Greenwich Council

Agenda item.

Review of obesity - Mapping work to address child obesity in Greenwich

To consider the key findings from the RBG obesity self-assessment that relate in particular to child obesity in Greenwich


The Chair explained that the item was also in relation to work being undertaken by the Healthier Communities and Adult Social Care Scrutiny Panel.


The meeting was addressed by the Associate Director of Public Health.  The Associate Director highlighted that:


·        there was a high rate of childhood obesity in the Borough; this was similar to areas with the same level of deprivation.  The data seemed to indicate that obesity rates were stabilising but that it was still at the high end nationally. The Associate Director clarified the difference between ‘overweight’ and ‘obese’ and noted that the proportion of overweight children was going down slightly but not that of obese children.

·        there were high levels of obesity with adults.

·        the levels were related to deprivation and ethnicity.

·        the national evidence indicated that there was no one single way to solve it.  It had to be a whole system approach and that a range of causes or factors needed to be addressed.



The Chair, Councillor Barwick, asked what local hospitals were doing to facilitate or encourage breast feeding.  The Associate Director of Public Health stated that the local maternity units had a baby-friendly initiative and were working with midwives to encourage breast feeding.  It stated that a collaborative approach was being followed.


Councillor Offord questioned what the current staffing situation was in relation to midwives.  In response the Director of Integrated Governance stated that there was circa one midwife per 29 mothers and that this was about the London average.  All midwives received annual training and they had to demonstrate that they had been fully trained to be re-registered.  The Director undertook to inform Members of the situation compared to ten years ago.


In response to further questions the Director stated that mothers of an African descent generally had higher rates of breast feeding but they also had a high rate of mixed feeding; and white working class women were less likely to breast feed.  As a result material encouraging breast feeding was suitably tailored.  The importance of peer pressure was also stressed.


Members were also informed that local policies recognised the importance of support groups for breast feeding mothers and that these were encouraged.  The Panel welcomed the initiatives to encourage breast feeding and to address the discrimination experienced by mothers regarding feeding in public, however, it was recognised that further work was required


In relation to ante-natal planning the Associate Director of Public Health stated that an assessment had been undertaken and areas for improvement identified.  The Panel noted that action plans would be part of the Health and Wellbeing Strategy.


In response to questions regarding the difference between childhood obesity and being overweight and how this related to age the Associate Director of Public Health stated that it depended on the age of the child as children developed at different rates, i.e. some would grow out of it. Members were informed that to reduce obesity required weight management programmes and behavioural changes.  It was noted that currently all children were weighed at reception and in Year 6 and Members recognised that if a child was overweight or obese as a child, there was a strong likelihood that they would be overweight or obese as an adult. 


In relation to the impact of genetics the Associate Director of Public Health clarified that there may be a genetic predisposition to put on weight but this was not the only determinant.  It was stated that genetically all people were designed to put on weight and that environmental and societal issues also played a significant part.


In response to questions relating to monitoring the quality of pre-school children’s food or the impact of the Borough’s Children’s Centres on diet, the Associate Director of Public Health stated that Children’s Centres had a lot of good practices including the healthy early years award.   All Centres had an action plan to tackle obesity through promoting physical activity and healthy eating.  Members welcomed the initiative of working with child minders to extend the good practices.


The Panel recognised the importance of increasing physical exercise as one of the tools to address childhood obesity.  Members questioned whether it would be possible to increase young people’s access to leisure facilities and how this could be progressed.  In response it was stated that young people were encouraged to use facilities as well as low cost/ no cost activities.


Members noted that the use of the outdoor gyms in the Borough’s parks was not monitored, however, intelligence from Friends of the Park groups indicated that  some were very well used however, in part, it depended on footfall and park usage.  The Associate Director of Public Health stated the evolving Parks and Open Spaces Strategy would be looking to see what parks can do to have an impact on activity.  Work was also being progressed on how to increase the use of the Borough’s leisure facilities but there were a number of financial constraints.  The Panel noted that the Strategy would be out for consultation in the summer and one of its objectives was to increase the use of parks and the facilities provided in them.


