Rapid Response in the BMJ

Myself, alongside Ed Cope and Richard Bailey offered our response to an article published in the BMJ, which was published as a rapid response.

Re: Effectiveness of a childhood obesity prevention programme delivered through schools, targeting 6 and 7 year olds: cluster randomised controlled trial (WAVES study)

 Adab et al [1] highlight the challenges associated with tackling the obesity epidemic and the role professional football clubs may play in this process. There is a common assumption by some in government, media and the general public that sport is unequivocally good. Football, and the brand English Premier League, has a global reach and mass youth appeal, which one could easily associate with a potential vehicle to harness health awareness and promotion messages [2]. However, adopting a philosophy of ‘football is good’ may be unwise, especially when exploring complex issues, such as obesity in children.

The inverse relationship between physical activity and obesity is relatively well-established [3], and there is growing evidence supporting the football as a context that can support the reduction of obesity [4], including clinically significant weight loss [5]. Yet, we need to understand the policy and practical conditions, such as physical education and school sport (PESS) settings, if we are going to realise the potential outcomes of any intervention. It seems appropriate to view the current PESS landscape within a broader policy context of austerity, triggered as a political tool to potentially mitigate the impact of the economic downturn in the UK and elsewhere.

Austerity-related policies impact sport through the closure of sport facilities [6], often hitting those in the most deprived areas hardest, whilst helping create a reality whereby government sport participation goals have not been met [7]. Within an environment of declining opportunity for sport participation, and the proverbial tightening of belts in school funding for PESS, the emergence of external providers and the outsourcing to private companies, including professional football clubs has become widespread [8]. This is a dramatically changing and unfamiliar environment, but one with which the different stakeholders in the battle against obesity must become familiar.

We support this research as adding further evidence about the potential of professional football clubs to deliver effective interventions and rigorous evaluations. Yet, we urge policy makers to strive for better-organised and delivered interventions, alongside challenging the false economy of broader austerity related policies, notably cuts to sport and leisure services and the outsourcing of PESS that may impact individuals, families and communities opportunities for quality physical activity and sport. Otherwise, there are likely to be further, and potentially more severe, public health and financial consequences in the future.

References –
1. Adab P, Miranda J.P, Emma R.L, Karla H, Emma F, Tim B, et al. Effectiveness of a childhood obesity prevention programme delivered through schools, targeting 6 and 7 year olds: cluster randomised controlled trial (WAVES study) BMJ 2018;360:k211
2. Parnell D, Stratton G, Drust B, & Richardson D. Football in the Community Schemes: Exploring the Effectiveness of an Intervention in Promoting Positive Healthful Behaviour Change. Soccer & Society 2013;14(1): 25-51. DOI: 10.1080/14660970.2012.69267
3. Ross R. & Janssen, I. Physical activity, total and regional obesity: dose-response considerations. Medicine and Science in Sports and Exercise 2001;33(6 Suppl):S521-7; discussion S528-9.
4. Milanović Z, Pantelić S, Čović N, et al. Broad-spectrum physical fitness benefits of recreational football: a systematic review and meta-analysis British Journal of Sports Medicine 2018. doi: 10.1136/bjsports-2017-097885
5. Hunt K, Wyke S, Gray CM, et al. A gender-sensitised weight loss and healthy living programme for overweight and obese men delivered by Scottish Premier League football clubs (FFIT): a pragmatic randomised controlled trial. The Lancet 2014;DOI: 10.1016/S0140-6736(13)62420-4
6. Parnell D, Millward P, & Spracklen, K. Sport and austerity in the UK: An insight into Liverpool 2014. Journal of Policy Research in Tourism, Leisure and Events 2015; 7(2), 200–203;DOI: 10.1080/19407963.2014.968309
7. Widdop P, King N, Parnell D, Cutts D, & Millward P. Austerity, policy and sport participation in England. International Journal of Sport Policy and Politics 2017; 10(1) 7-24; DOI:10.1080/19406940.2017.1348964)
8. Parnell D, Cope E, Bailey R, & Widdop P. Sport policy and English primary physical education: The role of professional football clubs in outsourcing. Sport in Society 2016; DOI:10.1080/17430437.2016.1173911
Competing interests: No competing interests




Parnell, D., Bailey, R., & Cope, E. (2018). Re: Effectiveness of a childhood obesity prevention programme delivered through schools, targeting 6 and 7 year olds: cluster randomised controlled trial (WAVES study). British Medical Journal, 360 DOI: https://doi.org/10.1136/bmj.k211

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