Dietary habits of young people attending secondary schools serving a multiethnic, inner-city community in the UK.

BACKGROUND: Childhood obesity is an escalating health concern with important implications, including increased risk of type 2 diabetes and cardiovascular disease. Although South Asians in the UK have an increased risk of developing these conditions, detailed studies on their lifestyles including the dietary habits of young people are scarce. METHODS: As part of an action research project, a food intake questionnaire was used to survey the dietary habits of 11-15-year olds attending five inner-city schools serving a predominantly South Asian population. Food choices were considered in the overall sample and in South Asians compared with white Europeans. RESULTS: 3418 (72% of registered pupils) responses were obtained. A subset of 3018 pupils could be categorised as either South Asian (86%) or white European (14%). Around one fifth of pupils started the school day without eating anything. Responses indicated high consumption of "negative" foods such as sweets, including Asian sweets (63%), but lower rates for "positive" foods such as vegetables (34%). In the full sample, 26% said they had consumed more than one can of sugar-sweetened fizzy drink and 17% reported eating more than one packet of full-fat crisps on the previous day. Poor dietary habits were indicated in both South Asian and white European pupils. CONCLUSIONS: Our large-scale survey confirmed poor dietary habits in secondary school pupils from a multiethnic community. Urgent efforts are needed to find ways of encouraging healthy lifestyles, particularly in populations with a high risk of developing cardiovascular disease and type 2 diabetes.

Relative efficacy of differential methods of dietary advice: a systematic review.

BACKGROUND: Dietary advice to lower blood cholesterol may be given by a variety of means. The relative efficacy of the different methods is unknown. OBJECTIVE: The objective was to assess the effects of dietary advice given by dietitians compared with advice from other health professionals, or self-help resources, in reducing blood cholesterol in adults. DESIGN: We performed a systematic review, identifying potential studies by searching the electronic databases of the Cochrane Library, MEDLINE, EMBASE, CINAHL, Human Nutrition, Science Citation Index, and Social Sciences Citation Index. We also hand-searched relevant conference proceedings, reference lists in trial reports, and review articles. Finally, we contacted experts in the field. The selection criteria included randomized trials of dietary advice given by dietitians compared with advice given by other health professionals or self-help resources. The main outcome was difference in blood cholesterol between the dietitian group compared with other intervention groups. Inclusion decisions and data extraction were duplicated. RESULTS: Eleven studies with 12 comparisons met the inclusion criteria. Four studies compared dietitians with doctors, 7 with self-help resources, and 1 with nurses. Participants receiving advice from dietitians experienced a greater reduction in blood total cholesterol than those receiving advice from doctors (-0.25 mmol/L, 95% CI -0.37, -0.12 mmol/L). There was no statistically significant difference in change in blood cholesterol between dietitians and self-help resources (-0.10 mmol/L, 95% CI -0.22, 0.03 mmol/L). CONCLUSIONS: Dietitians appeared to be better than doctors at lowering blood cholesterol in the short to medium term, though the difference was small (about 4%), but there was no evidence that they were better than self-help resources or nurses.

Physical activity and sedentary behaviours of South Asian and white European children in inner city secondary schools in the UK.

BACKGROUND: People of South Asian (SA) origin have an increased risk of premature coronary heart disease. In children of SA origin, there is an increased prevalence of obesity and evidence of insulin resistance. Risk factors for cardiovascular disease in children often persist into adulthood. Low levels of physical activity are likely to be linked to the rise in obesity. OBJECTIVE: To determine levels of physical activity and sedentary behaviours in secondary school pupils in the UK, including comparison of SA and white European (WE) children and those with and without a family history of cardiovascular disease. METHOD: Questionnaire survey conducted within an action research study in five inner city secondary schools serving a predominantly SA population. RESULTS: We obtained 3601 responses from 76% of eligible pupils. WE pupils were more likely to have walked to and from school compared to SAs. However, overall we identified low levels of physical activity and higher levels of inactive behaviours in both ethnic groups. Almost half (46%) of respondents spent four or more hours per day watching television or videos or playing computer games. An overall low level of active behaviour during school breaks was particularly emphasized in girls. We found no evidence of an association between physical activity levels and family history of cardiovascular disease. CONCLUSIONS: There is an urgent need for those with responsibility for young people's health, including parents, schools and community health providers, to consider and address the need for effective interventions to encourage increased physical activity levels.