Alcohol misuse: tackling the UK epidemic - London

Changes in family eating patterns and the consumption of fast foods, pre-prepared meals and carbonated
drinks, have taken place over the past 30 years while the amount of physical activity has been greatly
reduced both at home and in school. 17
Eating behaviours that have been linked to overweight and obesity
include snacking/eating frequently, binge-eating patterns, and eating out; in contrast, exclusive
breastfeeding of infants has a protective effect. 17
Though the increase in obesity among adolescents is a worrying trend, it is important not to contribute to
unnecessary anxiety among adolescents about their weight. Various studies of children and adolescents
have shown that a sizeable proportion are dissatisfied with their body size and shape. 23
This concern
increases with body mass index (BMI) and is more prevalent in females than in males. Research also
suggests a rise over time in dieting among adolescent females. 36
The Health Survey for England 1997
found that 20 per cent of 16 to 24 year old females who had a desirable body mass index (a BMI of between
20 and 25) thought they were too heavy. A significant proportion who were not overweight were trying to
lose weight (10% of the underweight and 45% of those with desirable weight). 23
Which adolescents have poor nutrition, are inactive or obese?
The Health Survey for England 1997 found that the eating habits of two to 15 year olds, though not those
of ‘young adults’, were related to social class and income. There was a decrease from social classes I and
II (combined) to IV and V (combined), and also from the highest to the lowest income quintile, in the
proportion consuming fruit and vegetables more than once every day. There was a corresponding increase
in the proportions consuming sweet foods, soft drinks and crisps more than once every day, or consuming
chips at least five days a week. 23
More recently, foods consumed by 14 to 16 year olds have been found to
be similar across socio-economic groups. Despite this similarity, those in higher social groups report wider
exposure to different foods while adolescents in lower social groups report greater independence in
food choices and more responsibility for organising these choices. 19
The Health Survey for England 23
and the Scottish Health Survey 24
both found some socio-economic
gradient in physical activity. The Health Survey for England found no consistent relationship between
overall activity (sports and exercise, active play, walking and housework/gardening) and social class or
household income. However, there were differences in participation in the different activity types
according to social class and equivalised household income. In particular, there was a marked social class
gradient in participation in sports and exercise among younger boys and all girls, with participation being
lower among social classes IV and V. Participation rates in sport among 11 to 15 year old girls of social class
I and II was 63 per cent in 1997; by contrast the participation rate among girls in social class IV and V was
47 per cent. 23
The Scottish Health Survey found subtle differences in the relationship between
participation in physical activity and social class. Girls in manual social class households were slightly
less likely to have a low level of activity but those in social class I/II were more likely than girls in
other groups to have participated in sports and exercise activities in the week before the interview. 24
Children and adolescents are at greater risk of gaining excess weight if one or both of their parents are
overweight. They may also be at greater risk in households with low incomes. 25
Children who suffer from
neglect, depression, or other related problems are at substantially increased risk of obesity during
childhood and in later life. 14
British Medical Association Adolescent health 7