Alcohol misuse: tackling the UK epidemic - London

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Interventions in adolescent nutrition, exercise and obesity
As concern about nutrition, exercise and obesity among adolescents, children and the population as a
whole has grown, interventions have been introduced to improve nutritional status, increase physical
activity and prevent and manage obesity. With regard to obesity in particular, many non-governmental
organisations do not view current interventions as radical enough to prevent the growing crisis which some
predict will end in epidemic rates of serious adult diseases such as diabetes and chronic heart disease.
Interventions in adolescent nutrition
Intervention in nutrition in early life has the potential to bring about major reductions in the incidence
of several adult diseases. 10
Unfortunately there is little agreement on the best way to improve the diets of
adolescents. Two main strands of current policy can be identified; first, educating adolescents about the
importance of making better nutritional choices and second, limiting the availability of unhealthy food
and providing healthy alternatives.
To date, most health policy has focused on educational interventions in schools. This approach has
recently been expanded; a new Healthy Schools Programme has been developed to promote health
education through local education and health partnerships. The government is encouraging schools to
adopt a whole school approach to food and nutrition. This involves integrating knowledge about nutrition
into all areas of the curriculum. The Food Standards Agency is currently involved in several initiatives to
raise the knowledge and skills of young people as they relate to food and nutrition. These initiatives
include travelling classrooms for cookery lessons and resources for schools and youth organisations. The
Food Standards Agency is also investigating peer education approaches. 19
Educational interventions in adolescent nutrition need not be limited to diet and health awareness. The
Food Standards Agency and Department for Education and Skills have identified several ‘competencies’
for health education including consumer awareness, food handling and preparation and food hygiene. 19
In addition to health education initiatives, the government has introduced several programmes to improve
the nutritional content of adolescents’ diets through the provision of healthy food. For example, in 2001,
minimum nutritional standards for school lunches were re-introduced in England. In Scotland nutrient
standards for school lunches in secondary schools will be introduced by 2006. 37
The government has also
recently introduced a National School Fruit Scheme, which will be fully operational by 2004, entitling
school children in England aged four to six to a free piece of fruit each school day. A similar scheme is
being introduced in Scotland 37
while Wales has launched a national strategy to improve physical and
economic access to healthy food. This is aimed at priority groups, including infants, children and young
people. 38
Although not targeted at today’s adolescents, the fruit schemes may help to encourage habits of
healthy eating among young children which will last until adulthood. Initial evaluation of the scheme in
England has been encouraging 39
and ongoing monitoring may provide a basis for adopting similar
schemes for older children and adolescents. If these current healthy eating initiatives are evaluated
positively, they could be sustained and built upon in the future.
Interventions in adolescent exercise and obesity
There are currently no overweight and obesity targets for England, Wales, Scotland or Northern Ireland.
However, the NHS Plan stated an intention to tackle obesity and the government currently has a number
of school-based initiatives to improve dietary habits (see above). Wales is working to develop and manage
initiatives to prevent and manage overweight and obesity among the population. 38
The Children’s National
Service Framework, due to be launched at the end of 2003, will address childhood obesity as part of the
broader issues around promoting a healthy diet and physical activity. 40
British Medical Association Adolescent health