The single most important intervention to tackle obesity…

Rutter, Harry

doi:10.1007/s00038-012-0385-6

Cited by 36 publications

(32 citation statements)

References 6 publications

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“…Successful interventions, if implemented at sufficient scale, have the potential to help prevent obesity as part of a wider obesity strategy. 27 Aligning the will of the public, private industry, and political leadership is key to progress.…”

Section: Resultsmentioning

confidence: 99%

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Downsizing: policy options to reduce portion sizes to help tackle obesity

Marteau

Hollands

Shemilt

et al. 2015

BMJ

156

106

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The worldwide prevalence of obesity and overweight has risen substantially over the past three decades with no country yet achieving a reduction.1 International and national ambitions to "end childhood obesity" 2 and "reduce non-communicable diseases by 25% by 2025" 3 are unmatched by policies that could realise them. The causes of obesity are complex but overconsumption of food and sugary drinks is a critical proximal determinant, driven in part by large portion sizes. The importance of developing interventions and policies to reduce the size, availability, and appeal of large portions is underscored by the compelling evidence that people eat and drink more from larger portions.

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Section: Resultsmentioning

confidence: 99%

“…27 Indeed, the food industry may find it difficult to act without regulation given "first mover disadvantage." 28 Including disincentives or sanctions for non-participation in voluntary agreements may also help.…”

Section: How Can These Interventions Be Achieved?mentioning

confidence: 99%

Downsizing: policy options to reduce portion sizes to help tackle obesity

Marteau

Hollands

Shemilt

et al. 2015

BMJ

156

106

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show abstract

“…159 Currently, only a tiny fraction of the literature on diabetes prevention is informed by an appreciation of the social complexity underlying pathogenesis of diabetes. [160][161][162] The 2014 Foresight Report on Obesity was a model of good practice in teasing out the complex interactions between genetic, physiological, psychological, sociocultural, economic, and political determinants of obesity; it provided a strong and consistent message that short term "behaviour change" interventions were unlikely to succeed in isolation. 163 A comparable initiative for type 2 diabetes could add richness to our current understanding of the condition and help to inform the design of evidence based strategies aimed at influencing its "upstream" determinants.…”

Section: Future Workmentioning

confidence: 99%

Efficacy and effectiveness of screen and treat policies in prevention of type 2 diabetes: systematic review and meta-analysis of screening tests and interventions

Barry

Roberts

Oke

et al. 2017

BMJ

258

234

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ObjeCtivesTo assess diagnostic accuracy of screening tests for pre-diabetes and efficacy of interventions (lifestyle or metformin) in preventing onset of type 2 diabetes in people with pre-diabetes. DesignSystematic review and meta-analysis. Data sOurCes anD methODMedline, PreMedline, and Embase. Study protocols and seminal papers were citation-tracked in Google Scholar to identify definitive trials and additional publications. Data on study design, methods, and findings were extracted onto Excel spreadsheets; a 20% sample was checked by a second researcher. Data extracted for screening tests included diagnostic accuracy and population prevalence. Two metaanalyses were performed, one summarising accuracy of screening tests (with the oral glucose tolerance test as the standard) for identification of pre-diabetes, and the other assessing relative risk of progression to type 2 diabetes after either lifestyle intervention or treatment with metformin.eligibility Criteria Empirical studies evaluating accuracy of tests for identification of pre-diabetes. Interventions (randomised trials and interventional studies) with a control group in people identified through screening. No language restrictions. results 2874 titles were scanned and 148 papers (covering 138 studies) reviewed in full. The final analysis included 49 studies of screening tests (five of which were prevalence studies) and 50 intervention trials. HbA 1c had a mean sensitivity of 0.49 (95% confidence interval 0.40 to 0.58) and specificity of 0.79 (0.73 to 0.84), for identification of pre-diabetes, though different studies used different cut-off values. Fasting plasma glucose had a mean sensitivity of 0.25 (0.19 to 0.32) and specificity of 0.94 (0.92 to 0.96). Different measures of glycaemic abnormality identified different subpopulations (for example, 47% of people with abnormal HbA 1c had no other glycaemic abnormality). Lifestyle interventions were associated with a 36% (28% to 43%) reduction in relative risk of type 2 diabetes over six months to six years, attenuating to 20% (8% to 31%) at follow-up in the period after the trails. COnClusiOnsHbA 1c is neither sensitive nor specific for detecting pre-diabetes; fasting glucose is specific but not sensitive. Interventions in people classified through screening as having pre-diabetes have some efficacy in preventing or delaying onset of type 2 diabetes in trial populations. As screening is inaccurate, many people will receives an incorrect diagnosis and be referred on for interventions while others will be falsely reassured and not offered the intervention. These findings suggest that "screen and treat" policies alone are unlikely to have substantial impact on the worsening epidemic of type 2 diabetes. registratiOn PROSPERO (No CRD42016042920).

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“…Reducing levels of inactivity, obesity, and NCD are complex issues (Rutter, 2012). This paper is not suggesting that it is straightforward for cities like Sofia to get people exercising more.…”

Section: Resultsmentioning

confidence: 89%

“…Landscapes may constrain physical activity through land use mix, urban design, travel behaviour, and green space allocation (Brownson et al, 2005;Heath et al, 2006). Thus, increasing physical activity in urban landscapes is a complex issue (Rutter, 2012). Das and Horton (2012, p. 189) argue that there has been too much focus on individual level changes and not enough deliberation on the social and physical environment that enable physical activity, noting that "efforts beyond the health sector through social and environmental change will be necessary if we are to see greater uptake of this healthier behaviour in people's lives".…”

Section: Introductionmentioning

confidence: 99%

Physical exercise, health, and post-socialist landscapes—recreational running in Sofia, Bulgaria

Barnfield

2016

Landscape Research

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The changes that have been brought about since the end of state socialism include modifications to the urban landscape of cities like Sofia, Bulgaria. There has been a decline in the number of green spaces, sports facilities, and state-run sport programmes. The changing urban landscape has seen the increase in car travel, car parking, and projects such as the Sofia Metro. Citizens from Bulgaria are among the least active in Europe, this has an enormous effect on the prevalence of obesity and non-communicable diseases. However, during the last decade there has been an increase in recreational running, and in particular informal running clubs in Sofia. This paper uses recreational running to understand the changing landscape of post-socialist cities and its effect on techniques of public health. Using data from two in-depth qualitative case studies of informal running clubs from Sofia to examine the effects of the changing urban landscape on recreational fitness practices and well-being, the rationale of this paper is that this has the potential to generate fresh suggestions about the effective promotion of public health through exercise in view of how and where urban running is currently conducted in post-socialist landscapes.

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The single most important intervention to tackle obesity…

Cited by 36 publications

References 6 publications

Downsizing: policy options to reduce portion sizes to help tackle obesity

Downsizing: policy options to reduce portion sizes to help tackle obesity

Efficacy and effectiveness of screen and treat policies in prevention of type 2 diabetes: systematic review and meta-analysis of screening tests and interventions

Physical exercise, health, and post-socialist landscapes—recreational running in Sofia, Bulgaria

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