Taking a stand to improve the health of a generation

Can standing up for class really improve children's health?
Can standing up for class really improve children's health?
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As a school in Bradford awaits the results of a pilot scheme, Sarah Freeman asks can making children stand during lessons really help improve health and reduce obesity?

It’s 10am in Miss Rogers’ class at West Grove Primary School in Bradford.

The 30 children are in the middle of literacy lesson - the task, to write a list of reasons why their school is the best in the city and deserves its own float in a summer parade. Most of the pupils, aged nine and 10, are sat at shared tables and chat as they complete the assignment. However, at the back of the classroom, six of the children are noticeably quieter. It’s not the only difference. This group are stood up and will be for the rest of the lesson.

The class is taking part in an experiment, which if it proves successful could see all the pupils doing away with chairs. The seven week pilot is part of Born in Bradford, the programme launched in 2007 to improve the lives of youngsters born in the BD postcode. Each pupil will stand for 230 minutes a week, their weight, height and blood pressure is taken at the beginning and end of the trial and in between their levels of activity are being carefully monitored.

“I think anyone coming into this class would see that those children who are stood up do seem to be concentrating more on their work,” says Hannah Rogers. “That may be because it just works, but it may also be because they know they are taking part in an experiment and they really want to try hard to make it successful.”

Hannah breaks off, instructing the class to put down their pens. It’s time for an ‘active break’ which involves them hopping for five minutes while trying to solve a series of sums. This too it turns out is part of the experiment.

“We have an active break every 30 seconds and it does seem to work,” says Hannah. “Some children find it hard to settle at their desk for an entire lesson. The active breaks are a distraction. They may only last a few minutes, but I do think it helps improve their overall concentration.”

The response from the pupils has been overwhelmingly positive. There have been no complaints that their legs ache and once their session is complete most only return to their usual desk reluctantly. When the pilot finishes at the end of next week, the results will be analysed by the team at Born in Bradford, which was launched in 2007 in the wake of research which showed that city’s mortality rate is twice the British average.

In an effort to get to the root cause of the spike it was decided to track 13,500 children born at Bradford Royal Infirmary between March 2007 and December 2010. While that monitoring continues, Born in Bradford has also launched specific research projects.

Two years ago it began testing the hand and eye co-ordination, word and letter recognition of all reception class pupils in the city’s 88 primary schools and the results of a five year study into a sharp rise in asthma and allergy should be known shortly. Elsewhere data collected by the researchers is being used by a team from York University to look at whether abused and neglected children fare better in care or remaining at home.

“It might not be obvious at first, but the Stand Out in Class study is also about improving health,” says Dr Sally Barber, Born in Bradford’s principal research fellow. “Sedentary behaviour has been shown to adversely affect children’s health, independent of the amount of physical activity that they do.

“Prolonged sitting is linked to obesity, high blood pressure, high cholesterol, poor glucose control, lower fitness, poorer cognitive development and poorer academic achievement.”

A recent study of almost 6,500 UK 7-8 years-olds showed that half were classed as sedentary for 6.4 hours a day. It’s a trend which only gets worse in adults. A survey conducted last year found that many of us spend up to 12 hours a day looking at computers, watching television and generally doing very little at all. Add in the time spent in bed, then it’s little wonder that the nation’s waistline is growing.

The idea of teaching children standing up has already been tried in Australia, but West Grove Primary is the first in Europe to trial the scheme.

“There has been a lot of research which shows the benefits of standing up in the workplace, but there have not been any studies specifically related to children,” says Sally. “Australian classrooms are laid out differently to here in the UK and they also have a lot more space, but we were keen to see what effect standing up would have on the youngsters.

“We won’t look at any data until the end of the pilot, but it will be interesting to compare the results of those children who had the new desks and those that didn’t. If the results are positive then we would have to look at how we could fund more of these desks. There is no one solution to improving children’s health. It’s about lots of different elements coming together.”

Born in Bradford has been described as one of the biggest and most important medical research projects ever undertaken in the UK. While deaths rates for children have fallen dramatically over the last century, between 2006 and 2010, 520 Bradford children died between the ages of 0 and 19. Of those, 340 were under one-year-old.

“There are definitely some anomalies when it comes to the health of children in Bradford that can’t be attributed to social or ethnic factors and that’s what we really want to unpick,” says Sally. “The aim is to find out more about the causes of childhood illness by studying children from all cultures and backgrounds as their lives unfold.”

The project has already registered a number of breakthroughs with a recent study linking low birthweight to air pollution and traffic. The research pooled the results of studies from 12 countries across Europe, involving more than 74,000 women who gave birth between 1994 and 2011. Bradford provided one of the biggest samples of 11,000 mothers.

“There tends to be social patterning - poor people tend to live in inner-city areas where there is more road traffic and poorer diet,” said Dr John Wright, chief investigator of Born in Bradford. “The study allowed for other issues that could affect a baby’s development, such as smoking, which also increases the likelihood of a low birthweight baby. However, only a minority smoke, whereas everybody is affected by air pollution in the area where they live.

“You can stop smoking, drink less alcohol and get more physical exercise. Pregnant women do this really well, but for air pollution there is nothing much you can do. This is a classic example of public health policymaking that needs to happen.”

The Centre for Research in Environmental Epidemiology in Barcelona has also recruited Born in Brad mothers for a study looking at a link between a toxin and lower birth weights. Acrylamide is found in high quantities in chips and crisps and the results were equally revealing. Testing took place in Denmark, England (represented by Bradford), Greece, Norway and Spain and the West Yorkshire sample had the highest levels of the five centres and almost twice the level of the Danish babies.

“Individually, these types of studies are interesting, but when you put them together they help to paint a picture of the city and that’s what Born in Bradford was set up to do,” says Sally.

Back at Miss Rogers’ class the pupils are in little doubt as to which way they’d rather be taught.

“It’s been really good,” says nine-year-old Evie Robinson. “I don’t know why, but I do think I concentrate much better when I’m stood at my desk. When we were first asked about taking part I did think that by the end of the class my legs would hurt, but they don’t, it’s been great.”

It’s also another reason why she thinks West Grove Primary is the best school in Bradford.