) data
set and provides the main reason why the patient was in hospital
3. Figures have been determined using ICD-10 code of E66-Obesity- in the primary diagnosis field in a HES record
4. The data are ungrossed ie the figures have not been adjusted for shortfalls in data. Note that earlier HES records are
sometimes adjusted for shortfalls, however over time there have been ongoing improvements in quality and coverage in the data
collected from the NHS
Source:
163
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1
2
3
Table 7.10 Finished Consultant Episodes with a primary diagnosis of obesity ,
by Government Office Region of residence and gender, 2006/074
England5
6
Male
Numbers
Female
4,068
1,117
2,943
338
345
666
453
425
300
654
406
481
84
144
148
97
112
96
196
96
144
254
201
518
356
306
204
458
310
336
All
England
North East
North West
Yorkshire and The Humber
East Midlands
West Midlands
East of England
London
South East
South West
hospital
2. The primary diagnosis is th first of up to 14 (7 prior to 2002/03) diagnosis fields in the Hospital Episode
Statistics (HES) data set and provides the main reason why the patient was in hospital.
3. Figures have been determined using ICD-10 code of E66-Obesity- in the primary diagnosis field in a
HES record
4. The data are ungrossed ie the figures have not been adjusted for shortfalls in data. Note that earlier
HES records are sometimes adjusted for shortfalls, however over time there have been ongoing
improvements in quality and coverage in the data collected from the NHS
Source:
164
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1
2
3
Table 7.11 Finished Consultant Episodes with a secondary diagnosis of obesity ,
by gender, 1996/97 to 2006/074
England5
6
Male
Numbers
Female
21,257
22,320
23,633
24,480
25,947
27,349
34,701
40,060
49,187
62,708
80,113
7,995
8,597
9,218
9,966
10,322
11,116
14,504
17,036
20,671
26,453
34,189
13,128
13,501
14,400
14,501
15,613
16,226
20,196
23,018
28,514
36,249
45,922
All
1996/97
1997/98
1998/99
1999/00
2000/01
2001/02
2002/03
2003/04
2004/05
2005/06
2006/07
hospital
2. As well as the primary diagnosis, there are up to 13 (6 prior to 2002-03) secondary diagnoses fields in
Hospital Episode Statistics (HES) that show other diagnoses relevant to the episode of care.
3. Figures have been determined using ICD-10 code of E66-Obesity in any of the secondary diagnoses
fields in a HES record
4. The data are ungrossed ie the figures have not been adjusted for shortfalls in data. Note that earlier HES
records are sometimes adjusted for shortfalls, however over time there have been ongoing improvements in
quality and coverage in the data collected from the NHS
Source:
165
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1
2
3
Table 7.12 Finished Consultant Episodes with a secondary diagnosis of obesity , by age, 1996/97 to
4
2006/07
England
1996/97
1997/98
1998/99
1999/00
2000/01
2001/02
2002/03
2003/04
2004/05
2005/06
2006/07
5
All6
Under 16
16-24
25-34
35-44
45-54
55-64
65-74
Numbers
75 and over
21,257
22,320
23,633
24,480
25,947
27,349
34,701
40,060
49,187
62,708
80,113
425
455
468
518
574
642
754
817
989
1,174
1,282
605
535
561
627
657
738
933
1,050
1,502
1,790
2,370
1,916
1,841
1,961
2,037
2,200
2,196
2,415
2,600
3,550
4,461
5,447
2,765
2,852
3,071
3,457
3,718
3,766
4,856
5,302
6,532
8,169
10,501
4,229
4,560
4,707
5,035
5,201
5,509
6,545
7,732
8,819
11,483
14,901
4,575
4,772
5,288
5,258
5,695
6,168
8,279
9,703
11,462
15,176
19,650
4,086
4,430
4,612
4,678
4,954
5,342
7,030
8,350
10,479
13,367
16,781
2,645
2,861
2,951
2,862
2,892
2,966
3,859
4,484
5,837
7,065
9,131
1. An FCE is defined as a period of admitted patient care under one consultant within one healthcare provider. Figures do not
represent the number of patients or the number of admissions as a person may have more than one episode of care within a year or
more than one episode of care within one visit to hospital
2. As well as the primary diagnosis, there are up to 13 (6 prior to 2002-03) secondary diagnoses fields in Hospital Episode Statistics
(HES) that show other diagnoses relevant to the episode of care
3. Figures have been determined using ICD-10 code of E66-Obesity in any of the secondary diagnoses fields in a HES record
4. The data are ungrossed ie the figures have not been adjusted for shortfalls in data. Note that earlier HES records are sometimes
adjusted for shortfalls, however over time there have been ongoing improvements in quality and coverage in the data collected from
the NHS
Source:
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1
2
3
Table 7.13 Finished Consultant Episodes with a secondary diagnosis of obesity ,
by Government Office Region of residence and gender, 2006/074
England5
6
Male
Numbers
Female
England
80,113
34,189
45,922
North East
North West
Yorkshire and The Humber
East Midlands
West Midlands
East of England
London
South East
South West
4,389
14,590
4,881
6,791
9,033
9,966
10,100
10,745
9,618
1,923
6,178
1,913
2,661
3,526
4,237
4,616
4,980
4,155
2,466
8,412
2,968
4,130
5,507
5,729
5,484
5,763
5,463
All
hospital
2. As well as the primary diagnosis, there are up to 13 (6 prior to 2002-03) secondary diagnoses fields in
Hospital Episode Statistics (HES) that show other diagnoses relevant to the episode of care.
3. Figures have been determined using ICD-10 code of E66-Obesity in any of the secondary diagnoses
fields in a HES record
4. The data are ungrossed ie the figures have not been adjusted for shortfalls in data. Note that earlier HES
records are sometimes adjusted for shortfalls, however over time there have been ongoing improvements in
quality and coverage in the data collected from the NHS.
Source:
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1
2
Table 7.14 Finished Consultant Episodes for Bariatric Surgery by gender, 1996/97 to
3
3
2005/06 and 2006/07
England
All
OPCS-4.2 procedure codes
Male
Numbers
Female
2
1996/97
1997/98
1998/99
1999/00
2000/01
2001/02
2002/03
2003/04
2004/05
2005/06
OPCS-4.3 procedure codes
4
121
141
187
193
250
278
334
451
711
997
19
24
38
26
44
37
64
89
129
187
100
117
149
167
206
239
270
362
578
780
1,890
362
1,520
2
2006/07
1. An FCE is defined as a period of admitted patient care under one consultant within one healthcare provider.
Figures do not represent the number of patients or the number of admissions as a person may have more than one
episode of care within a year or more than one episode of care within one visit to hospital
2. All OPCS-4.2 and OPCS-4.3 procedure codes used to define bariatric surgery have a corresponding ICD-10 code
of E66.- Obesity - in the primary diagnosis position to ensure that they are bariatric surgery. All OPCS-4.2 and 4.3
Codes used are described in Appendix B in further detail
3. All OPCS-4.2 and OPCS-4.3 procedure codes used to define bariatric surgery have a corresponding ICD-10 code
of E66 (Obesity) in the primary diagnosis position to ensure that they are bariatric surgery. All OPCS-4.2 and 4.3
Codes used are listed below and described in Appendix B in further detail:
The OPCS-4 procedure codes (1996/97 to 2005/06, and 2006/07) are: G28.1, G28.2, G28.3, G28.8, G28.9, G30.1,
G30.2, G30.8, G30.9, G31.1, G31.2, G31.3, G31.4, G31.8, G31.9, G31.0, G32.1, G32.2, G32.3, G32.8, G32.9,
G32.0, G33.1, G33.2, G33.3, G33.8, G33.9, G33.0, G38.8, G48.1, G48.2
The following additional 4 digit OPCS-4 codes have been added due to the use of OPCS-4.3 in 2006/07 data: G28.4,
G28.5, G30.3, G30.4, G31.5, G31.6, G32.4, G32.5, G33.5, G33.6, G38.7, G71.6
5. The data are ungrossed ie the figures have not been adjusted for shortfalls in data. Note that earlier HES records
are sometimes adjusted for shortfalls, however over time there have been ongoing improvements in quality and
coverage in the data collected from the NHS
6. Figures in 2006 bulletin have been revised due to inclusion of additional coding for bariatric surgery for both OPCS4.2 and OPCS-4.3 codes
Source:
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1
2
Table 7.15 Number of prescription items , net ingredient cost and average net ingredient cost per item of drugs for the
3
treatment of obesity prescribed in Primary Care and dispensed in the community, 1999 to 2007
England4
Thousands / £
2007
5
1999
2000
2001
2002
2003
2004
2005
2006
127
156
415
540
484
492
645
774
415
-
-
53
196
203
208
226
263
147
127
157
469
737
688
699
871
1,060
613
4,863
6,573
17,575
23,401
21,036
21,391
27,020
32,476
17,389
-
-
2,030
7,752
8,458
9,314
10,984
13,654
6,691
4,863
6,613
19,659
31,203
29,532
30,706
38,004
47,541
27,221
38
42
42
43
43
44
42
42
42
-
-
38
39
42
45
49
52
46
38
42
42
42
43
44
44
45
44
Prescription Items (thousands)
Orlistat
Sibutramine
Total6
Net Ingredient Cost (£ 000)
Orlistat
Sibutramine
Total6
Net Ingredient Cost per item (£)
Orlistat
Sibutramine
Total6
1. Prescriptions are written on a prescription form known as a FP10. Each single item written on the form is counted as a prescription item
2. Net Ingredient Cost (NIC) is the basic cost of a drug. It does not take account of discounts, dispensing costs, fees or prescription charge income
3. This information was obtained from the Prescribing Analysis and Cost Tool (PACT) system, which covers prescriptions prescribed by GPs, nurses,
pharmacists and others in England and dispensed in the community in the UK. Prescriptions written in hospitals /clinics that are dispensed in the community,
prescriptions dispensed in hospitals and private prescriptions are not included in PACT data
4. Prescriptions written in England but dispensed outside England are included
5. Data for 2007 is for the period January 2007 - June 2007 and therefore does not reflect a full year's data
6. Includes 'other' drugs that may be used for the treatment of obesity which include Mazindol, Rimonabant, Phentermine and Diethylpropion Hydrochloride.
