Flabby youngsters put health at risk

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FLABBY YOUTHS who prefer to hide behind the bike sheds with a sticky bun and a cigarette rather than chase a football round the sports field present one of the greatest challenges to public health, the Government's chief medical officer said yesterday.

Professor Liam Donaldson said the problems suffered by young people over their weight was one of the most striking findings from a survey, "The Health of Young People 1995-97", released yesterday. The survey, the largest ever undertaken, shows that one-third of those aged 16-24 were overweight or obese.

Most of those carrying excess flab were aware of the problem and were trying to shed it. But, more worryingly, young women tended to perceive themselves as overweight, even when they were not. Almost half of those who were at their desirable weight, defined as a body mass index (a measure that combines weight and height) of 21-25, said they were trying to lose weight. Even among the underweight (body mass index of 20 or less) one in ten said they were dieting.

Professor Donaldson said too many young women had negative attitudes to their body image and the problem of eating disorders was pervasive and under-recognised. "It has had wide publicity in the media but more needs to be done on that front by the health service," he said.

The levels of smoking found among young people are among the highest recorded. Instead of questionnaires, which are unreliable, the researchers from the Department of Public Health at University College, London, who conducted the survey, took samples of saliva and measured the levels of cotinine, a metabolite of nicotine, which gives an accurate picture of whether the sample comes from a smoker.

The results showed smoking increased from 20 per cent of boys at age 16 to 40 per cent at 18 and from 25 per cent of girls at 16 to 30 per cent at 18. By their early twenties more than 40 per cent of both sexes were regular smokers.

The proportion of children with cotinine levels above 15 nanograms per millilitre, indicating that they were regular smokers, rose steeply from the age of 12, diverging in the late teens as the pace of increase among women slowed. However, women smokers caught up and overtook the men by their early twenties.

Professor Donaldson said it was striking that although adult smoking was higher in lower social classes, among those aged under 15, experimentation with cigarettes occurred equally across the social scale. "In social classes IV and V smoking endures into adult life. People in upper social classes seem to drop it," he said.

The social class gradient was evident across almost every measure of ill health. The children of the poor eat less fruit and vegetables, smoke more, suffer more emotional problems and rate their own health as worse than the children of the rich.

Professor Donaldson said the Government's White Paper on public health, to be published in the new year, would address ways of preventing the health gap between the classes opening up in childhood.

"Health overall has improved a great deal in the second half of this century. Against that background of improvements in most of the causes of death we have seen these social class differences persisting. The White Paper will look at measures across government departments in environment, transport and housing, and public health programmes will strongly benefit from joining them together. It represents a fundamental change of emphasis with the past.

One message does appear to have got through: The need to use sun-cream to prevent sunburn. Over 90 per cent of 12-15 year olds rated this as "very important". Parents also rated it as the most important way of protecting the skin.

However, use of sun-cream declined with age, from 89 per cent at age three to 70 per cent at age 12 and 57 per cent at 15.