Download - The role of impulsivity in childhood obesity
![Page 1: The role of impulsivity in childhood obesity](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56814928550346895db65f29/html5/thumbnails/1.jpg)
The role of impulsivity in
childhood obesity
Myutan KulendranClinical Research Fellow
![Page 2: The role of impulsivity in childhood obesity](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56814928550346895db65f29/html5/thumbnails/2.jpg)
• 57th World Health Assembly (2004)
• Prevention and control of non-communicable diseases (NCD)
• NCD and social and economic inequalities
• Obesity is a major risk factor for morbidity and mortality internationally
Obesity
![Page 3: The role of impulsivity in childhood obesity](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56814928550346895db65f29/html5/thumbnails/3.jpg)
![Page 4: The role of impulsivity in childhood obesity](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56814928550346895db65f29/html5/thumbnails/4.jpg)
![Page 5: The role of impulsivity in childhood obesity](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56814928550346895db65f29/html5/thumbnails/5.jpg)
![Page 6: The role of impulsivity in childhood obesity](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56814928550346895db65f29/html5/thumbnails/6.jpg)
Health Consequences
![Page 7: The role of impulsivity in childhood obesity](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56814928550346895db65f29/html5/thumbnails/7.jpg)
Global rise in childhood obesity
![Page 8: The role of impulsivity in childhood obesity](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56814928550346895db65f29/html5/thumbnails/8.jpg)
![Page 9: The role of impulsivity in childhood obesity](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56814928550346895db65f29/html5/thumbnails/9.jpg)
Tracking of Obesity into adulthood
Freedman et al. 2001
![Page 10: The role of impulsivity in childhood obesity](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56814928550346895db65f29/html5/thumbnails/10.jpg)
Food advertising on and prevelence of overweight
![Page 11: The role of impulsivity in childhood obesity](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56814928550346895db65f29/html5/thumbnails/11.jpg)
Obesity Network
![Page 12: The role of impulsivity in childhood obesity](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56814928550346895db65f29/html5/thumbnails/12.jpg)
• Failure to act early
• No measurable change in right direction
• Environmental determinants misunderstood
• Window for effective action
• Normalisation of Obesity
The climate change of public health
![Page 13: The role of impulsivity in childhood obesity](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56814928550346895db65f29/html5/thumbnails/13.jpg)
Opportunities for intervention: Life course
![Page 14: The role of impulsivity in childhood obesity](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56814928550346895db65f29/html5/thumbnails/14.jpg)
Process Output Impact Outcome
Strategic policy and leadership
Policy Instruments• Service
delivery• Government
spending and taxations
• Advocacy• Laws and
regulation
BEHAVIOUR CHANGE
•Reduce energy intake•Increase physical activity
Supportive environment HealthHealth
EconomicEconomic
SocialSocial
EnvironmentEnvironment
Health Services
Monitoring, Evaluation and Research
Obesity Policy Action Framework
![Page 15: The role of impulsivity in childhood obesity](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56814928550346895db65f29/html5/thumbnails/15.jpg)
Fleurbaix Laventie Ville Sante Study
![Page 16: The role of impulsivity in childhood obesity](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56814928550346895db65f29/html5/thumbnails/16.jpg)
![Page 17: The role of impulsivity in childhood obesity](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56814928550346895db65f29/html5/thumbnails/17.jpg)
![Page 18: The role of impulsivity in childhood obesity](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56814928550346895db65f29/html5/thumbnails/18.jpg)
• Mindspace report published in March 2010
• Provides the operating framework for applying behavioural insight to public policy
• Behavioural Insights Team established in the Cabinet Office Strategy Unit
![Page 19: The role of impulsivity in childhood obesity](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56814928550346895db65f29/html5/thumbnails/19.jpg)