From 2007 only Rimonabant was also prescribed for the treatment of obesity in primary care
Source:
Prescribing Analyses and Cost (PACT) from the Prescription Pricing Division of the Business Services Authority (PPD of the BSA). The Information Centre
Copyright © 2008, re-used with the permission of the Prescription Pricing Division
169
6
99
112
131
65
184
63
82
86
122
115
1,060
Total
75
76
95
53
135
43
55
65
91
87
774
Orlistat
22
34
33
11
45
20
25
21
28
25
263
2
2
4
1
5
1
2
1
3
3
23
Sibutramine Rimonabant
Prescription Items (thousands)
6
4,326
4,988
6,351
2,857
8,091
2,885
3,776
3,797
5,422
5,037
47,541
Total
3,097
3,127
4,218
2,262
5,546
1,798
2,323
2,704
3,785
3,607
32,476
Orlistat
1,117
1,736
1,856
552
2,260
1,019
1,325
1,053
1,455
1,278
13,654
Thousands / £
6
44
45
48
44
44
46
46
44
45
44
45
Total
41
41
45
43
41
42
42
42
42
41
42
Orlistat
51
51
57
50
50
52
53
51
52
50
52
Copyright © 2008. Re-used with the permission of the Prescription Pricing Division
Source:
Prescribing Analyses and Cost (PACT) from the Prescription Pricing Division of the Business Services Authority (PPD of the BSA). The Information Centre
60
61
68
60
60
61
61
58
61
60
62
Average Net Ingredient Cost per item (£)
3. This information was obtained from the Prescribing Analysis and Cost Tool (PACT) system, which covers prescriptions prescribed by GPs, nurses, pharmacists and others in England and dispensed in the
community in the UK. Prescriptions written in hospitals /clinics that are dispensed in the community, prescriptions dispensed in hospitals and private prescriptions are not included in PACT data
4. For data at SHA level, prescriptions written by a prescriber located in a particular SHA but dispensed outside that SHA will be included in the SHA in which the prescriber is based
5. Prescriptions written in England but dispensed outside England are included
6. The 'Total' column includes 'other' drugs used for the treatment of obesity which include Mazindol, Phentermine and Diethylpropion Hydrochloride
7. Including unidentified Doctors (not possible for the Prescription Pricing Division of the Business Service Authority to allocate to a SHA)
111
125
277
43
285
68
128
41
183
152
1,411
Net Ingredient Cost (£ 000)
1. Prescriptions are written on a prescription form known as a FP10. Each single item written on the form is counted as a prescription item
2. Net Ingredient Cost (NIC) is the basic cost of a drug. It does not take account of discounts, dispensing costs, fees or prescription charges income
East Midlands
East of England
London
North East
North West
South Central
South East Coast
South West
West Midlands
Yorkshire and the Humber
England5,7
England5
Table 7.16 Number of prescription items1, net ingredient cost2 and average net ingredient cost per item of drugs for the treatment of obesity prescribed in Primary
Care3 and dispensed in the community, by Strategic Health Authority4 2006
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170
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Table 7.17 Prevalence of obesity using the Quality Outcomes Framework
by Strategic Health Authority, 2006/071
Percentages
England
England
2,3
9.1
North East
North West
Yorkshire and the Humber
East Midlands
West Midlands
East of England
London
South East Coast
South Central
South West
10.6
9.5
9.8
9.7
10.2
8.8
8.0
8.2
8.2
8.6
1. 2006/07 data as at end of June 2007
2. Registers for obesity are for patients aged 16 and over with a BMI greater than or equal to 30
in the previous 15 months
3. Adjusted prevalence rates show these registers as a percentage of the estimated practice list
size (for adults aged 16 or over)
4. For further information on the Quality Outcomes Framework (QOF) data see Appendix A
Source:
QMAS database - 2006/07 data as at end of June 2007
Copyright © 2008 The Information Centre, Prescribing Support Unit. All rights reserved.
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Appendix A: Key sources
Active People Survey
Eurostat
Expenditure and Food Survey
Forecasting Obesity to 2010
Foresight Tackling Obesities: Future Choices – Project report
Health Select Committee Report
Health Survey for England
Hospital Episode Statistics
Low Income Diet and Nutrition Survey
National Diet and Nutrition Survey
National Travel Survey
Prescription Pricing Division
Quality Outcomes Framework
School Meals Research Project
School Sport Survey
Scottish Health Survey
Tackling obesity in England
Taking Part Survey
Welsh Health Survey
Active People Survey
The Active People Survey (APS) is the largest ever survey of sport and active recreation to be
undertaken in Europe. It is a telephone survey of 363,724 adults in England (aged 16 and
over) and provides statistics on participation in sport and active recreation for all 354 Local
Authorities (LA) in England (a minimum of 1,000 interviews were completed in every LA in
England). The APS, conducted by Ipsos MORI on behalf of Sport England, started on the 15th
October 2005 and was completed on 16th October 2006. The sample was evenly divided over
each month and spread across the whole year for each LA to ensure the results are not biased
by variations associated with different seasons.
The primary objective of the APS is to measure levels of participation in sport and active
recreation and its contribution to improving the health of the nation. Sport and active recreation
includes walking and cycling for recreation in addition to more traditional formal and informal
sports. When measuring sports participation the survey were concerned with not only the type
of activity but also the frequency, intensity and duration.
Data from the APS is described in Chapter 4 (Physical activity among adults).
The Active People Survey 2005/06. Available at:
http://www.sportengland.org/index/get_resources/research/active_people.htm
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The survey was designed to measure the activity and fitness levels of the adult population
(aged 16 and over) in England. A representative sample of 6,000 adults was selected at
random throughout the country. The fieldwork was carried out between February and
November 1990. A total of 4,316 people completed the home interview stage - a response
rate of 75%. Seventy per cent of those interviewed took part in a physical appraisal with 62%
attending for tests at a specially equipped mobile laboratory and 8%, primarily the elderly and
inform, being tested on a recurred set of measurements in their homes.
Many aspects of behaviour, attitudes and beliefs were measured in the home interview. These
included:
•
•
•
•
•
•
•
Levels of participation in sport and active recreation, current and past, including access to
facilities and barriers to participation;
Physical activity at work, in housework, DIY and gardening and in moving about, that is
walking, cycling and stair-climbing;
Other lifestyle and health-related behaviour, including smoking, alcohol and dietary habits;
Current health status and history of illness;
Sports-related injuries;
Knowledge about exercise and attitudes towards physical activity, fitness and health;
Psychological variables including well-being, social support, stress and anxiety.
Information on the National Fitness Survey can be found in Chapter 4 (Physical activity among
adults).
Allied Dunbar National Fitness Survey. Available at:
http://www.data-archive.ac.uk/findingData/snDescription.asp?sn=3303
Eurostat
Data presented on BMI by European Union (EU) countries, collected by Eurostat uses Health
Interview Surveys (HIS). The HIS data are collected in different years depending on the
country, ranging from 1996 to 2003. There is no fixed periodicity in these kinds of health
surveys. Very few countries have a yearly survey on these topics, therefore data presented in
Table 2.17, Chapter 2 (Obesity among adults) should be treated with some caution. Data are
disseminated simultaneously to all interested parties through a database update and on
Eurostat's website.
There are other sources available which present international figures on BMI. A source of such
data is the World Health Organisation (WHO). The source of BMI from WHO varies from
country to country. The prevalence of obesity among EU countries is broadly similar between
Eurostat and WHO.
Data from Eurostat are presented in Chapter 2 (Obesity among adults).
Eurostat. Available at:
epp.eurostat.ec.europa.eu/portal/page?_pageid=0,1136184,0_45572595&_dad=portal&_sche
ma=PORTAL
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Expenditure and Food Survey
The Expenditure and Food Survey (EFS) was created in 2001 to replace the National Food
Survey (NFS) and the Family Expenditure Survey (FES). The EFS provides data on spending
and food purchases since the 1950s. In 2005/06 the EFS collected diaries of 16,085 people
from 6,785 households across the United Kingdom. Each household member over the age of
seven kept a diary of all their expenditure and quantities of purchased food and drink over a
two week period.
Historical estimates of household purchases between 1974 and 2000 have been adjusted to
align with the level of estimates from the FES in 2000. Whilst estimates of household
consumption from the NFS have been adjusted a break in the series between 2000 and 2001
remains and should be borne in mind when interpreting reported changes before and after this
period.
The aligned estimates are generally higher than the original ones and indicate that the scaling
has partially corrected for under-reporting in the NFS. Under-reporting may be lower in the
EFS because it does not focus on consumption but on expenditure across the board and is
largely based on till receipts.
Reliable estimates on food and drink eaten out from the EFS start in 2001/02, less reliable
estimates are available from the NFS going back to 1994.
EFS is the data source for two publications, Family Food, published by the Department for
Environment, Food and Rural Affairs and Family Spending, published by the Office for National
Statistics.
Chapter 6 (Diet) of this report reports on data published in Family Food. Throughout the
chapter figures used prior to 2001/02 are adjusted NSF estimates. The adjustments brought
the results of the NFS into line with the EFS, and tended to increase estimates of food and
drink purchases. The largest adjustments were for confectionery, alcoholic drinks, beverages
and sugar and preserves. Adjustments for eggs and carcase meat resulted in reduced NFS
estimates. Details of the adjustments to the NFS estimates can be found in Family Food
2002/03.
In 2005/06 significant revisions were made affecting estimates from 2001/02 to 2004/05. The
revisions introduce estimates of free food into both eating out and household food and quantity
and nutrient content for a range of unspecified food purchases which are estimated based on
averages of other food purchases recorded in the survey. Examples of free food estimates
now included in the survey are meals on wheels, free welfare milk in the home, free milk, fruit
and vegetables provided by schools, free meals provided by schools and employers, food
purchased for business that is paid for by employer and buffet meals where items are not
specified (such as Indian, Chinese, salad bar etc). In light of these revisions results reported in
Chapter 6 (Diet) of this report from 2001/02 to 2004/05 may differ from those reported in the
previous report: Statistics on Obesity, Physical Activity and Diet: England 2006.
As this survey collects information on purchases, consumption is approximated using a
wastage estimate. Purchases may differ from actual food consumption for a number of
reasons e.g. food may be discarded during preparation, food maybe left on the plate at the end
of a meal or food may become inedible before it can be consumed and is thrown away. When
average intakes are compared with reference nutrient intakes, a figure of 10% is used for
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wastage on all types of food and drink. Trends in energy and nutrient content of the purchases
are based on a database of nutrient profiles for different types of food which are kept up to
date by the Food Standards Agency.
Data from the EFS can be found in Chapter 6 (Diet).
Expenditure and Food Survey. Available at
http://www.esds.ac.uk/government/efs/
Family Food. Available at:
http://statistics.defra.gov.uk/esg/publications/efs/default.asp
Family Spending. Available at:
http://www.statistics.gov.uk/StatBase/Product.asp?vlnk=361
Forecasting Obesity to 2010
The Department of Health published the ‘Forecasting Obesity to 2010’ report in 2006. The
focus of this report is to forecast what levels of obesity in England may be in 2010 if current
trends in obesity prevalence continue unchanged. The report is split into three main sections.
Section 2 looks at the current picture of overweight and obesity prevalence among children
and adults, using data from the Health Survey for England 2003. The results present both the
prevalence of obesity among the population and also the estimated number of people within
the population who are obese. Section 3 uses trend data from HSE to project discernible
trends forward to 2010 and analyses these in relation to mid-year population estimates for
2010 to forecast the number and proportion of the population predicted to be obese and
overweight. Section 4 looks at the estimated number and proportion of adults and children who
may be obese in 2010 within different socio-demographic groups.
Data used from this report are presented in Chapter 2 (Obesity among adults) and 3 (Obesity
among children).
Forecasting Obesity to 2010. Department of Health, 2006. Available at:
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsStatistics/DH_4138
630
Foresight Tackling Obesities: Future Choices – Project report
One of the Foresight programmes based in the Government Office for Science. The report
considers how society might deliver a sustainable response to obesity in the UK over the next
40 years. One objective of the project was to analyse how future levels of obesity might
change and to identify the most effective future responses. The report presents key messages
and implications for the UK. These are based on an extensive analysis of a wide range of
evidence, including several commissioned evidence reviews, a systems analysis of the primary
determinants of obesity, scenarios of possible futures and a quantative model of future trends
in obesity and associated diseases.
To achieve this aim Foresight commissioned a model which utilises the dataset of the Health
Survey for England from 1994 to 2004 and employs extrapolation and microsimulation
techniques to predict the distribution of people across various BMI categories, to 2050. The
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report also models current and future costs of obesity and obesity related diseases to the NHS.
