1. BiB and the NCMP: reception year measurements Jane West

2. Measuring children’s size and growth Child obesity is an important problem. Over a fifth of children in England start school overweight or obese. The National Child Measurement Programme (NCMP) provides important data to monitor trends in BMI in English primary schools. Height and weight are recorded in reception and year 6. In Bradford for the school year 2012/2013 87.7% of children in their reception year at a Bradford primary school had their height and weight recorded through the programme

3. NCMP

4. Measuring children’s size and growth Height and weight cannot identify differences in body composition, in particular body fat. For a given BMI South Asian children have greater total and central fat than White British children and this may be important to the higher risk of heart disease and diabetes seen in South Asian adults. These differences in body composition are not identified by BMI It would be helpful to collect measures of size (beyond height and weight) that can provide estimates of body fat and help us understand better the differences in body composition across different groups and their importance to future health.

5. BMI Yajnik CS, Yudkin JS. Lancet 2004;363(9412)163

6. Born in Bradford

7. Information is sent to parents 8 weeks prior to the scheduled measurements with an ‘opt out’ consent form should they wish to withdraw their child from the measurements. Using data provided by Bradford Education & Learning we match children to their primary school School nurse teams visit all Bradford schools between March and May each year and collect triceps (peripheral fat) and subscapular skinfold thickness (central fat) and blood pressure measurements. Only children participating in BiB are measured. These visits were separate from those undertaken to collect height and weight for the NCMP but were recorded within 4 months of the NCMP measures (mean time since NCMP height and weight was 2.6 months in 2012/13). Reception year measurements

8. 3730 BiB children were eligible for school reception year 2012/13. Using data provided by Bradford Education & Learning we were able to match 2535 (68%) BiB children to their school. Opt out requests were received for 77 children (2%). 2458 (66%) BiB children were on the school nurse lists for measurement We excluded twins (n=58), those children who were not of White British or Pakistani origin (n=810) and those without complete data for all measurements (height; weight; triceps skinfold; subscapular skinfold) n=269. This resulted in 1409 participants (659 White British; 750 Pakistani origin) for the results presented here. Reception year 2012/13

9. The results presented at the PFE are just preliminary findings and we are not ready to share these online just yet. Please contact Jane West if you are interesting in discussing the findings so far Jane.west@bthft.nhs.uk Jane.west@bthft.nhs.uk Reception year 2012/13 - results

10. What next? These measurements have been repeated for reception year 2013/14 and are currently being collected from children in reception year 2014/15 A next sweep of data collection is currently being developed to collect further measurements from BiB children at ages 8 to 10. Physical measurements give us lots of information about growth but there are some things that can only be measured in blood (glucose, cholesterol, insulin) Repeat existing measurements (triceps & subscapular skinfolds; blood pressure) Additional measurements - biceps skinfold; waist circumference; bioimpedance

11. Next sweep Bioimpedance Test to estimate the different parts that make up the body (particularly fat and lean tissues) Requires the child to stand on a special scale with handgrips Quick and painless and measures how well the body conducts (reacts to) a very weak electrical signal Has been used successfully in a number of studies of UK schoolchildren

12. Acknowledgements We would like to thank all the primary schools in Bradford for their support and co-operation. We also thank the school nurses and health care assistants involved in collecting measurements for the BiB study and the public health team at BDMC. We are especially grateful to all the mothers, fathers and children who are taking part in the study.

13. More information www.borninbradford.nhs.uk Born in Bradford @BiBresearch Jane.west@bthft.nhs.uk