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Healthy weight and healthy eating

Obesity and excess weight

Obesity is a leading cause of ill health; an independent risk factor for cardiovascular diseases such as heart disease and stroke, as well as increasing the likelihood of developing other risk factors such as hypertension (high blood pressure) and type II diabetes. 

Obesity is commonly measured using weight and height to give a Body Mass Index (BMI) metric. Poor diet (containing a high proportion of foods high in fat, sugars and salt) and lack of exercise can lead to obesity, which in turn is a risk factor for non-communicable diseases such as cardiovascular disease and some forms of cancer.

In England, child BMI is measured at Reception Year (age 4 to 5 years) and Year 6 (aged 10 to 11 years) through the mandatory National Child Measurement Programme (NCMP). For the majority of children excess weight gain is the result of eating more calories than needed and/or undertaking too little physical activity to match calorie intake, or a combination of both.

In 2016/17, 9.8% of reception year children in Herefordshire were obese, while the combined proportion of obese and overweight was 22.9%.  For year 6 children, the prevalence of obesity was 19.2%, while the combined figure for obese and overweight children was 34.8%. For both age groups there were no significant differences between the local and national figures.

In 2015/16, 63.2% of adults in Herefordshire were estimated to be overweight or obese, similar to the national figure of 61.3% and the West Midlands figure of 63.9%. Comparison with GP records indicates that it is highly probable that obesity prevalence is under-recorded.

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In 2016/17, according to Quality and Outcomes Framework (QOF) data, approximately 15,000 adults registered with a Herefordshire general practitioner (GP) practice were obese, which represents 9.9% of all patients aged 18 years and over. Across Herefordshire GP practices the prevalence of obesity ranged between 6.0% and 14.9%, while the highest locality prevalence (10.6%) was recorded in North and West and the lowest (8.8%) in South and West.

Healthy eating

In 2016, Public Health England produced a new healthy eating model and accompanying Eatwell Guide.  

Results from the What About Youth (WAY) survey suggest that in 2014/15 an average of 2.48 portions of fruit and 2.54 portions of vegetables were consumed daily at age 15 in Herefordshire; more than nationally or regionally.

Data from Sport England’s Active Lives survey suggests that in 2015/16, the average number of portions of vegetables consumed daily by Herefordshire adults was 3.06, significantly more than in England (2.68) and the West Midlands region (2.62).  The average number of portions of fruit consumed daily was 2.88; also more than nationally (2.63) and regionally (2.65).

Healthy eating (children and young people)

The only source of information on children's healthy eating behaviour is the Every Child Matters (ECM) survey, which was carried out in participating primary and secondary schools in Herefordshire in the spring of 2009.

Key Points:

  • In 2009, 24% of children ate the recommended 5 or more portions of fruit and vegetables a day (higher than other areas), 8% had none.
  • 68% of pupils said they had done at least one hour of physical activity in the previous day

Overall in 2009, 31% of pupils in years 4 to 6 (the top three years in primary school) and 22% of pupils in years 7 to 10 (the first four years of secondary) ate at least 5 portions of fruit and vegetables the day before the survey.  In 2006, 24% of pupils in years 7 to 10 ate 5-a-day.

There was a general downward trend with age, with older pupils being less likely to get their 5-a-day.  This is particularly marked amongst males, where 34% of year 4s ate 5 or more portions, compared with 14% of year 10s.

It is possible to look at the number of portions of fruit and vegetables eaten according to the Body Mass Index (BMI) category of secondary pupils.  This cannot be shown for primary pupils as too few gave height and weight information to get a meaningful analysis.  Pupils classed as obese are the least likely to eat their 5-a-day (16% of pupils in this group), while those classed as overweight were the most likely (27%).  22% of pupils in the normal range ate their five a day, while 24% of those classed as underweight did so.

Pupils in years 7 to 10 were asked whether they considered their health when they chose what to eat.  Overall in 2009, 51% of pupils said they considered their health at least “quite often” (quite often, very often or always).  8% never considered their health when choosing what to eat.  This was similar to 2006 when 52% considered their health at least quite often and 9% never considered it.

In the 2009 survey, there was a reduction in the percentage of males considering their health at least quite often in the higher age categories, from 53% in year 7 to 37% in year 10.  This reduction was not seen among females.


6% of pupils in years 4 to 6, and 13% of those in years 7 to 10 had nothing to eat before lessons on the day of the survey.  In 2006, 8% of pupils in years 7 to 10 had eaten nothing before lessons.  Secondary pupils who were classed as overweight or obese were more likely to have eaten nothing before lessons (15% and 16%, respectively) than those in the normal range (10%) or underweight (4%).


14% of secondary pupils had no lunch the day before the survey in 2009 (11% in 2006).  Among female pupils, there was an increase in the percentage missing lunch with age, from 9% of girls in year 7, to 23% in year 10.