Foresight used the 2002 Health Select Committee’s findings and uses £1 billion as the
baseline for obesity attributable healthcare costs in the modeling exercise. The model used
forecasted costs solely on the basis of anticipated additional morbidity arising from the
increasing prevalence of obesity. Factors other than BMI, including costs of disease were fixed
at current levels.
Data used from this report are presented in Chapters 2, 3 and 7 (Obesity among adults, and
children, and health outcomes).
Foresight Tackling Obesities: Future Choices – Project Report. Government Office for Science,
2007 Available at:
http://www.foresight.gov.uk/Obesity/obesity_final/17.pdf
Health Select Committee Report
The Health Select Committee report was published by the House of Commons, in May 2004. It
looks at the health implications, trends, causes and what can be done to tackle obesity. The
report also looks at the institutional structures needed to deliver such improvements.
Information from this report can be found in Chapter 7 (Health Outcomes).
http://www.publications.parliament.uk/pa/cm200304/cmselect/cmhealth/23/23.pdf
The Health Survey for England (HSE) is an annual survey, monitoring the health of the
population which is currently commissioned by the Information Centre (the IC), and before
April 2005 was commissioned by the Department of Health. The HSE has been designed and
carried out since 1994 by the Joint Health Surveys Unit of the National Centre for Social
Research (NatCen) and the Department of Epidemiology and Public Health at the Royal Free
and University College Medical School (UCL). All surveys have covered the adult population
aged 16 and over living in private households in England. Since 1995, the surveys have also
covered children aged two to 15 living in households selected for the survey, and since 2001
infants aged under two have been included as well as older children. Trend tables are also
published each year updating key trends on a number of health areas.
Each survey in the series includes core questions and measurements such as blood pressure,
anthropometric measurements and analysis of saliva and urine samples, as well as modules of
questions on specific issues that vary from year to year. In recent years, the core sample has
also been augmented by an additional boosted sample from a specific population subgroup,
such as minority ethnic groups, older people or, as in 2006, children.
This statistical report mainly uses data from HSE 2006, except for where updates to data are
unavailable. The primary focus of the 2006 HSE report was cardiovascular disease and
associated risk factors such as high blood pressure, diabetes and obesity. The report
investigated associated lifestyle factors such as physical activity, diet, smoking and drinking,
and also focused on inequalities. The secondary focus of the HSE 2006 is childhood obesity
and other health risk factors for children, including diet, physical activity and smoking.
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In 1999, the survey concentrated on the health of adults in six minority ethnic groups: Black
Caribbean, Indian, Pakistani, Bangladeshi, Chinese and Irish. In 2004, the survey once again
investigated the health of minority ethnic groups; the category of Black African was added to
the six groups in the 1999 survey. Some information from the HSE 2004 is included in
Chapter 2 and 4 (Obesity among adults and physical activity amongst adults).
This report contains data and information from different HSE years. This is to provide the most
current information for the general population that was available at the time of publishing.
Where possible, data has been used from the HSE 2006, however there are some restrictions
to this. For further details of the HSE data used please see Appendix B (Technical notes).
Non-response weighting was introduced to the HSE in 2003, and has been used in all
subsequent years. All 2006 data in the HSE 2006 are weighted. Both weighted and
unweighted bases are given in each table. The unweighted bases show the number of
participants involved. The weighted bases show the relative sizes of the various sample
elements after weighting, reflecting their proportions in the English population, so that data
from different columns can be combined in their correct proportions. The absolute size of the
weighted bases has no particular significance, since they have been scaled to the achieved
sample size.
Since 1995, children’s data each year have been weighted to adjust for the probability of
selection, since a maximum of two children are selected in each household. This ensures that
children from larger households are not under-represented. Since 2003, non-response
weighting has also been applied in addition to selection weighting.
Trend tables in this publication present figures from 2003 onwards (the first year where nonresponse weighting was applied) with and without non-response weighting. Data are shown in
two rows or columns, one showing unweighted results and the other weighted results. For
tables showing trends in children’s data, results for years up to 2002 are based on selection
weighting only, and results for 2003 to 2006 are based on selection and non-response
weighting. A full discussion of the effects of non-response weighting can be found in the 2003
HSE report, Volume 3, Methodology and Documentation. In the commentary in this report,
where comparisons are made between 2006 figures and earlier years, weighted figures for
2006 are referred to since these are considered the most accurate estimate of prevalence. As
weighted figures are not available for years before 2003, it is not possible to use weighted
figures for earlier years and so the comparison is made with unweighted figures.
Data from the HSE are used in Chapters 2, 3, 4, 5, 6 and 7.
Health Survey for England 2006: cardiovascular disease (CVD) and risk factors adults, obesity
and risk factors children. Available at:
Main report:
www.ic.nhs.uk/pubs/HSE06CVDandriskfactors
Trend tables:
www.ic.nhs.uk/pubs/HSE06trends
Health Survey for England 2004: Health of Ethnic Minorities. Available at:
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Health Survey for England 2003: Risk factors adults for cardiovascular disease (CVD)
Available at:
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsStatistics/DH_4098
712
Hospital Episode Statistics
NHS hospital Finished Consultant Episodes (FCEs) in England have been recorded using
Hospital Episode Statistics (HES) since April 1987. HES aims to collect a detailed record for
each 'episode' of admitted patient care delivered in England by NHS hospitals or delivered in
the independent sector but commissioned by the NHS. HES data is presented in financial
years, from April to March.
A Finished Consultant Episodes (FCE) is a period of care under one consultant and patients
may experience more than one FCE in a single hospital admission. The figures do not
represent the number of patients, as a person may have more than one episode of care within
the year or more than one episode of care within a visit to hospital.
Data from HES used in the report, Tables 7.8 to 7.10, show FCEs with a primary diagnosis and
Tables 7.11 to 7.13 show FCEs with a secondary diagnosis of obesity. Within HES, diagnoses
are recorded using International Classification of Diseases (ICD) codes. From the financial
year beginning April 1995 onwards these were classified using the tenth revision of ICD (ICD10). Details of ICD-10 codes used are included in Tables 7.8 to 7.13. The primary diagnosis is
defined as the main condition treated or investigated during the relevant episode of healthcare.
HES data used in table 7.14 show the number of FCEs for bariatric surgery. These are
identified using a primary diagnosis of obesity and a main procedure code for bariatric surgery.
Within HES, procedures and interventions are recorded using the Office of Population,
Censuses and Surveys: Classification of Interventions and Procedures, 4th Revision (OPCS4)
codes. OPCS 4.2 were used to identify bariatric surgery procedure codes between the years
1996/97 to 2005/06 and OPCS 4.3 codes were used for 2006/07. Details of the OPCS4 codes
used are included in Table 7.14 and in Appendix B. The main procedure is usually the most
resource intensive procedure performed during the episode.
HES data are shown in Chapter 7 (Health outcomes).
Low Income Diet and Nutrition Survey
As the National Diet and Nutrition Survey (also described in this appendix) provided evidence
to suggest that differences in food consumption exist between lower and higher socioeconomic
groups, the Low Income Diet and Nutrition Survey (LIDNS) was conducted between 2003 and
2005 focusing specifically on people from the low income population in the United Kingdom.
This survey provides a comprehensive picture of food consumption and nutritional status of a
nationally representative sample living in low income and materially deprived households. It
also assessed numerous socio-economic, environmental, behavioural and attitudinal factors,
and lifestyle and health characteristics which relate to food consumption, nutritional status and
nutrition-related health. The purpose of the survey was to provide an evidence base that
would contribute to the development of food policy, which in turn would help to reduce health
inequalities.
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Screening questionnaire
A score-based screening questionnaire was devised specifically for LIDNS to provide a useful
and discriminating measure of low income and material deprivation. This included a series of
questions on use of cars/vans, receipt of incapacity benefit, income support or job seekers
allowance, housing and council tax benefits and then further questions on weekly net income
for those who have a borderline score.
Dietary Interview
From all households that were screened in as eligible for the survey, two respondents were
randomly selected to take part, either one adult (aged 19 and over) and one child (aged 2-18)
or two adults (in households with no children). Both respondents as well as the household’s
main food provider (if they were not one of the selected respondents) had an extensive faceto-face computer assisted personal interview. Information about the 24 hour dietary recall
process was then given and the first 24h recall was completed.
Repeat 24 hour dietary recall
An interviewer visited the household on a total of four randomly selected non-consecutive days
(including where possible a weekend day) over a ten day period to conduct the 24 hour dietary
recall interviews. The 24 hour recall method used was the ‘triple pass’ method, which gives
respondents three opportunities to think through what they ate and drank over the previous 24
hour period.
Respondent’s height and weight measurements were recorded during the second visit.
Nurse visit
All individuals completing three or four dietary recalls were eligible for the second part of the
survey, which consisted of a visit from a qualified nurse. The nurse collected details of any
prescribed medications and non-prescribed dietary supplements and took further
measurements, including blood pressure, waist and hip measurements and where consented
to, a blood sample.
Data from the LIDNS can be found in Chapter 6 (Diet)
Low Income Diet and Nutrition Survey. Available at:
http://www.food.gov.uk/science/dietarysurveys/lidnsbranch/
National Diet and Nutrition Survey (NDNS)
The National Diet and Nutrition Survey (NDNS) programme aims to provide a comprehensive
picture of the dietary habits and nutritional status of the population of the Britain. In its original
form the NDNS was a series of cross-sectional surveys covering the whole population from
age 1½ years upwards, split into four different population age groups. : children aged 1½ to 4½
years (fieldwork 1992/93), young people aged 4 to 18 years (1997), adults aged 19 to 64 years
(2000/01) and people 65 years and over (1994/95).
Following a review of the Food Standards Agency’s dietary survey programme in 2002/03 the
NDNS is now moving to a rolling programme in which the survey will run continuously with
fieldwork every year, starting in 2008, covering a UK representative sample of both adults and
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children. This will strengthen the ability to track changes over time and give flexibility to
respond more rapidly to changing data requirements
Data from the NDNS are essential for underpinning a wide range of the Food Standards
Agency’s work to protect consumer safety and promote healthy diets. The survey provides
detailed data on foods consumed by individuals and nutrient intakes with additional information
on nutritional status (derived from analysis of blood samples), physical measurements and
lifestyle habits such as smoking, drinking and physical activity.
The components of the survey
The survey includes various components (described below) in order to obtain the wide range
of information required. Respondents may choose to participate in some components but not
in others. The components of the most recent NDNS of adults aged 19-64 years are described
below.
Dietary interview
Initially a face-to-face dietary interview was carried out with the household member selected to
take part in the survey (the respondent), to provide information about their eating and drinking
habits, their socio-demographic circumstances (e.g. age and marital status) and the sociodemographic circumstances of their household (e.g. benefit status).
Seven-day weighed intake dietary record
Respondents were also invited to complete a dietary record for seven days. This involved
weighing and recording all food and drink consumed both at home and away from home,
including medicines taken by mouth and drinks of water. The dietary record collected detailed
information in order to look at the range of food consumption and nutrient intake within the
population. Food and nutrient intake data could also be related to physical activity and various
nutritional status and health measures.
Other components
These included a 24-hour urine collection (used to estimate salt intake); physical
measurements (BMI, blood pressure and waist and hip circumferences); a seven-day physical
activity record (to allow an investigation of the relationships between dietary intakes, body
composition and physical activity levels); and a blood sample (which was analysed for a range
of nutritional status indicators which reflect the levels of certain nutrients available for use in
the body).