![Page 20: The role of impulsivity in childhood obesity](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56814928550346895db65f29/html5/thumbnails/20.jpg)
ImpulsivityBehavioural Economic Theory
Reinforcement
![Page 21: The role of impulsivity in childhood obesity](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56814928550346895db65f29/html5/thumbnails/21.jpg)
Setting
A muti-dimensional weight management camp for obese children, n=31
Boys Girls
n=12 n=19
6/12 funded by PCT 15/19 funded by PCT
14 years (12-17 years) 13 years (12-17 years)
5 weeks (3-8 weeks) 5 weeks (3-8 weeks)
102 kg (85kg-154 kg) 88 kg (55kg-111kg)
BMI 34 (26-43) BMI 33 (21-39)
![Page 22: The role of impulsivity in childhood obesity](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56814928550346895db65f29/html5/thumbnails/22.jpg)
Hypothesis‘Do obese children lose significant weight during
a multi-dimensional lifestlye intervention summer camp’
‘Does impulsivity predict weight loss maintenance after the camp setting’
‘Are children happier after losing weight in a
camp setting’
![Page 23: The role of impulsivity in childhood obesity](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56814928550346895db65f29/html5/thumbnails/23.jpg)
Method: Pre-post Study
8 weeks multi-dimensional intervention
3 month maintenance-phone contact
7 months
Week 1
1.Parent and Child Temperament Questionnaire2.Child Wellbeing Questionnaires3.On-line parental Impulsivity task
4. Temporal Discounting Task
5. Go/NoGo Task
C
![Page 24: The role of impulsivity in childhood obesity](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56814928550346895db65f29/html5/thumbnails/24.jpg)
ImpulsivityTemporal Discounting Task Motor Impulsivity
£2 tomorrow OR £20 in 4 weeks
![Page 25: The role of impulsivity in childhood obesity](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56814928550346895db65f29/html5/thumbnails/25.jpg)
Temporal Discounting Task
• Computerised task
• 120 hypothetical questions
• Mont Carlo Simulation
![Page 26: The role of impulsivity in childhood obesity](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56814928550346895db65f29/html5/thumbnails/26.jpg)
Outcome Measures
PrimaryAnthropometric measures
Child impulsivity scores Child wellbeing scores
SecondaryParent impulsivity scores
![Page 27: The role of impulsivity in childhood obesity](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56814928550346895db65f29/html5/thumbnails/27.jpg)
![Page 28: The role of impulsivity in childhood obesity](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56814928550346895db65f29/html5/thumbnails/28.jpg)
Reduction in Motor Impulsivity Post Camp
p>0.05
![Page 29: The role of impulsivity in childhood obesity](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56814928550346895db65f29/html5/thumbnails/29.jpg)
Significant findings…..
• Change in motor impulsivity significant– Control for age and duration of stay
• Longer duration of stay associated with greater reduction in impulsivity
• Older show an attenuation in the reduction of impulsivity scores
![Page 30: The role of impulsivity in childhood obesity](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56814928550346895db65f29/html5/thumbnails/30.jpg)
![Page 31: The role of impulsivity in childhood obesity](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56814928550346895db65f29/html5/thumbnails/31.jpg)
Wellbeing Improved Post CampDomains (Pre-
Post)Sig.(2-tailed)
ONS 0.658
School 0.045
Eating 0.097
Sport 0.214
Health 0.006
Looks 0.002
Time 0.033
Domains (Pre-Post
Sig.(2-tailed)
Family 0.949
Home 0.818
School 0.185
Local Area 0.432
Choices 0.081
Safety 0.201
Total 0.007
![Page 32: The role of impulsivity in childhood obesity](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56814928550346895db65f29/html5/thumbnails/32.jpg)
Conclusions
• Key role of impulsivity in obesity– Development– Maintenance
• Screening using personality traits• Development of behavioural interventions
– Effective in similar regulating environments
• Children are happier with weight loss
![Page 33: The role of impulsivity in childhood obesity](https://reader036.vdocuments.mx/reader036/viewer/2022062518/56814928550346895db65f29/html5/thumbnails/33.jpg)
Further Work
• SMS study during maintenance phase of camp• Commitments vs Information
• Continue to monitor impulsivity and Wellbeing in a community based family intervention
• Use of pervasive technology to monitor physical activity
• Feedback and Social Norms