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Childhood obesity as one of the most serious global public health challenges for the 21st century.

Within England, the number of children who are obese is growing and has more than tripled over the past 25 years. The first years of life are critical in establishing good nutrition and physical activity behaviours that in turn can reduce the risk of developing obesity in later life.

Early Years settings have a crucial role in establishing safe and supportive environments in helping children and families to form healthy behaviours. Evidence supports interventions for early child feeding and physical activity in these settings to promote healthy behaviours and weight trajectories in this period of life. Training and educating staff in contact with families about infant feeding and health in infancy is a key recommendation to improve health outcomes.

London North West Healthcare (LNWH) NHS Trust – Nutrition & Dietetics Brent were commissioned by the Brent Council to develop and deliver a training package on infant nutrition and feeding to staff from private, voluntary and independent nurseries (PVIs), Children Centres, Health Visitors and Childminders.

The training was aligned Brent’s Healthy Early Years (HEY) awards, an accreditation and award scheme for Early Years settings in Brent that focuses on seven key health improvement areas for under-fives including: healthy eating; oral health; physical activity; breastfeeding immunisations; smoke free homes; emotional wellbeing.

The nutrition focused, evidenced based training modules were designed to be fun, interactive, and skills based and included (2hours each):

Module 1: Nutrition in the first year: introduction to solids

Module 2: Nutrition for infants: after the first year

Module 3: Nutrition policy and healthy lunch boxes: a refresher

Module 4: Managing allergies in the early years setting

Module 5: Raising children to eat well: managing fussy eaters

Overall, 14 sessions were delivered over 2 months with a total of 143 staff attending.

Evaluation and feedback showed that the Early Years Training Programme built knowledge and confidence in the application of infant nutrition and feeding in the Early Years settings. The training also empowered Early Years practioners to apply confidently for the HEY awards.

This year, a total of 27 Early Years Settings applied for the HEY awards so far and last year 12 settings received the award in Brent. Validations visits are currently been undertaken.

Further research is required to determine whether knowledge provided transpires to behaviour change for families and children in the settings.

LNWH NHS Trust – Nutrition & Dietetics Brent are also involved in other important childhood obesity prevention projects including:

• Healthy Little Eaters (Cook and Eat) – a nutrition and cooking programme (8 weeks) for children under 1-5 years in Children Centres in Brent.

• Fit4Health – a family lifestyle intervention (10 weeks) set in schools and leisure centres for those who have been recognised as overweight or obese by the 2014/15 National Child Measurement Programme. It is delivered Registered Dietitians involving nutrition, cooking, physical activity and behaviour change education. Both have been successful in achieving behavioural change and weight loss but commissioned on a short-term basis.

Obesity is a multi-faceted and cross-cutting condition, increasing year on year in an obesogenic environment. It requires a combined approach targeting families in the early stages to prevent children becoming overweight and obese and secondary prevention measures such as Fit4Health to target those children who have been identified as overweight or obese.

A long term, well designed whole-system approach to tackling childhood obesity is needed if we are serious about reducing levels of childhood obesity in the UK. Delivery team: Breeana Gardiner (Registered Dietitian) Farhat Hamid (Head of Nutrition & Dietetics) LNWH NHS Trust

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