Nutrition and obesity

Adolescent nutrition is an area of increasing concern, partly but not only because of the relationship to obesity.  As they get older and begin to move to more independence from their families, young people have more control over what they consume.  Habits of a lifetime can be formed at this stage and poor nutrition has many implications for both current and future health status.

Consumption of five portions a day of fruit and vegetables has become a marker for good diet.  The most recent National Diet and Nutrition Survey also reported that only one in 8 young people aged 11-18 in the UK ate five portions of fruit and vegetables every day (Public Health England, 2020a).

An industry levy on sugar sweetened soft drinks in England was introduced in April 2018. The most recent UK National Diet and Nutrition Survey shows that sugar consumption from soft drinks has been falling for all ages, but is still highest in 11-18 year olds (Chart 2.2).  A significant proportion of 11-18 year olds still exceed the daily recommended limits for sugar consumption (30 grams).

Poor nutrition is related to obesity. Chart 2.3 provides an overview of trends in obesity prevalence in 11-15 year olds since 1995, drawing on data from the Health Survey for England. This measurement of obesity is based on the UK national body mass index (BMI) percentiles classification. BMI measurements that fall into or above the 95th percentile of the 1990 reference population are classified as obese. This is the recommended method for calculating obesity in children, rather than using a BMI cut-off of 30, which is the usual method for its calculation in adults. However, this makes direct comparison between child and adult rates difficult.

According to these data, obesity in England peaked for girls in 2004 at 26.7%, and for boys in 2019 at 27.3%. Currently rates for boys in this age group are higher than for girls, but that trend has changed over time. The combined rate of obesity for all those aged 11-15 was 23.4% (nearly a quarter) in 2019, but the overall trend is not clear.

Estimates of obesity in children for Wales and Scotland are available from their own health surveys, including the Scottish Health Survey and the Public Health Wales Measurement Programme. The latest Scottish Health Survey 2019 reported that 21% of young people aged 12-15 were obese (Scottish Government, 2020). The Welsh Child Measurement Programme only includes children aged 4-5 years and comparable data for older children are not available. In Northern Ireland, government statistics on childhood obesity are only given for all children aged 2-15 collectively, again reducing comparability for our age group.

There are notable health inequalities in obesity rates for 10-11 year olds, as demonstrated in England by the National Child Measurement Programme (NCMP 2019/20). In that year – the last before the pandemic – obesity was over twice as high in the most deprived areas (27.2%) than the least deprived (13.9%). In addition, as Chart 2.4 shows, the difference in obesity prevalence at age 10-11 between the most and least deprived areas is increasing over time, largely due to increases in the more deprived areas.

Just as we published this website, the Office for Health Improvement and Disparities published new data from the 20/21 school year, showing that these trends had exacerbated, reflecting the largest increases in childhood obesity since the programme began in 2006/7, with a substantial increase in the gap between obesity in the least and most deprived areas (to 16.6%).  We have not added this to the chart but you can download the data from their site.

The NCMP also shows inequalities by ethnic group, with rates extending from 19.4% in white groups, to 29.7% in Black groups, and other ethic groups falling in between (NHS Digital, 2020a). There is also evidence from primary care that rates are higher for young people aged 10-24 with learning disabilities (NHS Digital, 2020b) Health and care of people with learning disabilities, Interactive Tool.

Obesity in 16-24 year olds is measured using BMI rates themselves, rather than their position on percentile charts. A BMI of more than 25 is considered a measure of overweight, and a BMI of 30 or more is considered a measure of obesity. Chart 2.5 presents the proportions of 16-24 year olds who were obese, by gender, in England from 2003 to 2019. In 2019, 11% of young men and 20% of young women in this age group were obese. Rates reported in the Scottish Health Survey 2017 for this age group were very similar, at 14% for young men and 21% for women (Scottish Government, 2020).

All data correct as of 1st November 2021