Child obesity is a major problem in the UK and abroad, and GPs regularly witness its profound emotional and physical repercussions. This book presents detailed evidence but on a narrow range of issues, for example, reducing the sale and consumption of sugary, soft drinks is worthwhile; parental body mass index predicts child obesity risk; and exercise improves endothelial function more than weight loss in obese children, hence benefiting cardiovascular risk even if weight loss is not achieved.
However, the chapter on genetics lacked any sense of practical application, with no exploration of how ‘whole genome sequencing technologies will be a large part of the solution’ in helping families either today or in the future.
The book confirmed that prevention programmes work not just by boosting physical activity, but also by the consequent reduction in children’s exposure to heavy marketing of unhealthy fast foods and soft drinks. But a case example of Sweden’s ban of TV advertising to younger children would have been more informative if the authors had included comparison data on its impact.
The discussion about beverages affecting dietary quality was interesting: preschooler milk consumption positively correlates with diet quality but intake is declining. Increases in sugary drinks are displacing nutrient-rich milk, which is clearly associated with child obesity. This could inform those giving individual advice or local pilot interventions.
Despite the topic’s relevance to primary care, this is a decidedly academic tome not targeted at GPs or those commissioning childhood weight and lifestyle programmes. Its strong focus on the extent of child obesity was insufficiently balanced, lacking examination of potential interventions; such as influencing behaviour change in differently-aged children, exploring changes to advertising and marketing to children, or evidence around brief interventions relevant to primary care. This book would be suitable for academics working in this important field, whereas those wanting broader generalist training in obesity could make use of the newly launched RCGP obesity e-learning sessions at www.elearning.rcgp.org.uk/obesity.
- © British Journal of General Practice 2014