The information from the dietary record was linked to a nutrient databank and nutrient intakes
were calculated from the quantities of foods consumed. No attempt has been made to adjust
the nutrient intakes presented here to take account of underreporting.
Data from the NDNS can be found in Chapter 6 (Diet).
National Diet and Nutrition Survey. Available at:
http://www.food.gov.uk/science/dietarysurveys/ndnsdocuments/
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Issues associated with reporting food consumption in dietary surveys
Miss reporting of food consumption in dietary surveys, generally under-reporting, is known to
be a problem in dietary surveys worldwide. Under-reporting can cause biased low estimates of
intake as respondent’s under-report their actual intake or modify their diet during the recording
period. The level of under-reporting needs to be borne in mind when interpreting findings from
dietary surveys, for example in comparing intakes with recommendations. Analysis of data
from the NDNS adults 2000/01 indicated that energy intake could be under-reported by about
25%. It is not possible to ascertain whether under-reporting was higher in this survey than in
the 1986/87 survey because there was no assessment of physical activity or energy
expenditure in the earlier survey. Doubly labelled water studies suggest similar levels of underreporting for other age groups except for pre-school children where levels were lower. There is
evidence that under-reporting is selective – fatty, sugary and snack foods and alcohol are
more likely to be under-reported than are other foods such as fruit and vegetables. However
the level of under-reporting for specific macro and micronutrients is not known.
National Travel Survey
The National Travel Survey (NTS) is a survey on personal travel. It provides the Department
for Transport, Local Government and the Regions (DTLR) with data to answer a variety of
policy and transport research questions. The 2006 NTS is the latest in a series of household
surveys designed to provide a databank of personal travel information for Great Britain. It is
part of a continuous survey that began in July 1988, following ad hoc surveys since the mid1960s. The survey is designed to identify long-term trends and is not suitable for monitoring
short-term trends.
NTS respondents keep a travel diary of their trips within Great Britain over a seven day period.
Travel details provided by respondents include trip purpose, method of travel, time of day and
trip length. The households also provided personal information, such as their age, gender,
working status and driving licence holding, and details of the cars available for their use. In
order to minimise the burden of completing the diaries respondents include walks of under one
mile on the seventh day only, but all tables in this publication include data on short walks (over
50 yards) grossed up for the full seven day period.
Data from NTS are used in Chapter 4 and 5 (Physical activity among adults and children).
The National Travel Survey 2006. Available at:
http://www.dft.gov.uk/pgr/statistics/datatablespublications/personal/mainresults/nts2006/
Prescription Pricing Division
Prescription statistics in this report are for calendar years. All prescription statistics in this
report are based on information systems at the NHS Business Services Authority Prescription
Pricing Division (NHSBSA (PPD)). The system used is the Prescription Cost Analysis (PCA).
This system is based on an analysis of all prescriptions dispensed in the community, i.e. by
community pharmacists and appliance contractors, dispensing doctors, and prescriptions
submitted by doctors for items personally administered.
Data from the Prescription Pricing Division can be found in Chapter 7 (Health outcomes).
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Quality Outcomes Framework
The Quality and Outcomes Framework (QOF) was introduced as part of the new General
Medical Services (GMS) contract on 1 April 2004. It is a voluntary annual reward and incentive
programme for all GP surgeries in England, detailing practice achievement results. The QOF
contains four main components, known as domains. Each domain consists of a set of
measures of achievement, known as indicators, against which practices score points according
to their level of achievement
QOF is measured by QMAS, a national IT system developed by NHS Connecting for Health
(CfH). It is not a comprehensive source of data on quality of care in general practice, but it is
potentially a rich and valuable source of such information, providing the limitations of the data
are acknowledged. The Prescribing Support Unit (PSU), part of the Information Centre, works
on behalf of the Department of Health and in collaboration with CfH to obtain extracts from
QMAS to support the publication of QOF information.
The sum of the practice list sizes for the 8,372 practices included in the 2006/07 QOF
publication is 53,681,098. This represents 99.8% of registered patients in England (based on
registration data from the ePACT system of the Prescription Pricing Division of the NHS
Business Service Authority, January to March 2007).
QMAS captures the number of patients on the clinical register for each practice. The number of
patients on the clinical registers can be used to calculate measures of disease prevalence
expressing the number of patients on each register as a percentage of the number of patients
on each practice lists. In 2006/07, QOF began a clinical register on obesity which is based on
patients aged 16 and over with a BMI greater than or equal to 30 in the previous 15 months
Practice list data is available for patients aged 15 and over, to account for this difference
between age ranges between the obesity register and practice list an adjusted practice list
number is estimated for those aged 16 and over which is then used to determine adjusted
prevalence rates which are quoted within this report.
Data from the QMAS database can be found in Chapter 7 (Health outcomes).
Quality and Outcomes Framework Information. Available at:
http://www.ic.nhs.uk/our-services/improving-patient-care/the-quality-and-outcomes-frameworkqof-2006/07/qof-2006-07-data-tables
School Meals Research Project
In 2001 National Nutritional Standards were reintroduced to set out the frequency with which
school caterers must provide items from the main food groups. The Department for Education
and Skills (DfES) and the Food Standards Agency (FSA) commissioned a survey in 2003 to
assess compliance with the standards and to measure food consumption in school among
secondary school pupils. The survey was conducted in nationally representative sample of 79
secondary schools across England providing information about catering practise and food
provisions at lunchtime and information about the food selections and nutrient intake of 5,695
secondary school pupils aged 11 to 18.
Data from the School Meals Research Project report can be found in Chapter 6 (Diet).
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School Meals in Secondary Schools in England. Available at:
http://www.food.gov.uk/science/dietarysurveys/schoolmealsresearch
School Sport Survey
The Department for Children, Schools and Families (DCSF) commissioned Target Nutrient
Specifications (TNS), an independent research company, to conduct the fourth annual survey
of school sport in England covering the academic year 2006/07. The survey aimed to collect
information about levels of participation in physical education (PE) and school sport in
partnership schools. In total, 21,745 schools within school sport partnerships took part in the
survey between May 2007 and July 2007. The 2006/07 survey reported on what over 6 million
school children are doing in terms of physical activity. The survey is the largest of its kind in
Europe.
School sports partnerships bring primary, special and secondary schools together in a network
benefiting from extra staff and funding to increase sports opportunities for pupils. At the time of
the 2006/07 survey 86 per cent of pupils in schools within the School Sport Partnership
programme participated in at least two hours of high quality PE and out of hour’s school sport
in a typical week. This compared to 80 per cent in 2005/06, 62 per cent in 2003/04 and the
estimated position of 25 per cent in 2002.
Data from the School Sport Survey can be found in Chapter 5 (Physical activity among
children).
The 2006/07 School Sport Survey. Available at:
https://dservuk.tns-global.com/schoolsports2007/DownloadableDocuments/200607%20School%20Sport%20Survey%20Report.pdf
Scottish Health Survey
The Scottish Health Survey provides information on the health and health-related behaviours
of people living in private households in Scotland. Among the Surveys’ aims are to estimate
the prevalence of a range of health conditions and to monitor progress towards Scottish health
and dietary targets. The 2003 survey is the third in a series which began in 1995 with a survey
of adults aged 16 to 64. The 1998 survey also included children aged 2 to15 and adults aged
65 to 74 for the first time. The 2003 survey did not have any age limits and included children
from 0 upwards and adults aged 16 and over. All three surveys were commissioned by what is
now the Scottish Executive Health Department.
Data from the 2003 Scottish Health Survey is included in Chapters 2, 3, 4 & 5 and are
compared with results for England using the HSE.
The Scottish Health Survey 2003. Available at:
http://www.scotland.gov.uk/Resource/Doc/76169/0019729.pdf
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Tackling obesity in England
In 2001, the National Audit Office (NAO) produced this report which among other subjects,
estimated the cost of treating obesity. Costs of obesity were estimated by taking a prevalencebased, cost of illness approach based on extensive literature review and using published data.
The cost of treating obesity covers the costs of GP consultations related to obesity, hospital
admissions and outpatient attendances and drugs prescribed to help obese patients lose
weight. The most recent published data on incidence of these events in England was multiplied
by unit costs to calculate a total cost. Prescription costs for obesity were taken from
Prescription Cost Analyses reports for England.
The cost of treating the consequences of obesity covered the cost of treating diseases such as
coronary heart disease which can be directly attributed to obesity. The cost of treating these
diseases was estimated by calculating the relevant population risk proportion. A systematic
review of literature was undertaken to establish for each disease, the best data available on
the proportion of that disease in the population that was attributable to obesity. This proportion
was defined by the relative risk of developing the associated diseases for individuals with
obesity compared to the risk for non-obese individuals.
To establish the cost of treating associated diseases in 1998, data on GP consultation rates,
hospital inpatient admissions and hospital outpatient attendances were obtained. These were
multiplied by unit costs to derive an estimate of the NHS treatment costs for each disease.
Prescription costs were taken from Prescription Cost Analyses reports for England. These cost
estimates were then applied to the data on relative risk and age and sex specific prevalence of
obesity from the HSE to give an estimate of the cost of treating the consequences of obesity.
It is recognised that the direct costs of treating obesity, estimated as £9.5 million in 1998 is
probably an under-estimate because the main component of this cost, GP consultations, was
based on data from 1991-92 since which obesity prevalence has increased, and no data were
available for consultations with practice nurses and dieticians in primary care.
Also, the costs of treating the consequences of obesity is likely to be under-estimated. There
are a number of potentially important diseases that were excluded from the analyses because
of the lack of data to allow an estimate of the proportion of treatment costs that could be
attributed to obesity, for example, depression, hyper-lipidemia and back pain, because no
studies were identified in the review that reported the relative risk for obese individuals of
developing these conditions. Other limitations of the study are the differing definition of obesity
in some of the studies (although no bias was determined), the application of the international
studies to the UK population and the cost to other public organisations is not covered e.g.
costs to social services.
Information from Tackling Obesity in England can be found in Chapter 7 (Health Outcomes).
Tackling Obesity in England. Available at:
http://www.nao.org.uk/publications/nao_reports/00-01/0001220.pdf
Taking Part Survey
The Taking Part Survey (TPS) was commissioned by the Department for Culture, Media and
Sport (DCMS) working in partnership with several of its non-departmental public bodies. The
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survey collects data about engagement and non-engagement in culture, leisure and sport. This
information helps the DCMS and its partner bodies to better understand those who do, and do
not, engage with its sectors.
The DCMS's current Public Service Agreements (PSAs) have a significant focus on increasing
participation in Arts, Sport, Museums and Heritage, particularly by a range of ‘priority groups’.
The TPS has now become the mechanism for monitoring progress against several of these
targets.
Since mid-July 2005, BMRB Social Research has been conducting continuous face to face
interviews with adults aged 16 or over living in private households in England
The TPS releases quarterly results to monitor performance against the PSA targets in addition
to a more comprehensive annual report. Data from the 2005/06 Annual report and the latest
progress report currently available have been used in this publication.
Data from the Taking Part Survey are used in Chapter 4 (Physical activity among adults).
