• Pre-school
• Primary
• Secondary
• Post-16

Primary

We visited the children twice during their primary school years: between October 2006 and December 2007, when the children were aged between 6 and 8 years old, and between October 2008 and September 2009, when the children were aged between 8 and 10 years old. We were interested in the reasons why some children become overweight, so we measured different lifestyle aspects of both the children and their parents.

Measurements at age 6-8 years with the children

We wanted to know how physically active the children were, and what foods they ate, so we asked the children to wear an activity monitor for a week and their parents kept a food diary of all the foods they ate over 4 days.

We then visited most of them at school and took different measurements:

• Height, weight, waist circumference
• Skinfold thickness
• Size of their skeleton
• Saliva sample

The children also filled in some questionnaires with us, looking at food knowledge; their feelings about eating and body perceptions.

Measurements at age 6-8 years with the parents

We visited the parents at home and they completed questionnaires on their:

• Food knowledge and environment
• Food intake
• Physical activity and the physical activity environment of their child
• Perception of their child's weight
• We also measured their height, weight, waist and hip circumference and took a saliva sample.

54 parents took part in focus groups and interviews to explore parental views and opinions on childhood overweight and obesity. Another aim was to identify effective preventive strategies that would be acceptable to families.

Measurements at age 8-10 years old with the children

We were interested to see how much the children had grown from when we saw them 2 years earlier, and whether their physical activity levels had changed.

We measured the children's physical activity for a week using an activity monitor, and then visited the children at school. They completed questionnaires for us on:

• Sports clubs they attend
• How they feel about themselves physically
• Their home environment
• Their feelings about eating
• Body image

We measured their height, weight and waist circumference.

Measurements at age 8-10 years old with the parents

Parents completed a questionnaire on the home environment.

What did we find?

During 2006-2008, 619 children and 617 parents/carers took part and we visited 74 primary schools. In 2008-2009, 590 children and 495 parents/carers took part and we visited all 74 primary schools again.

Physical activity

To keep healthy, children are recommended to do at least 60 minutes of physical activity every day at an intensity equivalent to a brisk walk (or faster!). This can be done as smaller chunks, such as 4 lots of 15 minutes.

At age 6-8, 510 GMS children completed the physical activity measurements.

We found:

• The children did an average of 40 minutes of physical activity per day (so below the recommendations)
• Only 59 children reached the recommendation of at least 60 minutes physical activity every day
• Boys were more active than girls
• More activity took place on weekdays than weekends
• Children who were more active were less likely to be overweight

At age 8-10, 508 children completed the measurements.

We found:

• The children were slightly less active than at age 6-8 (down from 40 minutes per day at age 6-8, to 37 minutes per day at age 8-10), especially the girls
• Only 51 children reached the 60 minutes per day recommendation for good health
• Children who were overweight at age 6-8 had reduced their physical activity at age 8-10 more than healthy-weight children

209 children took part in at least one school sports club each week, and 342 did at least one outside-school sports club. The children told us about 19 different school sports clubs and 21 different outside-school clubs, so it's great to see so much choice available.

Food intake

To stay healthy, it is recommended that children consume a healthy, balanced diet which is rich in fruit, vegetables and starchy foods. It is also recommended that snack foods such as cakes, biscuits, chocolates and sweets should be eaten only occasionally or in small amounts, so that they make up a relatively small part of the overall diet (The Eatwell Guide).

At age 6-8 years, 4-day food diaries were completed by 474 of the GMS children. We found that the children consumed 1.7 portions of fruit and vegetables per day (excluding fruit juice), so this was just over 2 portions per day when fruit juice was included compared to the '5 a day' recommendation. Fruit and vegetable intake ranged from 0 to 5.6 portions per day.

Using the information we collected from the food diaries, we also created a 'healthy' and 'unhealthy' indicator score. We did this so that we could look at how many 'healthy' foods (such as wholemeal bread, fruit, vegetables and non-processed meat and fish products) and 'unhealthy' foods (such as biscuits, confectionery, processed meat and fish products and full-sugar carbonated drinks) were consumed each day.

We found that the children consumed 5.0 portions of 'healthy' foods and 5.3 portions of 'unhealthy' foods each day. The number of 'healthy' foods consumed each day ranged from 0.25 to 14.5 portions, and the number of 'unhealthy' foods consumed each day ranged from 1.0 to 10.0 portions.

Dietary patterns

We looked at the children’s food diaries from age 6-8 years to see if different children ate different combinations of foods, and whether they were generally ‘healthy’ or ‘unhealthy’. Four main different patterns of diet were found, with the most prevalent being a healthy pattern of eating vegetables and whole grains, and not eating chips and sugary cereals. However, children who ate a more unhealthy diet were more likely to have a parent who did not realise their child was overweight.

Body measurements

At age 6-8, the children were on average 1m 25cm tall and weighed an average of 26.6kg. Their heights ranged from 1m 8cm to 1m 40cm and their weights from 16.6kg to 52.1kg.

At age 8-10, the children had grown to an average of 1m 36cm and 33.4kg. They ranged in height from 1m 16cm to 1m 55cm and in weight from 19.2kg to 70.8kg.

Girls and boys were similar heights and weights at both ages.

We found that at age 6-8 442 children were a healthy weight for their height, that's 74% of the children we measured. 155 were overweight or obese.

At age 8-10 these numbers had changed, so that 390 of the children we measured were a healthy weight (67%) and 195 were overweight or obese.

Parent’s perception of their child’s weight

We found that at age 6-8 years many parents were unable to identify if their child was overweight. Parents used a mixture of methods to assess their child’s weight, include comparing them with other children, and whether their clothes fitted. Parents relied on extreme cases of overweight to make these judgements, and as such were not always able to tell that their child was overweight. We have used these results to create a new tool to help parents and professionals more accurately assess whether their child is overweight. This work is ongoing and results will be linked here once completed.