Members questioned the correlation between rates of childhood obesity and levels of deprivation.  In response the Associate Director of Public Health said it was still the case that according to statistics deprivation paid a part.  Research showed that those on a low income were most likely to buy the cheapest food which had the most calories.  The Panel noted that initiatives were being undertaken to encourage the use of fresh produce and home cooking as one way of promoting a healthy diet.  Members also noted that community cooking clubs had been set up in the Borough which had a flexible approach and could be set up anywhere with portable kitchens.


In relation to sugar Members questioned what measures were being taken to reduce its use in particular with the increase in childhood obesity.  In response it was stated that the Borough was a member of the Sugar Smart Initiative, which was an awarding winning scheme. 


The Panel received a presentation from two head teachers who emphasised that schools followed a whole child and family approach, encouraging children to enjoy healthy food and have an active lifestyle.  It was stated that schools were working with GS Plus to promote this work and kitchens and canteens had been rebranded with new layouts and with a greater use of salads and fresh food.  Teachers were encouraged to eat with children and schools tried to sell a balanced meal and monitor what children ate.  Members noted that teachers monitored the contents of packed lunches and that the school councils gave out stickers to healthy packed lunches.  Furthermore, healthy eating was taught and children were growing food and subsequently preparing and cooking it; this was in addition to the science of food and the history of food. 


The Panel was also informed that schools were working with partners and companies to promote healthy choices; and, that local schools had been recognised in the McDougall National Cooking competition and this also promoted how to break the cycle of poor diet. 


In relation to physical activity in schools the Panel was informed that children did a minimum of two hours of PE a week.  Children were also taught to play without equipment so that they could do this outside of school.  The Panel noted that schools encouraged children to learn to ride bikes safely and how to care for them.  Furthermore, children (and parents) were encouraged to walk to school and this was part of their school travel plan. 


The Panel was informed that schools sought to promote a range of different sports, for example BMX riding, diving and street hockey.  Clusters of schools had hired a coordinator to have inter-school activities for sports or athletics. 


The Panel noted that schools had benefitted, and continued to benefit, from the Borough’s co-hosting of the London 2012 Olympics and Paralympics.  It was stated that this had promoted role models from the world of sport which had inspired children.  The Headteacher also informed the Panel that schools had a whole child approach which included meditation sessions to teach children to be calm. 


In response to a question Members were informed that children’s weight and height was measured in Year 6.  Should a child be obese the parents would receive a letter from the Health Service providing them advice and support on how to reduce weight.  It was recognised that the letter parents received could cause anxiety but it was a national initiative to reduce obesity rates.


The Panel recognised the work was being under by the Borough’s schools to address childhood obesity.  Members noted that in order to take this work further the Headteachers would value additional input from health visitors to work with families.  The importance of early intervention was stressed by all parties.


Members were also informed by the Headteacher attendees that children and young people did not always use leisure centres nor knew what they offered.  It was stated that there may be issues for young people regarding the cost. However, the Assistant Director of Sport and Commissioning stated previous initiatives to provide free or discounted access had not led to an increase of use. The Panel noted that there was an issue with regard to young people not playing outside in general. It was also stated that the success of the Sports Premium was difficult to evaluate in comparison to its predecessor.


The Panel was informed by the Assistant Director Commissioning & Resources that the school nursing and health visiting service was being re-commissioned with a focus on reducing obesity and that family intervention to promote healthy eating was undertaken.


The Panel welcomed the work being undertaken by Children’s Services to support schools and healthy lifestyles.  The importance of the Council, Headteachers and governing bodies continuing to work together was stressed by Members.


