Changes in diet and physical activity after a pilot intervention to tackle childhood obesity in a deprived inner-London community: an observational cohort study

Abstract

BackgroundLocal authorities in England are uniquely positioned to modify obesogenic local environments contributing to childhood obesity. Evaluating the effects of local authority-led, community-wide approaches is challenging. This study examines changes in diet and physical activity in children aged 6–11 years after a 4-year, complex, community-based, pilot intervention in Golborne, one of the most deprived areas in London. MethodsThe Go-Golborne intervention aimed to shape the local environment by building on local assets, connecting stakeholders in local government and the community, and synchronising existing activities. Activities focused on six themes to make changes to local environments and reduce the consumption of sugary snacks and beverages, increase fruit and vegetable intake, promote healthy snacks, increase active play and travel, and reduce screen time. We analysed changes in self-reported diet and physical activity, collected annually in 2016–19, from children from six local schools. Results were compared with the data collected at baseline. We used multilevel, linear (for dietary outcomes), and logistic (for physical activity) random-slope regression models to examine changes in diet and physical activity by time on study, adjusting for baseline age, sex, ethnicity, deprivation quintile, school, and baseline weight status. Dietary outcomes were calculated by summing the total occasions a participant indicated they ate or drank a certain food or drink (reported as portions per day, expressed as a β coefficient). The physical activity outcomes were developed by creating six binary variables to distinguish those who were most active from those who were least active. Findings1650 children (mean age 7·9 years [SD:1·6]; 808 [49%] girls and 842 [51%] boys) were included. After 3 years of follow-up, we noted reductions in sugary beverage consumption (adjusted β –0·43 portions [95% CI –0·55 to –0·32]; p<0·0001) and car travel to and from school (adjusted odds ratio [OR] 0·19 [95% CI 0·06 to 0·66]; p<0·0001), whereas screen time increased (high vs moderate or low; 2·30 [1·36 to 3·90]; p=0·0021). For other dietary and physical activity outcomes, no evidence of changes and no variation by subgroups were noted. InterpretationLocal authorities can make changes to the obesogenic environment, and mixed results from the Go-Golborne intervention show that collaboration is possible between academics, local authorities, and the community, highlighting the need for robust intervention design in real-world settings, where the need for practical community interventions are met alongside academic rigour. FundingRoyal Borough of Kensington and Chelsea. CB is funded by the School for Public Health Research of the National Institute for Health and Care Research (grant reference PD-SPH-2015). CJ is partly funded by Public Health at the Royal Borough of Kensington and Chelsea and by the National Institute for Health and Care Research Applied Research Collaborative. The views expressed are those of the authors and not necessarily those of the National Institute for Health and Care Research or the Department of Health and Social Care.