Childhood obesity and educational attainment : A systematic review

Background This report describes the findings and methods of a systematic review of research which explores the relationship between obesity and educational attainment. It has been conducted at a time of great concern about levels of obesity in the UK, and the negative physical, psychological and social impacts of obesity. Current research suggests that there may be a relationship between obesity and poor educational attainment. It is likely that obesity and poor school performance are elements of a broader picture of inequalities in health and education, whereby disadvantaged socio-economic groups tend to have poorer health and lower levels of education. However, it is possible that other factors influence obesity and attainment, such as gender, discrimination and poor mental and emotional well-being. This systematic review was therefore commissioned to address the question: What do we know about the relationship between childhood obesity and educational attainment, from the research literature? In order that our review might be informed by those closest to observing any interaction between obesity and attainment, we sought the perspectives of teachers and young people to identify the causal pathways that seemed most pertinent to them. Findings Is there a statistical association between obesity and educational attainment? While often conflicting, an overall pattern emerges from the research evidence suggesting that there is a weak negative association between obesity and educational attainment in children and young people; i.e. that higher weight is associated with lower educational attainment. Obesity is also associated with other variables, such as socio-economic status, and when these other variables are taken into consideration, the association between obesity and attainment becomes still weaker, and often loses statistical significance. To what extent does the research evidence explore the influence of the broader determinants of health, and in particular socio-economic position, in explaining any link between obesity and attainment? Place of residence, ethnicity, occupation, gender, religion, education, socio-economic status (SES) and social capital were all explored as potential moderating variables in the included research. Twenty-three of 29 studies used a measure of socio-economic status as a moderating variable. Various factors appear to contribute to low educational attainment to some extent, although given the variation in definitions, analyses and quality of data, it is impossible to point to any causative or definite risk factors. Authors of the included studies have posited theories suggesting that the link between obesity and educational attainment is moderated by individual and societal factors. Does the research evidence support or refute these? Most studies explored the influence of obesity upon attainment. Only two studies examined the influence of attainment upon obesity. Many authors suggested multiple causal pathways, many of which remained untested in their studies. The moderating variables used in statistical analyses of the relationship between obesity and attainment were not consistent with the causal pathways proposed, which is probably a reflection of the constraints imposed upon authors conducting secondary analyses of pre-existing datasets (i.e. they made use of existing variables, rather than collecting their own, tailored data). The most frequently cited factors resulting from obesity and impacting upon educational attainment were poor mental health, stigmatisation and discrimination, disordered sleep, decreased time spent in physical activity and socialising, and absenteeism. Different perspectives on obesity and attainment Few young people initially thought that obesity and educational attainment were associated. However, they considered obesity and educational attainment to be of importance to young people. Young people considered parental influence and circumstances, including family income and poverty, and bullying and emotional health to be the most important factors which might explain an association between obesity and educational attainment. Most teachers said that there was an association between obesity and educational attainment. Bullying, low self-esteem and emotional well-being, poverty and poor diet, and physical activity were commonly cited by teachers as being the most important and credible mediating variables in this association. Teachers also considered gender, ethnicity and parental influence to be important factors. While researchers, teachers and young people identified causal pathways whereby low academic attainment resulted from poor mental and emotional health among obese children and young people, only four studies adjusted for mental and emotional health variables. This may represent a significant divergence in the perspectives of researchers and stakeholders. Alternatively, it may be that in the 23 studies which conducted a secondary analysis of an existing dataset, such data were not available to the authors. Another divergence concerns the impact of reduced participation in sports and social activities. While teachers and young people located this within a broader framework of isolation and lower socialisation suffered by obese children – and thus felt reduced sports participation would result in lower attainment – three studies in the included research proposed a causal pathway in which reduced participation in sports and social activities might lead to increased time spent studying and hence higher attainment

Assessing the policy and practice impact of an international policy initiative: the State of the World's Midwifery 2014.

BACKGROUND: Understanding how policies lead to changes in health systems and in practice helps policymakers and researchers to intervene more successfully. Yet identifying all the possible changes that occur as a result of a new policy is challenging not only methodologically and logistically, as limited resources are available to conduct indefinite evaluations, but also theoretically, as a complete mapping and attribution of post-hoc changes requires a full understanding of the mechanisms underpinning all change. One option is to identify possible changes across a number of policy impact domains. METHODS: Using a Policy Impact Framework, we brought together data from media, documents and interviews to identify changes to midwifery policy, practice and provision, following the launch of a new global policy initiative, the State of the World's Midwifery (SoWMy 2014) report published in 2014. We used these identified impacts to develop a map of the mechanisms underpinning these changes. RESULTS: SoWMy 2014 contributed to a number of changes at national levels, including increased status of midwifery within national governments, improved curricula and training opportunities for midwives, and improved provision of and access to midwifery-led care. These contributions were attributed to SoWMy 2014 via mechanisms such as stakeholder interaction and acquisition of government support, holding national and international dissemination and training events, and a perceived global momentum around supporting midwifery provision. Policy initiatives of this kind can lead to changes in national and international policy dialogue and practice. We identify factors and mechanisms that are likely to increase the scope and scale of these changes, at contextual, national and global levels. CONCLUSIONS: Identifying changes following a policy using a policy impact framework can help researchers and policymakers understand why policies have the effect they do. This is important information for those wishing to increase the effectiveness of future policies and interventions