The Taking Part Survey. Available at:
Main report:
http://www.culture.gov.uk/Reference_library/Publications/archive_2007/tps_annualreport0506.
htm
Progress report on PSA3: Final estimates from year two:
http://www.culture.gov.uk/NR/rdonlyres/13C1A6B7-9F63-45BB-A734211FE9A97953/0/ProgressreportonPSA3Finalestimatesfromyeartwo.pdf
Welsh Health Survey 2005/06
The Welsh Health Survey is a source of information about the health of people living in Wales,
the way they use health services, and the things that can affect their health and is produced by
the Welsh Assembly Government. This survey replaced two previous surveys: the former
Welsh Health Survey (undertaken in 1995 and 1998) and the former Health in Wales Survey
(undertaken every two to three years between 1985 and 1996). Results from this survey are
not comparable with those from the previous surveys because of differences in the
questionnaires and the way the survey is designed and conducted. One addition to the survey
is the collection of some limited information on children’s health. More detailed information for
children is collected from 2007 onwards.
The Welsh Health Survey 2005/06 Available at:
http://new.wales.gov.uk/topics/statistics/publications/health-survey200506/?lang=en
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Appendix B: Technical notes
Overweight and obesity
Adults BMI
Children - UK National BMI percentile classification
Children - International Obesity Task Force (IOTF)
NICE guidance
Physical activity among adults
Activity types, frequency, duration, and intensity
Summary activity levels
English, Scottish and Welsh comparisons among adults
Physical activity among children
Active sport
Diet and nutrition
Fruit and vegetable portions
Estimated Average Requirements and Reference Nutrient Intakes
Age standardisation
Use of HSE data from different years
Blood pressure
Weighted HSE data used in Chapter 7: Health Outcomes
General Health Questionnaire
Hospital Episode Statistics: coding for bariatric surgery
Overweight and obesity
Adults BMI
Overweight and obesity among adults is measured in the HSE using Body Mass Index (BMI).
The mean BMI is calculated by dividing weight in kilograms, by the square of the height
squared in metres (kg/m2).
BMI =
Weight (kg )
Height 2 (m 2 )
Adults are classified into the following BMI groups:
BMI range (kg/m2)
Under 18.5
18.5 to less than 25
25 to less than 30
Definition
Underweight
Normal
Overweight
30 and over
Obese
40 and over
Morbidly obese
25 and over
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Children
UK National BMI percentile classification
Due to differences in growth rates among boys and girls at each age, it is not possible to apply
a universal formula in calculating obesity and overweight in children. Each sex and age group
therefore needs its own level of classification for obesity. The UK National BMI percentile
classification is therefore used which gives a BMI threshold for each age above which a child is
considered overweight or obese. Those children whose BMI is above the 85th percentile are
classified as overweight and those children whose BMI is above the 95th percentile are
classified as obese, compared to 1990 BMI UK reference data. The percentiles are given for
each sex and age. According to this method, 15% and 5% of children in 1990 had a BMI
above this level and were thus classified as overweight/obese. Increases over 15% and 5% in
the proportion of children who exceed the reference 85th/95th percentiles over time indicate an
upward trend in the prevalence of overweight and obesity. Unless otherwise specified figures
relating to the prevalence of childhood obesity in this report are determined by this method.
International Obesity Task Force (IOTF)
This is an alternative method of determining childhood obesity. It is based on BMI reference
data from six different countries around the world (over 190,000 subjects in total aged 0 to 25
from UK, Brazil, Hong Kong, the Netherlands, Singapore, and the United States). The BMI
percentile curves that pass through the values of 25 kg/m2 and 30 kg/m2 (standard cut-off
points for overweight and obesity, respectively) at age 18 were smoothed for each national
dataset and then averaged. The averaged curves were then used to provide age and sexspecific BMI cut-off points for children and adolescents aged 2 to 18. The benefit of this
approach is that it allows international comparisons of levels of obesity in children to be made.
Figures derived using this method are discussed in section 3.7, Chapter 3 (Obesity among
children) of this bulletin commenting upon results from Foresight: Tackling Obesities: Future
Choices. For further information this report is available at:
http://www.foresight.gov.uk/Obesity/obesity_final/17.pdf
NICE guidance
NICE guidance suggests that the measurement of waist circumference should be used in
people with a BMI less than 35kg/m2 to assess health risks (as shown in the table below).
Assessing risk from overweight and obesity
Waist circumference
Low
High
Very high
Normal weight
No increased risk
No increased risk
Increased risk
Overweight (25 to less than 30 kg/m2)
No increased risk
Increased risk
High risk
Increased risk
High risk
Very high risk
Obesity I (30 to less than 35 kg/m2)
For men, low waist circumference is defined as less than 94 cm, high as 94–102 cm, and very high as greater than 102 cm.
For women, low waist circumference is less than 80 cm, high is 80–88 cm and very high as greater than 88 cm.
BMI classification
Source:
National Institute for Clinical Excellence (NICE) guidelines
Further information on the NICE guidelines is available at:
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Physical activity among adults
Adults’ physical activity in the last four weeks was measured in the Health Survey for England
2006 by examining overall participation, frequency of participation in activities that lasted at
least 15 minutes, type of activity, and duration of activities. A question about intensity of the
activity was asked for sports and exercise and for walking. Responses to the question on
occupational activity were taken into account in the estimation of the summary activity levels.
The HSE 2006 includes an analysis of physical activity over time. These comparisons include
Health Survey data from 1997, 1998, 2003 and 2006. It was not possible to include 1994 due
to important differences in the questions, which would limit the meaningfulness of these
comparisons. In 2003 the short version of the questionnaire was administered and 1997 and
1998 results were recalculated in order to allow for comparisons. To enable continuation of
these trend data, the same methods for analysis were used in 2006. In summary, the key
differences between the physical activity questions in 1997, 1998, 2003 and 2006 are as
follows:
•
•
The minimum cut-off for walking, 15 minutes in 1997, 1998 and 2006 but 30 minutes in
2003.
The lower duration limit for an activity (including walking) to be included was 15 minutes in
1997, 1998 and 2006 and 30 minutes in 2003.
Activity types, frequency, duration, and intensity
Details about three main types of physical activity were asked in the questionnaire. For most
activities in which they had participated, informants were asked on how many days in the last
four weeks they had done the activity for at least 15 minutes, and the average length of time
spent on those days.
1. Home activity consisted of housework and gardening/DIY/building that lasted 15 minutes or
more. The lead-in question was ‘Have you done any housework in the last four weeks?‘
Informants were shown a card with a list of examples of light housework and were asked if
they had done any of the listed activities. They were then asked about heavy housework by
showing another card with higher intensity activities, for which frequency was assessed. A
similar sequence of questions was asked for gardening/DIY/building work. Frequency of light
home activity (i.e. those activities listed in the first set of show cards) was not assessed.
2. Walks of 15 minutes or more. The key question was ‘During the past four weeks, on how
many days did you do a walk of least 15 minutes?’ Walking intensity was assessed by asking
informants to rate their usual walking pace (slow / average / fairly brisk / fast).
3. Sports and exercise activities that lasted 15 minutes or more. For sports and exercise
activities in the four weeks prior to interview, informants were asked ‘Can you tell me on how
many separate days did you do (name of specific sport and exercise activity) for at least 15
minutes at a time during the past four weeks…?’, followed by a question about the activity’s
usual duration on these days. The intensity of these activities was assessed by asking
informants whether or not the activity had made them ‘out of breath or sweaty’.
The summary measure of physical activity levels group’s informants according to the Chief
Medical Officer (CMO) physical activity guidelines, which are that adults should take part in five
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or more occasions per week of activity of at least moderate intensity, of 30 minutes or more
duration. He also recommended that at least twice a week this should include activities to
improve bone health, muscle strength and flexibility. Moderate intensity activities have an
energy cost of at least 5 kcal/min but less than 7.5 kcal/min and include heavy housework or
gardening and sports which make the individual breathe heavily or become sweaty.
The summary measure incorporates three basic dimensions (frequency, intensity, and
duration) of the informants’ overall physical activity level. As in 1998 and 2003, full time
workers in manual occupations who reported being at least moderately active in their work
were counted as having done 20 days’ activity in the last four weeks and part time workers as
12 days’ activity.
The summary activity level classification is as follows:
•
•
•
High activity: 20 or more occasions of moderate or vigorous activity of at least 30 minutes
duration in the last four weeks (at least five days a week). It should be noted that the term
‘high’ is relative in this context and corresponds to the minimum activity level required to
acquire some general health benefits (e.g. reduction in the relative risk for cardiovascular
morbidity). However, it does not necessarily indicate larger doses of activity required for
optimal cardiovascular fitness or for optimal weight control.
Medium activity: 4 to 19 occasions of moderate or vigorous activity of at least 30 minutes
duration in the last four weeks (one to five days a week).
Low activity: Up to three occasions of moderate or vigorous activity of at least 30 minutes
duration in the last four weeks (less than once a week).
For comparisons of summary activity levels over time, HSE 2006 data have been analysed
with the lower duration for activities set to 30 minutes, to be comparable with results obtained
from the shorter 2003 questionnaire. 1997 and 1998 data were also reanalysed using this
longer minimum duration, and limiting occupational data to the single question asked in 2003
and 2006, to enable data for the four years to be compared.
English, Scottish and Welsh comparisons among adults
The Scottish Health Survey (SHS) 2003 physical activity module is directly comparable to the
SHS 1998 one and therefore comparisons over time are uncomplicated. It was not possible to
draw comparisons with SHS 1995 due to important differences in the relevant questions which
would limit the meaningfulness of these comparisons.
The HSE 2003 used a shorter questionnaire than the SHS 2003. In summary, the key
differences between the two questionnaires were:
•
•
The HSE questionnaire included a 30 minute cut-off for all activities (except sports and
exercise which used a 15 minute limit), so any time spent on activities below these cut-off
points was not recorded. The SHS questionnaire recorded all time spent on activities, with
the exception of the sports and exercise questions which, like HSE, excluded activities
lasting fewer than 15 minutes
In contrast to the SHS, HSE 2003 did not record the total duration of time spent on heavy
housework, heavy manual work/gardening/DIY, and walking, it simply recorded all
instances that lasted at least 30 minutes.
To make the data comparable between the two countries two steps were taken:
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•
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To compare participation rates, all activity sessions that lasted for fewer than 30 minutes in
SHS 2003 were excluded
To compare the proportions of adults meeting the physical activity recommendations all
housework, heavy manual work/gardening/DIY, and walking sessions were assumed to
have lasted 30 minutes in both surveys.
The Welsh Health Survey asked adults on which days in the past week they did at least 30
minutes of light, moderate, and vigorous exercise or physical activity. In this survey blocks of
activity lasting more than 10 minutes, which were done on the same day, count towards the full
30 minutes. Respondents were asked to include physical activity which is part of their job.
Examples of each type of activity are:
•
•
•
light activity - housework or golf
moderate activity - heavy gardening or fast walking
vigorous activity - running or aerobics.
Physical activity among children
The HSE 2006 questions collected details about the out-of-school activity of children aged 2 to
15 in three main categories: sports and exercise, active play, and walking. Children aged eight
and over were also asked about their participation in housework/gardening. The decision to
exclude activities which are part of the school curriculum was taken for three main reasons.
Firstly, it was assumed that, generally speaking, the amount of activity carried out by children
as part of school lessons would be similar for all children (according to their age) and would
contribute to a ‘standard’ additional amount of activity for each child. Secondly, activities as
part of the school curriculum would generally be compulsory and the survey was more
concerned with what children would do of their own choice. Thirdly, since a large proportion of
data would be collected by proxy from a parent, it was felt that information about activities
during school lessons would be less accurate than information about leisure time activities.
