Strategies for the prevention of obesity in children
The prevalence of obesity is increasing at an unprecedented rate in the United Kingdom, in both adults and children. Obesity is a risk factor for many chronic diseases and may also lead to psychological disorders. The long-term successful treatment of obesity is a difficult goal to achieve. Preventing obesity, particularly in children, has become a public health objective. In this thesis, two strategies for the prevention of obesity in children are presented. The first study utilised a health promotion approach. A school-based programme, aimed at children aged 5-7 years, was developed and delivered in lunchtime clubs over four school terms (initial cohort, n 218). Healthy eating and/or physical activity were the focus of the learning objectives in an interactive and supportive teaching environment. Results of the intervention showed an improvement in children's knowledge and a modest increase in fruit intake, which was independent of a rise in parental consumption. Schools appear to provide an important opportunity for children to undertake physical activity. Satisfaction with the programme was high for parents and teachers. This pilot study is the first such interventioh in this age group in the UK and it may provide guidance for future initiatives. The teaching materials developed are to be made available nationally. In a second study, the effect of glycaemic index (GI) on appetite and satiety was investigated in a cohort of children aged 9-11 years (n 37). In this within-subject design study, all subjects received three test breakfasts, low-GI, low-GI with added sucrose or high-GI, in a random order, for three days each. This was followed by a buffet style lunch where food intake was recorded covertly. Results showed a significantly lower lunch intake after the low GI and low GI with added sucrose breakfasts when compared to both the high-GI and a trial day when habitual breakfast was eaten at home. Satiety pre-lunch was rated lower after the high-GI breakfast compared to the other two breakfasts. This is the first study to investigate the effect of low-GI meals on appetite and satiety in a group of normal and overweight children. It adds to the growing body of evidence for a role of low-GI foods in weight management. Obesity is a complex and multifactorial condition, which must be addressed on many levels. The research undertaken in this thesis provides evidence for pursuing both a health promotion approach and dietary manipulation to decrease the GI of a diet as potential strategies for the prevention of obesity in children.
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