Recovery JSNA: Moving and eating
Health behaviours, such as physical activity and eating a balanced diet have a huge impact on our health. These lifestyle choices can act as risk factors for a range of diseases such as diabetes, obesity, and coronary heart disease. Regular physical activity in children has a range of benefits, ranging from improved learning to better mental and physical health. For adults, physical activity can have a protective effect against many chronic conditions.
The COVID-19 pandemic meant that our population has spent more time in their homes, with reduced access to outdoor space due to government restrictions in place. People were relying on their local areas, any private outdoor space (gardens) and indoor space to exercise and be physically active in.
This chapter covers the following topics:
Moving and eating during the COVID-19 pandemic
Public Health England and the UK Food Standards Agency carried out the National Diet and Nutrition Survey Rolling Programme (NDNS RP) between August and October 2020 to assess the impact of the pandemic on the diet and physical activity of people in the UK. Looking at self-reported diet and physical activity, alongside dietary behaviours collected in a web questionnaire, the study gathered data from 1,000 participants. These participants previously took part in the NDNS RP, roughly 2 and a half years previously.
Some of the main findings of the study were:
It was found that the mean number of fruit and vegetable portions consumed daily was 2.8 for children aged 11 - 18, 3.7 for adults aged 19 - 64, and 4.5 for adults aged 65+. This shows an increase in number of fruit and vegetable portions with age.
The means for all groups had decreased when comparing these means to the data collected in the previous survey, roughly 2 and a half years prior to the pandemic - by 0.2, 0.7 and 0.4 portions respectively.
Cutting down on or skipping meals
When asked whether they or a member of their household had cut down on or skipped any meals since the start of the pandemic, 19% of participants reported that they had. Of that 19%, the main reason (72%) for doing so was that the food they wanted was not available in the grocery shops.
Changes to food shopping and food preparation
68% of those surveyed said that they visited the grocery shops less and nearly 60% said that they had cooked more at home since the start of the pandemic.
Participants were asked if their physical activity level had changed since the start of the pandemic. Both children aged 2-10 years and 11-18 years saw the largest self reported decrease in physical activity level, at 43% and 54% respectively. However for all age groups, more people reported that their physical activity had decreased or remained the same than those that reported it had increased.
COVID-19 and weight
Excess weight and obesity can lead to various serious medical conditions, including:
- Type 2 diabetes
- Coronary Heart Disease
- Some types of cancer
During the course of the COVID-19 pandemic, emerging evidence has been produced that suggests that those living with overweight or obesity are at much increased risk of serious complications and even death from COVID-19.
The findings that have come from numerous study types, carried out both in the UK and other countries, are widely in agreement on the relationship between weight and COVID-19 complexities.
The risks associated appear to increase progressively with an increasing BMI above the healthy weight range, even after adjusting for other potential impacting factors such as demographic.
There are various factors that can put a person at higher risk of serious complications from COVID-19, such as age and ethnicity, however excess weight may be one of the few risk factors that can be modified, with existing evidence of effecting interventions.
Percentage of adults (aged 18+) classified as overweight or obese
Adults are defined as overweight (including obese) if their body mass index (BMI) is greater than or equal to 25kg/m2
The percentage of adults classified as overweight or obese has remained consistent in Wiltshire over recent years, seeing a slight decrease in 2017/18, down to 58%, but since increasing to 60%. England, the South West and Wiltshire all see a similar percentage of adults classified as overweight or obese, with roughly every 3 out of 5 people classed as overweight or obese.
Nearly 10% of patients aged 18+ registered with GP surgeries in Wiltshire in 2019/20, were classed as obese. Although prevalence of obesity is slightly lower in Wiltshire in comparison to the South West and England, it has increased over the past three years.
Physical activity and diet
Physically active adults
The percentage of physically active adults in Wiltshire has remained consistent over the last several years, at just over 70%. This is similar to the South West, but higher than England, which most recently (2019/20) recorded the percentage of physically active adults at around 66%.
Physically active children and young people
The percentage of physically active Children and Young People saw an increase for all three areas from 2017/18 to 2018/19. Wiltshire has the lowest percentage of the three areas at 43.7%, compared with 46.8% (England) and 50% (South West).
Fruit and vegetable consumption
The proportion of adults reporting that they meet the recommended 5 portions of fruit and vegetables on a usual day has remained consistent in recent years, with 58.6% of adults in Wiltshire reporting they meet the recommended amount in 2019/20. This is similar to the proportions seen in 2019/20 in South West (60.1) and slightly higher than England (55.4%).
Access to outdoor space
The national lockdowns in England, implemented by the goverment as part of the COVID-19 restrictions, meant that people were spending more time at home than ever. One in three workers were based exclusively at home in the Spring 2020 lockdown and nearly 90% of children of school age had been homeschooled.
During the lockdowns, limited exercise outside the home was permitted, but restricted to the local area, making access to local parks and public gardens important.
Private outdoor spaces
Whilst Wiltshire has a similar percentage of addresses with private outdoor spaces to the South West and England, the average size of outdoor space is significantly larger for properties in Wiltshire, at 492m2, in comparison to South West (413m2) and England (326m2).
Parks and public gardens
Wiltshire residents have to travel an average distance of 552m to their nearest park or public garden, which is notably shorter in comparison to England (986.8) and the South West (1345.5). The average number of parks or public gardens within a 1,000m radius of a home in Wiltshire is 2.9, which is higher than the average for England (2.5) and South West (2).
Health conditions affected by weight, diet and physical activity
Coronary Heart Disease
The risk of getting coronary heart disease can be reduced by making several lifestyle changes, including eating a healthy balanced diet, being physically active and keeping to a healthy weight
Prevalence of Coronary Heart Disease has remained fairly steady over the past 3 years. Prevalence within Wiltshire was 3.5% in 2019/20, lower than South West (3.6%), yet higher than England (3.1%)
A number of factors can increase a persons risk of hypertension (high blood pressure) including:
- excess weight
- eating too much salt and not enough fruit and vegetables
- not doing enough exercise
The prevalence of Hypertension in Wiltshire has remained consistent over the last three years. Wiltshire has a higher prevalence of Hypertension, most recently at 15.6% in 2019/20 in comparison to England (14.1%) and South West (15.0%)
For those with type 2 diabetes, a healthy diet and active lifestyle can help to manage blood sugar levels. Being active can help to lower blood sugar levels, and losing weight (if overweight) makes it easier for the body to lower blood sugar levels, and can improve blood pressure and cholesterol.
The prevalence of diabetes in those aged 17+ in Wiltshire has remained at a similar level over the past three years, most recently at 6.6% in 2019/20. This is slightly lower than the prevalence for South West (6.8%) and England (7.1%).
Admissions for diabetes for children aged 0 to 9
The rate of admissions for diabetes for children aged 0-9 has seen some variation in recent years in Wiltshire, but has remained fairly stable over the past three years, at around 26 admissions per 100,000 persons. This is lower than the rate for England (27.6 per 100,000) and South West (30 per 100,000) in 2019/20.
Admissions for diabetes for children aged 10 to 18
Admission rates for persons aged 10-18 years have fluctuated in the last 5 years, and 2019/20 has seen an increase, with admission rates of around 75 per 100,000 compared with 57 per 100,000 in 2018/19. Wiltshire admission rates do remain lower than the South West and England.
Visually obvious dental decay in 5 year olds
Wiltshire saw a significant decrease in the percentage of 5 year olds with visible dental decay in 2018/19, at 13/1%, compared with 22.1% in 2016/17. Percentages in England and South West continue to be around 23% and 20% respectively.