How Should Academics Engage in Policymaking to Achieve Impact?

This article reviews the advice from the academic and ‘grey’ literatures to identify a list of dos and don’ts for academics seeking ‘impact’ from their research. From ‘how to do it’ sources, we identify consistent advice on how to engage effectively, largely because it is necessarily vague, safe, and focused primarily on individuals. We then consider the wider policymaking system in which actors make political choices and have unequal access to impact opportunities. We identify the effort it takes to have actual policy impact and how far academics should be expected to go to secure and take credit for it. </jats:p

Ecosystem size predicts eco-morphological variability in a postglacial diversification

Identifying the processes by which new phenotypes and species emerge has been a long-standing effort in evolutionary biology. Young adaptive radiations provide a model to study patterns of morphological and ecological diversification in environmental context. Here, we use the recent radiation (ca. 12k years old) of the freshwater fish Arctic charr (Salvelinus alpinus) to identify abiotic and biotic environmental factors associated with adaptive morphological variation. Arctic charr are exceptionally diverse, and in postglacial lakes there is strong evidence of repeated parallel evolution of similar morphologies associated with foraging. We measured head depth (a trait reflecting general eco-morphology and foraging ecology) of 1,091 individuals across 30 lake populations to test whether fish morphological variation was associated with lake bathymetry and/or ecological parameters. Across populations, we found a significant relationship between the variation in head depth of the charr and abiotic environmental characteristics: positively with ecosystem size (i.e., lake volume, surface area, depth) and negatively with the amount of littoral zone. In addition, extremely robust-headed phenotypes tended to be associated with larger and deeper lakes. We identified no influence of co-existing biotic community on Arctic charr trophic morphology. This study evidences the role of the extrinsic environment as a facilitator of rapid eco-morphological diversification

The hard labour of connecting research to policy during covid-19

The worlds of policy and academia are often distant and can be difficult to span. In this post Kathryn Oliver and Annette Boaz reflect on their experience of working in the Government Office for Science to help produce the government’s new Areas of Research Interest and the particular challenges involved in establishing and mobilising networks of researchers and policymakers to work towards shared goals

How Should Academics Engage in Policymaking to Achieve Impact?

This article reviews the advice from the academic and 'grey' literatures to identify a list of dos and don'ts for academics seeking 'impact' from their research. From 'how to do it' sources, we identify consistent advice on how to engage effectively, largely because it is necessarily vague, safe, and focused primarily on individuals. We then consider the wider policymaking system in which actors make political choices and have unequal access to impact opportunities. We identify the effort it takes to have actual policy impact and how far academics should be expected to go to secure and take credit for it

The dos and don'ts of influencing policy: a systematic review of advice to academics

Many academics have strong incentives to influence policymaking, but may not know where to start. We searched systematically for, and synthesised, the ‘how to’ advice in the academic peer-reviewed and grey literatures. We condense this advice into eight main recommendations: (1) Do high quality research; (2) make your research relevant and readable; (3) understand policy processes; (4) be accessible to policymakers: engage routinely, flexible, and humbly; (5) decide if you want to be an issue advocate or honest broker; (6) build relationships (and ground rules) with policymakers; (7) be ‘entrepreneurial’ or find someone who is; and (8) reflect continuously: should you engage, do you want to, and is it working? This advice seems like common sense. However, it masks major inconsistencies, regarding different beliefs about the nature of the problem to be solved when using this advice. Furthermore, if not accompanied by critical analysis and insights from the peer-reviewed literature, it could provide misleading guidance for people new to this field

Building new bridges between research and policy during a national lockdown

Annette Boaz and Kathryn Oliver are social scientists with expertise in production and use of evidence for, policy. In this blogpost, they reflect on their recent experiences putting their knowledge into practice at the heart of government during a national lockdown. They describe the significant changes they had to make to their planned programme of (face-to-face) engagement work and how it was possible to build relationships and get a significant programme of work underway online to mobilise existing evidence in response to the COVID-19 pandemic and the UK government’s Areas of Research Interest framework