In 2016, the World Health Organisation released and comprehensive list of recommendation that could help governments to address the levels of childhood obesity and overweight. The focus of the WHO report is on reversing the rising obesity trend in children aged under 5 by working holistically with key aspects of children’s environment to promote healthy behaviours. The fundamental areas of primary prevention of obesity in children are identified as follows:
- Promote intake of healthy foods and reduce the intake of unhealthy foods – by implementing clear food content labelling and taxation rules on foods rich in sugar-content and reducing marketing of unhealthy foods aimed and children and adolescents
- Promote physical activity and reduce sedentary behaviours in children – by informing children and their parents on the recommended levels of physical activity, providing physical activity facilities at schools, nurseries and in the community and enabling families to be physically active in the community by improving safety, improving facilities in green spaces and providing training on active travel to and from school/workplaces.
- Strengthen prenatal and antenatal care guidance to put more emphasis on activities aimed at reducing obesity levels in children – such as better diagnosis and management of hyperglycaemia and gestational hypertension, monitoring and management of gestational weight gain, nutritional and physical activity advice to parents.
- Educating women of childbearing age about the importance a maintaining a healthy weight when thinking about becoming pregnant, healthy weight gain during pregnancy, and then education post pregnancy – importance of breastfeeding, optimum time for weaning.
- To support children in developing healthy habits in food consumption, physical activity and sleep patterns.
- To develop comprehensive programmes that promote healthy environment at schools and promotes nutrition literacy and physical activity in children – by implementing healthy standards for any school meals, eliminating sales of unhealthy foods in school and restricting the opening of fast food outlets around schools, implementing quality physical education and nutrition literacy programmes
- To develop family-based lifestyle weight management interventions of obese children.
To date most of public health intervention programmes have had limited success in tackling the rising prevalence of obesity. It is likely that the limited benefits of such programmes were attributable to their narrow scope; the interventions were aimed addressing some specific determinants of excess weight but not the whole environment where people lived, their community’s social norms surrounding food, eating, and lifestyle – all of which strongly influence what, when, and how much food is consumed.
NICE guideline, similarly to the WHO reports, recommends a holistic approach to obesity prevention targeting it from multiple angles. The following strategies are encouraged:
- Prioritisation of prevention and obesity treatment by local authority and NHS professionals
- Provide safe space for incidental and planned physical activity
- Provide cycling routes, safe play areas and other facilities that encourage outdoor physical activity
- Implement Department for Education and Skills guidance on food procurement and healthy catering in schools, nurseries and other childcare facilities
- Minimise sedentary activities during play time in nurseries
- Schools should ensure that all their policies promote physical activity and healthy diet
- Workplaces should provide opportunities for staff to eat a healthy diet and be physically active, through i) promotion of healthy choices in restaurants, shops and vending machines, ii) providing showers and secure cycle parking, iii) supporting use of local leisure facilities and lunchtime walks, cycling to work, mandated policies for food businesses that promote healthy eating, such as the Healthier Catering Commitment, etc.
- Primary care organisations and local authorities should recommend to patients, or consider endorsing, self-help, commercial and community weight management programmes that follow NICE best practice standards for obesity prevention and treatment.
 WHO 2016: Report of the commission on ending childhood obesity. Available from: http://apps.who.int/iris/bitstream/10665/204176/1/9789241510066_eng.pdf
 Department of Education and Skills: School Food IN England. Departmental advice for governing boards. Available from: https://www.gov.uk/government/publications/standards-for-school-food-in-england