Being overweight puts you at increased risk of serious illness or death from Covid-19, experts say – and now new anti-obesity strategies have been launched across the UK. In Bradford, community-based programs to promote healthy lifestyles offer a new approach to the problem. Dr John Wright of the city’s Royal Infirmary explains why radical thinking is needed.
Our full focus on Covid-19 has covered up another global pandemic that has been more insidious but much more harmful: obesity. At the start of the pandemic, we spotted common patterns in our sickest Covid-19 patients – they were more likely to have diabetes and heart disease and, in particular, to be obese. As the new coronavirus takes temporary retirement in the UK, obesity has become a center of attention not only for the NHS, but also for the Prime Minister as a weight loss model for the country.
The Covid-19 treatments we are discovering through our research trials provide significant, albeit modest, improvements in survival. However, prevention is better than cure, and if we are to protect our citizens, we must not only strengthen our preventive public health measures to stop transmission in the short term, but also reduce their risk of harm from the disease. infection while fighting obesity. longer term.
Professor John Wright, physician and epidemiologist, heads the Bradford Institute for Health Research and is a veteran of the cholera, HIV and Ebola epidemics in sub-Saharan Africa. He writes this newspaper for BBC News and records from hospital services for BBC Radio.
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At the hospital, we followed the lives of 16,000 children from birth as part of the Born in Bradford Project to understand how the complex interplay between our genes, lifestyles and environment affects our subsequent risk of physical disease and mental. It’s like a huge Child of Our Time study, but with the best scientists around the world working together to unravel the clues. The project has shown that our risk of obesity starts very early in life and is particularly high for children of South Asian origin. The breadcrumb trail on why South Asians have two to four times the risk of diabetes and heart disease leads back to birth.
As these Bradford children grow up, they face a very different future whether they live in Ilkley, one of the richest places in the country, or Manningham, one of the poorest. If they grow up in downtown Manningham, they will be surrounded by fast food swamps and food deserts with healthy options. Poor quality homes lack proper kitchens to prepare healthy meals. The roads are too busy and dangerous to cycle or even walk to school. The lack of parks and gardens hinders active play. Junk food advertising infects young minds, and poor quality food is all some families can afford.
Our efforts to fight obesity are woefully futile and the size of the world’s population continues to grow. Too often we focus on blaming people for poor choices rather than tackling the larger, interactive and complex conditions that lead to obesity. There is no simple behavior change advice comparable to hand washing or social distancing, no simple medications like dexamethasone or remdesivir to dispense.
Dr Mathew Mathai has worked in the Pediatric Diabetes Clinic at St Luke’s Hospital in Bradford for over a decade. When he started, he says, children with type 2 diabetes were unknown at the clinic – now there are 18 at a time.
His clinic was held practically during the pandemic and he will be seeing his patients again soon, with a proper opportunity to weigh them in and find out how the social distancing restrictions have affected them.
“It will be really interesting to see what the lockdown has done: for some it has been a useful time to think about exercise. And others went the other way and they spent all the time watching TV and eating more, ”he said.
Much of his clinic’s work is about motivation – and Dr Matai is keen to mobilize people in the community who can help him.
One of those people is Tahira Amin, a dietitian, who was on maternity leave when she realized that more could be done locally to help improve the fitness, health, and general vibe of the downtown area around. Lister Mill in Bradford.
“I wanted to enjoy my pregnancy but still needed a challenge and looked at what I could do in the local community,” she says. She had previously participated in a program to teach young Muslim women and girls fencing and now she had an idea for another project – promoting good health by taking back plots and turning abandoned land into a community garden.
Amin believes that meeting other people in an active, outdoor setting is a better way to learn about healthy lifestyles than to sit in a classroom. “We can grow food, learn about food and nutrition, and get exercise that really helps fight obesity,” she says.
Sofia Rashid lives nearby and is happy with the changes, especially as it has made it much easier for her disabled seven-year-old daughter to navigate her walker in the greener spaces.
“We all took care of the subdivision and helped make things grow. All the women here are helping and we got out of lockdown – it was encouraging to have someone thinking about health, ”she says.
Rashid says the response to Amin’s project has been amazing. “She also teaches us about healthy eating and she has put together a group of cyclists, so some of us are planning to cycle for the first time,” says Rashid. “Last weekend we had a street clean-up where all the ladies in the area got together, it was people of all ages. ”
Dr Mathai is confident it’s local programs like this that will make a real difference, especially for kids who need help navigating the range of take-out options on offer in the city.
“It’s not a medical problem, it’s a social and community problem that needs to be resolved,” he says. “Local parks, government and services need to take the lead, with doctors there to support this community approach.
In Bradford, we build on our work in Born in Bradford to establish the world’s first “City Collaboratory” that recognizes that we need a radically different approach to preventing obesity. It brings together policymakers, communities, schools, city planners, transport experts and researchers to help develop and test whole system approaches that will act in all aspects of the city to save lives.
Our local and national response to Covid-19 has shown what is possible with a common goal and a collective effort. Let us use the same vigor and the same determination to fight the other pandemic.
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