However any activities carried out on school premises but not as part of school lessons (e.g.
after school clubs, during break times) were covered by the questions asked. For pre-school
children, activities done at any nursery or playgroup the child attended were included. In
common with the 2002 questionnaire, no information was collected on intensity; it is therefore
assumed that all reported activities were of at least moderate intensity.
Details of the following activities were collected:
•
•
•
•
Walking; whether the child had done any continuous walks of at least 5 minutes;
Housework/gardening (aged 8 and over only); whether the child had done any 'housework
or gardening that involved pulling or pushing, like hoovering, cleaning a car, mowing grass
or sweeping up leaves for at least 15 minutes; if so on how many days; and the total
duration of housework/gardening on each of these days;
Sports and exercise activities; this category included activities such as swimming, football,
tennis, gymnastics, and was intended to cover more 'organised' or structured sporting
activities;
Active play; defined as 'active things like ride a bike, kick a ball around, run about, play
active games, jump around'.
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The summary physical activity levels categories are as follows:
•
•
•
Group 3 'high': active for 60 minutes on 7 days in the last week. Assuming that all
reported activities were of at least moderate intensity, this group refers to those children
who met the recommended level of physical activity.
Group 2 'medium': active for 30 to 59 minutes on 7 days in the last week. Group 2
represents those achieving the lower recommended level which is at least 30 minutes (but
less than an hour) of at least moderate intensity per day. The same intensity assumption
highlighted above applies here.
Group 1 'low': active at a lower level or not active at all. This group refers to children
who did not meet either of the physical activity guidelines.
Active sport
The Department for Culture, Media and Sport Public Service Agreement (PSA) and the Taking
Part Survey define the following as active sports: swimming or diving; BMX, cycle-cross,
mountain biking; cycling; bowls; tenpin bowling; health, fitness, gym or conditioning activities;
keep fit, aerobics, dance exercise; judo; karate; taekwando; other martial arts; weight training;
weightlifting; gymnastics; snooker, pool, billiards; darts; rugby league and union; American
football; football; cricket; hockey; baseball/softball; netball; tennis; badminton; squash;
basketball; table tennis; track and field athletics; jogging, cross-country, road running; angling
or fishing; canoeing; windsurfing or boardsailing; ice skating; golf, pitch and putt, putting;
skiing; horse riding; climbing/mountaineering; hill trekking or backpacking; karting; volleyball;
orienteering; rounders; rowing; boxing; waterskiing; lacrosse; yoga; fencing; and other types of
sport for example roller-blading, street hockey, skateboarding, water polo, surfing, scuba
diving, gliding, hang/paragliding, parachuting or parascending. Also included are in the valid
activities which are recorded in the ‘other sports’ category. Walking is excluded from the active
sport target
Diet and nutrition
Fruit and vegetable portions
Fruit and vegetable consumption is measured in portions, using guidelines specified in the ‘5 a
day’ programme. The government recommends that people should eat five portions of fruit and
vegetables a day. Five portions are defined as 400g of fruit and vegetables per day, an
average of 80g per portion. A variety of foodstuffs represent a portion, including vegetables
(fresh, frozen, canned), vegetables in composite dishes (such as pies or curries), salads,
pulses, fruit (fresh, frozen, canned, dried), fruit in composites (such as pies or crumbles) and
fruit juice. Below is a table showing the recommended portions sizes of the different types of
fruit and vegetables in terms of everyday household measures. These measures have been
used by the Health Survey for England when collecting data through dietary recall and for
estimation of the number of portions respondents have consumed. The Low Income Diet and
Nutrition Survey also followed the government guidelines in terms of what and how much
counts as a portion, but estimated the weight of the fruit and vegetables consumed and divided
by 80 (or 157 in the case of fruit juice to convert to millilitres) to determine the number of
portions.
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According the current guidelines, fruit juice, regardless of how much is drunk in excess of one
small glass (150ml), only counts as a maximum of one portion per day. This is due to its low
fibre content and its high content of non-milk extrinsic sugars, which, when consumed in too
high a quantity can lead to tooth decay and dental health problems. Pulses (such as beans,
lentils and chick peas) can also only contribute a maximum of one portion per day regardless
of how much is consumed; whilst they do contain fibre, they do not provide the same mixture of
vitamins, minerals and other nutrients that can be obtained from fruit and vegetables. Due to
their high starch content, potatoes in any form (including sweet potato varieties) and other
starchy vegetables, such as plantain and green bananas, do not count towards the ‘5 a day’
portions. Nuts and seeds do not count towards the ‘5 a day’ portions. These guidelines and
quantities are based on adult requirements and while the government recommends that
children over the age of five should also consume five portions of a variety of the foodstuffs
shown below, their portion sizes may be smaller. However, survey measures of fruit and
vegetable consumption among children are based on adult portion sizes.
Food item
Portion size
Pulses
Salad
Vegetables in composites, such as vegetable chilli
Very large fruit, such as melon
Large fruit, such as grapefruit
Medium fruit, such as apples
Small fruit, such as plums
Very small fruit, such as blueberries
Dried fruit
Frozen fruit / tinned fruit
Fruit in composites, such as stewed fruit
Fruit juice
3 tablespoons
3 tablespoons
1 cereal bowl
3 tablespoons
1 average slice
Half a fruit
1 fruit
2 fruits
2 average handfulls
1 tablespoon
3 tablespoons
3 tablespoons
1 small glass (150ml)
Estimated Average Requirements and Reference Nutrient Intakes
In 1991 the Committee on Medical Aspects of Food and Nutrition Policy (COMA)
recommended that population average intakes of different macronutrients should not exceed
specified limits. For example the population average intakes of total fat, saturated fatty acids
and non-milk extrinsic sugars (principally added sugars) should not exceed 35 per cent, 11 per
cent and 11 per cent of food energy respectively.
Energy intake is compared against the Estimated Average Requirement (EAR) for a group.
Estimates of energy requirements for different populations are termed EARs and are defined
as the energy intake estimated to meet the average requirements of the group. About half the
people in the group will usually need more energy than the EAR and half the people in the
group will usually need less.
Nutrient intakes derived from surveys are compared with Reference Nutrient Intakes (RNIs).
These RNIs represent the best estimate of the amount of a nutrient that is enough, or more
than enough, for about 97 per cent of people in a group. If average intake of a group is at the
level of the RNI, then the risk of deficiency in the group is very small.
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Health Survey for England (HSE)
Age Standardisation
Adult data have been age-standardised throughout the HSE 2006 to allow comparisons
between groups after adjusting for the effects of any differences in their age distributions.
When different sub-groups are compared in respect of a variable on which age has an
important influence, any differences in age distributions between these sub-groups are likely to
affect the observed differences in the proportions of interest. All age standardisation has been
undertaken separately within each gender, expressing male data to the overall male population
and female data to the overall female population. When comparing data for the two genders, it
should be remembered that no age standardisation has been introduced to remove the effects
of the genders’ different age distributions.
Footnotes have been provided in this report on tables where age standardised figures have
been presented and include the following variables: equivalised household income quintile and
Government Office Region.
Further information on overweight and obesity prevalence across SHAs is given in ‘HSE:
Health and Lifestyle Indicators for Strategic Health Authorities 1994 - 2002’. This includes an
age-standardised time series of overweight and obesity prevalence levels by SHA. This
publication is available at:
http://www.dh.gov.uk/PublicationsAndStatistics/PublishedSurvey/HealthSurveyForEngland/He
althSurveyResults/HealthSurveyResultsArticle/fs/en?CONTENT_ID=4077728&chk=5Mjlqy
Use of HSE data from different years
This report contains data and information from different years of the HSE. This is to provide
the most recent information for the general population that was available at the time of
publishing. Where possible, data has been used from the most recent 2006 HSE results,
however there are some restrictions to this.
In some cases data is not presented in the HSE reports in the format required for this report,
therefore additional analysis of the data set is undertaken. At the time of publishing, the HSE
2006 data set was not available for such additional analysis; therefore data from previous
HSE survey years was used as appropriate.
In Chapter 2 BMI is shown by smoking status, alcohol consumption and summary physical
activity levels. As these required additional analysis they were produced using the most
recent HSE data set available for analysis which covered only the general population (i.e. not
a year when there was a boost sample as the core sample is smaller in these years) to ensure
a sufficiently large sample, this was 2003.
In Chapter 4 physical activity levels are shown by BMI breakdown and again this is based on
the 2003 HSE data set due to the need for additional analysis and a large enough sample
size.
Chapter 7 discusses blood pressure, cardiovascular disease (CVD), ischemic heart disease,
longstanding illnesses, general health questionnaire (GHQ12) scores and type 2 diabetes by
BMI and waist circumference. Analysis of these health conditions by BMI was carried out on
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the 2003 data set and reported on in Statistics on Obesity, Physical Activity and Diet 2006.
This analysis could not be updated to 2004 or 2005 HSE data as the core sample sizes in
those years were too small to facilitate the breakdowns by BMI.
Blood pressure, longstanding illnesses and GHQ12 scores by waist circumference have all
been analysed using the 2005 data set, providing the most up to date data available, however
CVD and ischemic heart disease by waist circumference have been analysed using 2003
data. This is because the boost sample in 2005 was elderly people and the CVD module of
questions was only asked of people aged 65 and over, therefore it is not possible to show the
prevalence of these two conditions for the general population in 2005. Therefore HSE 2003
was used, since this was the last year (prior to 2006) which collected sufficient information on
the general population and provided larger sample sizes.
Where chapters in this report show a breakdown by ethnicity, the 2004 HSE data set has
been used because the boost sample in that year consisted of people from minority ethnic
groups. The sample sizes of these groups were not big enough in more recent years to show
the breakdowns required for this report.
Blood pressure
The levels of blood pressure used to define hypertension in the HSE are in accordance with
the latest guidelines on hypertension management. To compute the prevalence of
hypertension, adult informants were classified in one of four groups on the basis of their SBP
(systolic blood pressure) and DBP (diastolic blood pressure) readings and their current use of
anti-hypertensive medication.
•
•
•
•
Normotensive-untreated SBP<140 mmHg and DBP<90 mmHg, not currently taking any
prescribed drugs that lower blood pressure
Hypertensive-controlled SBP<140 mmHg and DBP<90 mmHg, currently taking prescribed
drugs that lower blood pressure
Hypertensive-uncontrolled SBP≥140 mmHg and DBP≥90 mmHg, currently taking
Hypertensive-untreated SBP≥140 mmHg and DBP≥90 mmHg, not currently taking any
The last three categories together are considered as ‘hypertensive’ for the purpose of this
report. The definition of hypertension used for clinical purpose talks about ‘sustained’ levels of
high blood pressure, while HSE only measures blood pressure at one point in time. This needs
to be taken into account when interpreting the results. Hypertensive controlled and
hypertensive uncontrolled groups are all those who take drugs that lower blood pressure,
irrespective of the reason they were prescribed.
Weighted HSE data used in Chapter 7: Health Outcomes
Tables 7.1 to 7.5 show prevalence of blood pressure levels, CVD, IHD, longstanding illness
and GHQ12 scores by waist circumference. Questions on CVD, longstanding illness and
GHQ12 scores are asked during the interview visit, whereas blood pressure and waist
circumference are measured during the nurse visit. Different weights are used within the HSE
depending on which stage of the process the information is collected (interview or nurse).
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In all five tables the weighted prevalence figures for the breakdown by waist circumference
uses the nurse weight since waist circumference was measured by the nurse.
