The National Child Measurement Programme (NCMP) is the Government’s approach to tackling childhood obesity by measuring children in reception (age four to five) and year six (age ten to eleven) in mainstream state-maintained schools in England.
Independent and special schools are not included in this data. Childhood obesity is a good indicator of adult obesity which can lead to poor health outcomes. The data allows local areas to plan services to tackle childhood obesity and monitor progress. The programme runs between September and August each year, with over a million children being measured previously.
Measuring childhood obesity during a pandemic
Due to the COVID-19 pandemic, there was a disruption to the 2019/2020 data collection. Therefore, the NCMP did not officially open as usual at the start of the 2020/21 school year in September 2020. Local authorities were not required to start collecting child measurement data due to this. However, in March 2021, following the closure of schools, Local Authorities were tasked to collect a representative sample of child measurement data to enable a national estimate of children’s weight status (including obesity prevalence) for 2020/2021 and assess the impact of the pandemic on children’s physical health.
The sample of schools was stratified by deprivation and ethnicity, taking every ninth school to yield 10% of children in the local area, after factoring in that there could be a higher-than-normal level of pupil absence. The aim was to have a representative sample of children measured in England in terms of deprivation and ethnicity mix.
Statistical weighting was applied to the data collected to produce a dataset representative of the population measured by NCMP in England in previous years. Estimates of body mass index (BMI) classification rates, e.g. the proportion who are obese, are broadly comparable to previous years.
The impact of the pandemic means that the sample of 2020/2021 data is much smaller than previous years and the confidence intervals are wider; however, the data still can provide an insight into the current state of childhood obesity in England.
How did age, time and sex affect the findings?
In 2020/2021, NCMP survey estimates indicate that:
- 4% of reception children were obese (including severely obese), 13.3% were overweight, and most children, 71.3%, were a healthy weight. The study is subject to a margin of error, and it is likely that the prevalence of obesity is between 14.2% and 14.6%.
In comparison, children in year 6 have a higher rate of obesity with an estimation of:
- 5% of children were obese (25.3% – 25.8% likely obesity prevalence). 15.4% were overweight, and 57.8% were a healthy weight for their age.
Further investigating show that the prevalence of childhood obesity in reception had been relatively stable since 2006/07, but during the COVID-19 pandemic (2020/21), an 4.6% increase was seen. The prevalence of obesity now stands at 14.4% for 2020/21, whereas in 2019/20, it was 9.9%. For year six children, the prevalence of obesity has increased slowly from 19% in 2010/11 to 21% in 2019/20, then increased once again to 25.5% in 2020/21. Additionally, severe obesity prevalence increased for reception and year six children at the same time.
Sex was also factored in the report and found that the obesity prevalence between boys and girls was larger in year six than in reception.
- In 2020/21, NCMP estimates indicate that 14.8* of boys and 14.1% of girls in reception were obese and that 29.2% of boys and 21.7% of girls in year six were obese.
- In reception, 70.5% of boys were a healthy weight compared to 72.3% of girls, and in year six, 54.2% of boys were a healthy weight compared to 61.7% of girls.
Due to the disruption of the school year in 2020/21, it is an incomplete year of data collection. However, it does highlight the increase in childhood obesity prevalence during the pandemic. The data will become more clearer when the results from the 2021/22 NCMP is revealed.
How did geography, ethnicity and deprivation affect the findings?
The study found the following data on obesity rates of reception children in the different regions of England, with all regions having a higher prevalence for obesity in 2020/21 than in 2019/20. The largest increase was in London, where it increased from 10% to 15.3%. The smallest increases were in the Southeast by 3.7% and the Southwest by 3.8%.
Similarly, the prevalence of childhood obesity for reception children was higher in 2020/21 than 2019/20 in all regions. The largest increase was in London, where it increased from 23.7% to 30%, with the smallest increases found in the Northwest (3%) and Southeast (3.2%)
In terms of ethnicity, obesity prevalence was highest for black children in both reception and year six. It was also the lowest for Chinese children in reception and white and Chinese children in year six. The study also found that underweight prevalence was highest for Asian children in both reception and year six.
Deprivation and childhood obesity have a clear correlation with obesity prevalence in children at the reception and year six levels, over twice as high in deprived areas than in the least deprived areas. In reception, obesity prevalence in deprived areas was 20.3% compared to least deprived areas at 7.8% and in year six children, obesity prevalence was 33.8%, and in the least deprived areas, it was 14.3%.
