into research good sport
by Dr Amelia Lake
Human Nutrition Research Centre at the
by Jeanette Crosland
University of Newcastle-upon-Tyne
Accredited Sports Dietitian
The environment and obesity
Research
January saw the publication of two significant documents;
Within our profession we are frequently being encour-
NICE published guidelines entitled ‘Promoting and creating
aged to undertake research. Other professions have
built or natural environments that encourage and support
a tendency to comment that we do not publish work
physical activity’ (1); and the Department of Health re-
as often as they do. Research can be something no
leased ‘Healthy Weight, Healthy Lives: A Cross Government
more arduous than using information we normally col-
Strategy for England’ (2).
lect. However that extra little burden of doing every-
The NICE guidelines were directed at all professionals thing correctly, obtaining ethical approval, deciding
whose remit includes the built or natural environment. NICE how to disseminate the research, writing in the correct
described this publication as ‘the first ever national, evidence- format for the chosen journal… it probably puts some
based recommendations on how to improve the physical en-
of us off.
vironment to encourage physical activity to improve health.’
Like everyone reading this article I rely heavily on
The ‘Healthy Weight, Healthy Lives’ document captured the
scientific papers as a source of information – a neces-
media’s imagination and attention. Issues surrounding food la-
sity for evidence based practice. And in my world a lot
belling, vouchers and incentives to lose weight were big news
of my clients are likely to have read the same papers,
stories. This far-reaching document sees obesity being tackled
so how do I go about ensuring that I am analysing the
through broader strategies such as town planning.
information in front of me correctly – vital if I am using
Environmental influences on obesity are not new. While
the information to formulate advice.
this topic has gained recent prominence, it has been on the
I thought maybe I would share a few points that have
research agenda for some time. I recently read an article writ-
helped me in my quest to understand what I read and
ten in 1978 which described the obesogenic home food envi-
lead to a rather surprising outcome.
ronment (3). The obesogenic environment has been defined
Asking questions. Papers always include a contact
as ‘the sum of influences that the surroundings, opportunities,
and authors have proven very keen on the whole to
or conditions of life have on promoting obesity in individuals or
answer questions or discuss aspects of their work.
populations’ (4).
Asking questions confidently. We are experts in our
These ‘obesogenic environments’ are considered to be
chosen area, and researchers will generally respect this
one of the driving forces behind today’s escalating obesity
but also accept that we may need to talk through cer-
epidemic (5). The ANGELO (analysis grid for environments
tain aspects of the work that we are not so familiar with.
linked to obesity) framework defined by Swinburn et al. (5)
Asking for the names of others may be working in the
describes four categories of environment: physical (‘what
field. Their work may not yet be published but they may
is available’), political (‘the rules’), socio-cultural (‘attitudes
be happy to discuss it.
and beliefs’) and economic environment. These environ-
Questioning why something was done in a certain
ment are then divided into two levels; ‘micro-environments’
way not another way. This has given me answers but
and ‘macro-environments’. The micro-environment includes
has also resulted in authors carrying out further work that
schools, workplaces, home environment, retailers, community
gave me information I could not find any where else.
groups and neighbourhoods. The macro-environment includes
Questioning why work was carried out? Asking why
policy, education systems, the media, transportation systems
a certain centre had decided to research something
and health systems.
where there is so much other evidence helped me un-
Both these recently published documents could be de-
derstand not only the work but how to influence future
scribed as tackling obesity at both the micro and macro-envi-
work.
ronment levels, and addressing many of the levels of environ-
Bringing together a group of people with similar inter-
ment Swinburn et al suggested. In the ‘Healthy Weight, Health
est. Just a one-off meeting with contributors perhaps
Lives’ document there is a map of the major sectors who have
keeping in touch afterwards by email if information
a role to play in tackling excess weight. These include individu-
becomes available.
als and families, the food industry and right through to public
At the end of the day what I am saying is communi-
transport, planning and town planners.
cate – a basic dietetic skill. Talking to people has helped
The obesity problem is complex and the solutions required
me understand the written word but it has also helped
to tackle excess weight need to be multi-disciplinary in nature.
me to influence some of the research in my own area
While food and the food environment, remains our core inter-
of disability sport; an area where it has to be said, there
est as dietitians and nutrition professionals, for work to progress
is little sound evidence compared to able bodied sport.
in this area we need to cross traditional disciplinary boundar-
And the surprising outcome is that those I have spoken
ies (6). The importance of the environment, and particularly
to have finally got me involved in the research and I
the built environment, will be addressed on the 3rd June 2008
should soon have my name included in a couple of
(London) when the Association for the Study of Obesity (ASO)
publications. After nearly 30 years as a dietitian this is not
are holding a conference on this topic of ‘Obesity and the
something that I expected to do but it means I am help-
Built Environment’, for further information please see the ASO
ing those same ‘scientists’ who helped me by answering
website for more details: www.aso.org.uk
my questions, and it didn’t hurt too much!
For a full list of references please visit NHDmag.com
26 NHDmag.com May ‘08 - issue 34
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