Totals in all five tables include those without a valid waist measurement recorded. There the
weighting used in analysis needs to take account the stage of the process for which the
associated variable is collected. The blood pressure variable is collected by the nurse and
therefore uses the nurse weight to calculate weighted prevalence totals, but weighted totals for
CVD, longstanding illness and GHQ12 are based on the interview weight since these are
collected at the interview stage.
Further details of weighting can be found in the methodology chapter of the Health Survey for
England 2005: Health of Older People www.ic.nhs.uk/pubs/hse05olderpeople
General Health Questionnaire
The General Health Questionnaire (GHQ12) is a measure of psychological well-being. This
questionnaire consists of twelve questions concerning general level of happiness, depression,
anxiety and sleep disturbance over the past few weeks. As in previous Health Surveys, a score
of 4 or more was used as the threshold to identify informants with possible psychiatric disorder,
and is referred to as a ‘high GHQ score’. Perceived social support was measured by seven
questions regarding the quality of relationships with family and friends. These were also asked
in self-completion format.
Hospital Episode Statistics codes: coding for Bariatric Surgery used in table 7.14
Using Hospital Episode Statistics (HES) data held at the Information Centre, the number of
Finished Consultant Episodes (FCEs) for bariatric surgery has been determined where the
primary diagnosis was obesity (ICD-10 code E66) and the main procedure was one of the
following OPCS codes for the relevant time periods. OPCS-4.2 codes were used between
1996/97 to 2005/06 and OPCS-4.3 codes for 2006/07. This is outlined in detail below.
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The OPCS-4 procedure codes for bariatric surgery in years 1996/97 to 2005/06,
and in 2006/07 are:
G28.1 Partial gastrectomy and anastomosis of stomach to duodenum
G28.2 Partial gastrectomy and anastomosis of stomach to transposed jejunum
G28.3 Partial gastrectomy and anastomosis of stomach to jejunum nec
G28.8 Other specified partial excision of stomach
G28.9 Unspecified partial excision of stomach
G30.1 Gastroplasty nec
G30.2 Partitioning of stomach NEC
G30.8 Other specified plastic operations on stomach
G30.9 Unspecified plastic operations of stomach
G31.1 Bypass of stomach by anastomosis of oesophagus to duodenum
G31.2 Bypass of stomach by anastomosis of stomach to duodenum
G31.3 Revision of anastomosis of stomach to duodenum
G31.4 Conversion to anastomosis of stomach to duodenum
G31.8 Other specified connection of stomach to duodenum
G31.9 Unspecified connection of stomach to duodenum
G31.0 Conversion from previous anastomosis of stomach to duodenum
G32.1 Bypass of stomach by anastomosis of stomach to transposed jejunum
G32.2 Revision of anastomosis of stomach to transposed jejunum
G32.3 Conversion to anastomosis of stomach to transposed jejunum
G32.8 Other specified connection of stomach to transposed jejunum
G32.9 Unspecified connection of stomach to transposed jejunum
G32.0 Conversion from previous anastomosis of stomach to transposed jejunum
G33.1 Bypass of stomach by anastomosis of stomach to jejunum nec
G33.2 Revision of anastomosis of stomach to jejunum nec
G33.3 Conversion to anastomosis of stomach to jejunum nec
G33.8 Other specified other connection of stomach to jejunum
G33.9 Unspecified other connection of stomach to jejunum
G33.0 Conversion from previous anastomosis of stomach to jejunum nec
G38.8 Other specified Other open operations on stomach
G48.1 Insertion of gastric bubble
G48.2 Attention to gastric bubble
The following additional 4 digit OPCS-4.3 codes are used in the 2006/07 data
(these are in addition to the OPCS4 codes listed above):
G28.4
G28.5
G30.3
G30.4
G31.5
G31.6
G32.4
G32.5
G33.5
G33.6
G38.7
G71.6
Sleeve gastrectomy and duodenal switch
Sleeve gastrectomy NEC
Partitioning of stomach using band
Partitioning of stomach using staples
Closure of connection of stomach to duodenum
Attention to connection of stomach to duodenum
Closure of connection of stomach to transposed jejunum
Attention to connection of stomach to transposed jejunum
Closure of connection of stomach to jejunum NEC
Attention to connection of stomach to jejunum
Removal of gastric band
Duodenal switch
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Appendix C: Government policy and
targets
Obesity
Healthy Weight, Healthy Lives: A Cross Government Strategy for England
The government’s new ambition on excess weight, announced in the Comprehensive
Spending Review 2007 is to be the first major country: to reverse the rising tide of obesity and
overweight in the population, by ensuring that all individuals are able to maintain a healthy
weight. Our initial focus is on children: by 2020 we will have reduced the proportion of
overweight and obese children to 2000 levels. The Department of Health is responsible for
overall policy on obesity and is jointly responsible with the Department for Children, Schools
and Families (DCSF) for tackling child obesity. Although the ambition covers a period of 12
years, progress for the first three years 2008-11 will be monitored through the inclusion of child
obesity as one of the indicators in the Child Health PSA (PSA 12). This will provide a solid
platform upon which to expand efforts to reduce the proportion of overweight children, as well
as the proportion of obese children in order to fulfil the 2020 ambition.
While accountability for meeting the ambition will be based on indicators of BMI in Reception
and Year 6, the government want to ensure that action is not solely focused on these age
groups. They are therefore committing to publishing an annual report setting out performance
against these and other BMI indicators:
•
•
•
•
Children in Reception Year: overweight and obesity levels;
Children in Year 6: overweight and obesity levels;
Young adults: overweight and obesity levels (based on Health Survey for England data);
Adults: overweight and obesity levels (based on Health Survey for England data).
However, because changes to population measures of BMI can take some time to become
apparent, the government will complement these with a range of early indicators of success
which it is yet to finalise.
For further information on this and the government’s wider strategy on tackling this health
issue please view the full document on the link below.
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance
/DH_082378
Public Service Agreements
In October 2007, the government published a new long-term plan to reverse the rising tide of
obesity and overweight in the population. As part of this a new Public Service Agreement
(PSA) was created with the aim of improving the health and well being of children and young
people. The PSA aims to:
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Reduce the number of obese and overweight children to 2000 levels by 2020. In the
context of tackling obesity across the population
This replaces the previous target to:
•
Halt the year-on-year rise in obesity among children aged under 11 by 2010 in the context
of a broader strategy to tackle obesity in the population as a whole.
http://www.hm-treasury.gov.uk./media/C/F/pbr_csr07_psa12.pdf
NICE guidance
The National Institute for Health and Clinical Excellence (NICE) and the National Collaborating
Centre for Primary Care (NCC-PC) have recently published guidance on the prevention,
identification, assessment, treatment and weight management of overweight and obesity in
adults and children.
The guidance is intended to provide recommendations on the clinical management of
overweight and obesity in the NHS. It also provides guidance on primary prevention
approaches aimed at supporting adults and children to maintain a healthy weight. The latter
will include advice as to what can be done in schools, in the workplace and in the wider
community.
The guidance was published December 2006 and can be accessed on the NICE website.
White Paper
The Government’s White Paper Choosing Health: Making Healthier Choices Easier was
published in November 2004. It set out how the Government will make it easier for people to
make healthier choices by offering them practical help to adopt healthier lifestyles. Choosing
Health laid out a challenge programme of practical action aimed at saving thousands of lives in
years to come.
The White Paper set out a comprehensive plan of action on physical activity, diet, personalised
support, information and curbs on marketing, giving a strong foundation for tackling obesity.
The White Paper delivery plan (Delivering Choosing Health), together with discrete plans
focusing on nutrition (Choosing a Better Diet) and Physical Activity (Choosing Activity) set out
how the White Paper commitments will be delivered.
http://www.dh.gov.uk/assetRoot/04/10/57/13/04105713.pdf
Physical activity
NICE guidance
In March 2006 the National Institute for Health and Clinical Excellence (NICE) published
physical activity public health intervention guidance concerning four common methods used to
increase individual physical activity levels. On the basis of its review of the available evidence,
NICE recommended that primary care practitioners should take the opportunity, whenever
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possible, to identify inactive adults and advise them to aim for 30 minutes of moderate activity
on 5 days of the week (or more).
http://www.nice.org.uk/guidance/PHI2/?c=296726
Public Service Agreements
•
•
Enhance the take-up of sporting opportunities by 5 to 16 year olds so that the percentage
of school children in England who spend a minimum of two hours each week on high
quality PE and school sport within and beyond the curriculum increases from 25% in 2002
to 75% by 2006 and to 85% by 2008, and to at least 76% in each School Sport Partnership
by 2008. This is a joint target between Department for Children Schools and Families
(DCFS) Department for Culture, Media and Sport (DCMS).
By 2008, increase the take-up of cultural and sporting opportunities by adults and young
people aged 16 and above from priority groups, by:
•
Increasing the number who participate in active sports at least twelve times a year by 3%,
and increasing the number who engage in at least 30 minutes of moderate intensity level
sport, at least three times a week by 3%. Department for Culture, Media and Sport (DCMS)
PSA target.
http://www.culture.gov.uk/about_us/Priorities_targets/
Choosing activity: a physical activity action plan
Choosing activity: a physical activity action plan was published in March 2005 and sets out
government’s plans to encourage and co-ordinate the action of a range of departments and
organisations to promote increased participation in physical activity across England. It is a
summary of how the government will deliver the commitments on physical activity presented in
the public health white paper Choosing Health: making healthier choices easier. It brings
together all the commitments relating to physical activity in Choosing Health as well as other
action across government, which will contribute to increasing levels of physical activity. These
include school PE and sport and local action to encourage activity through sport, transport
plans, the use of green spaces and by the NHS providing advice to individuals on increasing
activity through the use of pedometers.
http://www.dh.gov.uk/assetRoot/04/10/57/10/04105710.pdf
National Service Framework for Coronary Heart Disease
The National Service Framework for Coronary Heart Disease (NSF CHD), published in March
2000, set out a strategy to modernise CHD services over ten years. It details 12 standards for
improved prevention, diagnosis, treatment and rehabilitation and goals to secure fair access to
high quality services. The NSF CHD required that all NHS bodies will have agreed and be
contributing to the delivery of a local programme of effective policies on increasing physical
activity.
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance
/DH_4094275
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Diet
School Food Trust
The School Food Trust was established by the Department for Education and Skills in
September 2005. Its remit is to transform school food and food skills, promote the education
and health of children and young people and improve the quality of food in schools.
http://www.schoolfoodtrust.org.uk/index.asp
Choosing Health? Choosing a Better Diet
‘Choosing Health? Choosing a Better Diet’ was published in Spring 2004 and sets out
nutritional priorities in England. Improving health and narrowing health inequalities are
priorities for the government. However, although there is much government can do to
maximise opportunities for people to enjoy better health, these are issues for society as a
whole. The NHS and other public bodies, local government, the voluntary and community
sector, individuals, communities, the food industry, employers and the media all have a role to
play.