The Panel received a presentation from the Principal Transport Planner in relation to improving the physical environment to encourage walking or cycling.  These included enhancements for pedestrians by having green ways and having 20mph zones across the borough to allow more walking.  Members noted that initiatives included a swing bridge over Deptford Creek; that the Ridgeway was now traffic free: that a new network of paths in Avery Hill promoted greater opportunities for walking and cycling; cycling training for young people and families, including sessions in schools; safe walking and cycling routes to school; and providing crossing and school patrols.


The Panel welcomed the increase in the rates of walking and cycling in the Borough and noted that there was scope for further improvement.  Members stated that the importance of encouraging cycling and walking rather than the use of the bus was key in reducing obesity rates.  This would require behavioural changes and this would take time.


In response to questions the Principal Transport Planner informed the Panel that the Council had a cycle loan scheme and that the training promoted safe cycling.  Schools also usually had secure storage for bicycles and that where necessary the Council provided bicycles for training and awareness sessions.


The Panel received a presentation from the Planning Policy Manager regarding the impact of planning policy on applications for takeaways and in particular their positioning in relation schools. 


Members noted that the Council’s powers were limited and that applicants could appeal any decisions not taken in accord with national, regional and local policy.  Should there be no valid planning rounds to refuse an application it would be likely that any appeal would be successful with costs awarded against the Authority.


In relation to the proposed new cinema in Eltham High Street, the Planning Policy Officer clarified that the type of restaurant was not a planning matter.


Members expressed their concern that there were only a limited range of powers to control hot food takeaways and their proximity of schools.  The Chair of the Healthier Communities and Adult Social Care Scrutiny Panel informed the meeting that the Directorate of Regeneration, Enterprise and Skills was working closely with Public Health on this matter.


In relation to the use of leisure centres the Assistant Director of Sport and Commissioning clarified that there was increased participation, in particular at the Waterfront.  Changes to layouts, such as integrated libraries and leisure centres, and activities for children in both areas to encourage attendance by young people.  It was noted that the co-location could improve the programme and offer more activities and work with Public Health was being undertaken on how libraries could promote health or have signposting to activities in the borough.  Members noted that the leisure centres provide a universal service but they did run taster programmes to try and fit activities that would attract children and families. 


The Assistant Director also informed the Panel that the operatives of the Borough’s leisure centres, Greenwich Leisure Limited (GLL), had an outreach programme.  The Assistant Director Commissioning & Resources said that Children’s Centres were encouraging families into centres and that special sessions at discounted had been held.


In response to questions the Assistant Director of Sport and Commissioning stated that the option of reducing prices or reviewing the current pricing structure would be looked at.  However, research had shown that cost was not necessarily the main determinant for why young people did not necessarily attend a leisure centre on a regular basis.  It was stated that there was a demand for increased integration; and that libraries could be used as a way of promoting activities.  Further work on providing healthy eating options at leisure centres was being progressed in particular where the provider was GS Plus.  The Assistant Director undertook to circulate information to Members on the usage of the centres, the pricing structure, discounts and promotions.


The Assistant Director clarified that the Sportathon was about mass participation in sport and physical activity whereby the London Youth Games was an inter-school competition.  The Council continued to work with the Army to promote healthy lifestyles.


In response to a question the Assistant Director stated that he would circulate statistics on the percentage of leisure centre users were from a Black, Asian or Minority Ethnic communities.


The Chair, Councillor Barwick, thanked all the participants for their contributions.


Resolved -


1.            That the report and presentations be noted.


2.            That the following recommendations and suggestions be forwarded to the Healthier Communities and Adult Social Care Scrutiny Panel:


·        Primary schools doing well to tackle issue of childhood obesity

·        Greater support needed for breastfeeding friendly places

·        Leisure Centres must ensure their cafés have healthy food. 

·        Leisure Centres need to be more inviting to families/young people

·        Consideration be given to free leisure centre activities for young people

·        Greenwich to consider taking a position on sugar.


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