The nutritional priorities, for the population of England as a whole, are:
•
•
•
•
•
increase average consumption of a variety of fruit and vegetables to at least 5 portions per
day (estimated to be 2.8 portions per day in 2000/01 from the National Diet and Nutrition
Survey data);
increase the average intake of dietary fibre to 18 grams per day (estimated to be 13.8
grams per day in 2000/01 from the National Diet and Nutrition Survey data);
reduce average intake of salt to 6 grams per day (estimated to be 9.5 grams per day in
2000/01 from the National Diet and Nutrition Survey data);
reduce average intake of saturated fat to 11% of food energy (estimated to be at 13.3% in
2000/01 from the National Diet and Nutrition Survey data);
maintain the current trends in reducing average intake of total fat to 35% of food energy
(estimated to be at 35.3% in 2000/01 from the National Diet and Nutrition Survey data);
and
•
reduce the average intake of added sugar to 11% of food energy (estimated to be 12.7% in
2000/01 from the National Diet and Nutrition Survey data).
http://www.dh.gov.uk/Consultations/ClosedConsultations/ClosedConsultationsArticle/fs/en?CO
NTENT_ID=4084430&chk=IRO27F
‘5 a day’ programme
The government’s ‘5 a day’ programme aims to increase fruit and vegetable consumption by
•
•
raising awareness of the health benefits
improved access to fruit and vegetables through targeted action
The ‘5 a day’ programme has five strands with are underpinned by an evaluation and
monitoring programme
•
School Fruit and Vegetable Scheme (formerly the National School Fruit Scheme)
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•
•
•
•
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Local ‘5 a day’ initiatives
National/local partners (Government Health Consumer Groups)
Communications programmes
Work with industry – producers, caterers, retailers
http://www.dh.gov.uk/en/Policyandguidance/Healthandsocialcaretopics/FiveADay/index.htm
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Appendix D: Editorial notes
For the purpose of clarity, figures in the bulletin are shown in accordance with the Information
Centre publication conventions.
These are as follows:
.
..
0
not applicable
not available
zero
less than 0.5
Numbers greater than or equal to 0.5 are rounded to the nearest integer. Totals may not sum
due to rounding.
Most data in the bulletin discussed in the text are presented in a table; the relevant table
number is given at the end of the last paragraph in the discussion around each table. For data
where no table is presented a reference number to the data source is provided in the relevant
section of text.
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Appendix E: Further information
This new report (published 31st January 2008) draws together statistics on obesity, physical
activity and diet. It is expected the next report will be published in late 2008. This report forms
part of a suite of statistical reports. Other reports cover drug use among young people, alcohol
and smoking.
Constructive comments on this report would be welcomed. Any questions concerning any
data in this publication, or requests for further information, should be addressed to:
The Contact Centre
1 Trevelyan Square
Boar Lane
Leeds
West Yorkshire
LS1 6AE
Telephone: 0845 300 6016
Email: enquiries@ic.nhs.uk
Press enquiries should be made to the Information Centre media line at: 0845 257 6990.
Further details can be found at:
http://www.ic.nhs.uk/news-and-media/press-office-contact-details
This report is available on the internet at:
www.ic.nhs.uk/pubs/opadjan08
The 2006 report, also published by the Information Centre can be found at:
www.ic.nhs/pubs/opad06
Information on data sources used within this report are described in Appendix A and
government plans and targets discussed in Appendix B. However further information regarding
the topics discussed within this report maybe found from the following sources:
5-a-day
The 5-a-day website provides lots of useful information and resources for health professionals
as well as the general public about healthy eating and fruit and vegetable consumption
http://www.5aday.nhs.uk/
Annual Report of the Chief Medical Officer
Over the last 150 years, annual reports have been published by the Chief Medical Officer,
almost every year. These reports provide an important record of the nation’s health and the
major challenges faced by government in tackling the main problems. In the last twenty years
or so, the annual report has also provided detailed accounts of a wide range of initiatives taken
by the government on public health and in the NHS.
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/AnnualReports/DH_076817
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Association for the Study of Obesity
The Association for the Study of Obesity (ASO) was founded in 1967 and is the UK's foremost
organisation dedicated to the understanding and treatment of obesity. The ASO has three key
objectives:
•
•
To promote professional awareness of obesity and its impact on health.
To educate and disseminate recent research on the causes, consequences, treatment, and
prevention of obesity
•
To prioritise obesity and provide opinion leadership in the UK.
http://www.aso.org.uk/portal.asp
Food Standards Agency
The Food Standards Agency (FSA) is an independent government department set up by an
Act of Parliament in 2000 to protect the public's health and consumer interests in relation to
food. The FSA provides advice and information to the public and government on food safety
from farm to fork, nutrition and diet. It also protects consumers through effective food
enforcement and monitoring. Although the FSA is a government agency, it works at 'arm's
length' from government because it does not report to a specific minister and is free to publish
any advice it issues.
http://www.food.gov.uk/
General Household Survey 2002
The General Household Survey (GHS) is a multi purpose continuous survey carried out by the
Office of National Statistics (ONS) which collects information on a range of topics from people
living in households in Great Britain. The survey started in 1971. The GHS 2002 module ‘Sport
and leisure’ contains further useful information on the participation of adults (aged 16 and over)
in a wide range of sport and leisure activities.
www.statistics.gov.uk/LIB2002/default.asp
International Obesity TaskForce
The International Obesity TaskForce (IOTF) is a global network of expertise, a research-led
think tank and advocacy arm of the IOTF. The IOTF is working to alert the world to the growing
health crisis threatened by soaring levels of obesity. It works with the World Health
Organisation, other NGOs and stakeholders to address this challenge.
www.iotf.org
National Institute for Health and Clinical Excellence (NICE)
NICE’s website includes some information and clinical guidelines on the prevention,
identification, assessment and management of overweight and obesity in adults and children.
http://www.nice.org.uk/CG43
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National Obesity Forum
The National Obesity Forum (NOF) was established by medical practitioners in May 2000 to
raise awareness of the growing health impact that being overweight or obese was having on
patients and the NHS
http://www.nationalobesityforum.org.uk/
National Child Measurement Programme
The National Child Measurement Programme (NCMP) weighs and measures children in
Reception (aged 4–5 years) and Year 6 (aged 10–11 years). The findings are used to inform
local planning and delivery of services for children, and gather population-level surveillance
data to allow analysis of trends in excess weight. The NCMP data for the school year 2006/07
has been collected by the Information Centre (IC) and a national report is due for publication
on the IC website in the week commencing the 18th of February 2008.
www.ic.nhs.uk
Primary Care Management of Adult Obesity – Dr Foster
The aim of the report Primary Care Management of Adult Obesity, published by Dr Foster, is to
examine the degree to which Primary Care Organisations (PCOs) across the UK are currently
tackling the problem of obesity.
www.drfoster.co.uk/library/reports/obesityManagement.pdf
School Fruit and Vegetable Scheme
Under the scheme, all four to six year old children in Local Education Authority maintained
infant, primary and special schools are now entitled to a free piece of fruit or vegetable each
school day. It was introduced after the NHS Plan 2000 included a commitment to implement a
national school fruit scheme by 2004.
www.dh.gov.uk/en/Policyandguidance/Healthandsocialcaretopics/FiveADay/FiveADaygenerali
nformation/DH_4002149
Scientific Advisory Committee on Nutrition
The Scientific Advisory Committee on Nutrition (SACN) is an advisory committee of
independent experts that provides advice to the Food Standards Agency and Department of
Health as well as other government agencies and departments. Its remit includes matters
concerning nutrient content of individual foods, advice on diet and the nutritional status of
people.
www.sacn.gov.uk/
Securing Good Health for the Whole Population
Derek Wanless’ first report ‘Securing our Future Health: Taking a Long-Term View’ was
published in April 2002. This identified three scenarios for meeting the long-term financial and
resource needs of the NHS for the next two decades, to 2022. In its response to the report, the
government announced that it would address the ‘fully engaged’ scenario identified by Mr
Wanless. Under this scenario the level of public engagement in relation to health is high, life
expectancy goes beyond current forecasts, health status improves dramatically, use of
resources is more efficient and the health service is responsive with high rates of technology
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uptake. The scenario envisaged delivery of better health outcomes at less cost than the others
considered.
In April 2003, the Prime Minister, the Chancellor and the Secretary of State for Health asked
Derek Wanless, ex-Group Chief Executive of NatWest, to provide an update of the challenges
in implementing the fully engaged scenario set out in his report on long-term health trends.
Derek Wanless' final report "Securing Good Health for the Whole Population" was published
on 25th February 2004.
www.hm-treasury.gov.uk/consultations_and_legislation/wanless/consult_wanless04_final.cfm
South East Public Health Observatory
The South East Public Health Observatory (SEPHO) is one of nine regional observatories
throughout England and Wales and is a member of the Association of Public Health
Observatories (APHO). SEPHO’s aim is to improve health and reduce inequalities in the
South East region by providing information and support to local organisations, partners and
stakeholders.
As part of the PHO Choosing Health series, the report Choosing Health in the South East:
Obesity defines obesity and overweight, its causes and impacts on health, and looks at this
issue as it varies with geography, age, gender, ethnicity, etc. It also discusses obesity and
overweight in children and interventions.
http://www.sepho.org.uk/Download/Public/9783/1/SEPHO%20obesity%20report%20Nov%200
5.pdf
For further information on a wide range of public health issues (including obesity, physical
activity and diet) visit the APHO website.
http://www.apho.org.uk/resource/item.aspx?RID=44273
Tackling child obesity
This report is based on a joint study conducted by the Audit Commission, the Healthcare
Commission and the National Audit Office, one of a series that looks at the “delivery chains”
between important national policy intentions (set out in government departments’ Public
Service Agreement targets agreed with HM Treasury) and local delivery.
www.nao.org.uk/publications/nao_reports/05-06/0506801.pdf
Time Use Survey
The UK Time Use Survey is conducted on behalf of a funding consortium consisting of: the
Economic and Social Research Council; the Department of Culture, Media and Sport; the
Department for Education and Skills; the Department of Health; the Department of Transport,
Local Government and the Regions; and the Office for National Statistics.
The main aim of the survey was to measure the amount of time spent by the UK population on
various activities. The UK 2000 Time Use Survey was the first time that a major survey of this
type has been conducted in the UK and as such provides an opportunity to inform a crosssection of policy areas as well as having interest for academia, social research centres and the
advertising and retail sector.
In 2000, the first Time Use Survey was carried out using a combination of questionnaires and
diaries. In 2005, a pre-coded time use diary was used to collect the results from adults aged 16
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and over as part of the National Statistics Omnibus Survey. The Omnibus diary results are
compared with the data collected in the UK 2000 Time Use Survey.
http://www.statistics.gov.uk/cci/article.asp?ID=1600
World Health Organisation
The World Health Organisation (WHO) have a created a global database on BMI. This
database provides both national and sub-national adult underweight, overweight and obesity
prevalence rates by country, year of survey and gender. The information is presented
interactively as maps, tables, graphs and downloadable documents.
www.who.int/bmi/index.jsp
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Statistics on Obesity,
Physical Activity and
Diet: England,
January 2008
Price: Free
Published by The Information Centre
ISBN
978-1-84636-187-6
Bulletin N/A
This publication may be requested in large print or other formats.
For further information contact:
online: www.ic.nhs.uk
telephone: 0845 300 6016
email: enquiries@ic.nhs.uk
Copyright © 2008, The Information Centre. All rights reserved.
This work remains the sole and exclusive property of The Information
Centre and may only be reproduced where there is explicit reference to the
ownership of The Information Centre, and where applicable the appropriate
referenced organisation.
This work may be re-used by NHS and government organisations without
permission. Commercial re-use of this work must be granted by The
Information Centre, and where applicable the appropriate referenced
organisation.

Statistics on Obesity, Physical Activity and Diet: England

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