National Survey For Wales 2017-18: Population Health - Lifestyle

Figure 19: Percentage of adults who reported being active (at least 150 minutes) or inactive(less then 30 minutes) the previous week, by yearThere was little change inPercent7060physical activity between502016-17 and 2017-18 (the40changes were not302010statistically significant).Physical activity guidelines changed in 2011, and data on weeklyminutes of activity was collected for the first time in 2015. The changein survey methodology for 2016-17 led to a discontinuity in the resultsfor physical activity and these should not be compared.02016-172017-18Active at least 150 minutesActive less than 30 minutesFigure 20: Percentage of adults who reported being active for at least 150 minutes orinactive (active less than 30 minutes) in the previous week, by Health Board (agestandardised), 2016-17 and 2017-18 combined (a)52Betsi CadwaladrPowysHywel DdaAbertawe Bro Morgannwg34662359Aneurin BevanCardiff & ValeThe proportion of adults whoLess than 30minutesminutes the previous weekWelsh Average:150 minutes ormore265037Welsh Average:Less than 30minutes41Cwm Taf150 minutes ormore4453were active for at least 150ranged from 41 per cent inCwm Taf to 66 per cent inPowys .The proportion of inactiveadults ranged from 23 per centin Powys to 44 per cent inCwm Taf.335729(a) See Local authority / health board estimatesFurther informationFurther information can be found in the accompanying tables on StatsWales and on the NSW webpages.9

Section 5:Body Mass IndexOver half (60 per cent) of adults were classified as overweight or obese including 22 perAt acent who were obese. Men were more likely to be overweight, but not obese, thanGlancewomen. Rates of adults who were overweight or obese increased with the level of areadeprivation. Young adults were least likely to be overweight or obese.Figure 21: Percentage of adults who were overweight or obese, by sex60%66%(22% Obese)54%(23% Obese)wereoverweight orobese(22% Obese)Men were more likely to beoverweight, but not obese,than womenFigure 22: Percentage of adults who were overweight or obese, by ageAdults aged 16-24 were leastlikely to be overweight or obese(33 per 7475 ercentFigure 23: Percentage of adults who were overweight or obese, by area deprivation80The proportion of adults who60were overweight or obese40increased with deprivation200Quintile 1- mostdeprivedQuintile 2Quintile 3Quintile 4Quintile 5- 221410

Figure 24: Percentage of adults who were overweight or obese, by year70overweight / obese between602016-17 and 2017-18 (the5040changes were not statisticallyData from 2016-17 onwards is from the NSW and isnot directly comparable to the WHS 201520142013201220102011showed an increase in200902008trend, the former WHS2007102005/06For context and a longer time2004/05202003/04PercentThere was little change inoverweight / obesity between2003/04 and 2015.ObeseFigure 25: Percentage of adults who were overweight or obese, by Health Board (agestandardised), 2016-17 and 2017-18 combined (a)Overweight/Obese57Betsi Cadwaladr20Obese1922Welsh Average:Overweight/Obese60Abertawe Bro Morgannwg2365Cwm TafWelsh Average:Obese2965Aneurin BevanPowys to 65 per cent in CwmTaf and Aneurin Bevan.59Hywel Ddawere overweight or obeseranged from 54 per cent in54PowysThe proportion of adults whoThe proportion of adults whowere obese ranged from 18per cent in Cardiff and Vale to29 per cent in Cwm Taf.2556Cardiff & Vale18(a) See Local authority / health board estimatesHealthy body weight and underweight: Two in five adults living in Wales were classified as having a healthy body weight (38 per cent). 2 per cent were underweight.Mean height and weight, by gender:MenMean height (cm)Mean weight (kg)Women1788616371Persons17078Further informationFurther information can be found in the accompanying tables on StatsWales and on the NSW webpages.11

Section 6:Multiple healthy lifestyle behavioursFive Healthy Lifestyle behaviours:Not SmokingNot drinking above weekly guidelinesEating five or more portions of fruit and vegetables the previous dayBeing physically active for at least 150 minutes in the previous weekMaintaining a healthy weight / body mass index10 per cent of adults exhibited fewer than two of the five healthy lifestyle behaviours. Men,At amiddle aged adults, and those in the most deprived areas were most likely to exhibit fewerGlancethan two of the behaviours.Figure 26: Percentage of adults by number of healthy behavioursNumber of healthy behaviours01234The majority of adults in5Wales (64 per cent) exhibitedeither two or three of the fivehealthy behaviours.1%9%31%20%33%6%Figure 27: Percentage of adults who had 0 to 1 of the 5 healthy lifestyles, by sex10%13%Men were more likely toexhibit fewer than two of8%exhibited 0 or 1healthy behavioursthe five healthy lifestylebehaviours than women.Figure 28: Percentage of adults who had 0 to 1 of the 5 healthy lifestyles, by age20The proportion of adultsexhibiting fewer than two ofPercent15the five healthy lifestyle10behaviours was highest inmiddle age.500 to 1 healthybehaviours16-2425-3435-4445-5455-6465-7475 9710141210712

Age-standardisedpercentFigure 29: Percentage of adults who had 0 to 1 of the 5 healthy lifestyles, by areadeprivationThe most deprived quintile20had the highest proportion15of adults exhibiting fewer10than two of the five healthy5lifestyle behaviours (15 percent).00 to 1 healthybehavioursQuintile1 - mostdeprivedQuintile2Quintile3Quintile4Quintile5 - leastdeprived1512979PercentFigure 30: Percentage of adults who had 0 to 1 of the 5 healthy lifestyles, by year12There was no change in the10proportion of adults whoexhibiting fewer than two864Trend information is not available before 2016-17 due to the change inalcohol consumption guidelines in 2016. There were alsodiscontinuities in other components of the measure, in particularphysical activity and fruit & vegetables.healthy lifestyle behavioursbetween 2016-17 and 201718.202016-172017-18Figure 31: Percentage of adults who had 0 to 1 of the 5 healthy lifestyles, by Health Board(age-standardised), 2016-17 and 2017-18 combined (a)Betsi CadwaladrPowysHywel Dda100 to 1 healthybehaviours78Abertawe Bro MorgannwgCwm Taf13Aneurin BevanCardiff & ValeWelsh Average:0 to 1 healthybehaviours12The proportion of adults whoexhibited 0 to 1 of the fivehealthy lifestyle behavioursranged from 7 per cent inPowys to 13 per cent in CwmTaf.119(a) See Local authority / health board estimatesFurther informationFurther information can be found in the accompanying tables on StatsWales and on the NSW webpages.13

Summary Table: Health-related lifestyle behaviours - summary of key variables, adults aged 16 & over (a)Per centE-cigaretteuserSmokerAll aged 16 Weeklyalcoholconsumptionabove 14 unitsAte 5 portionsfruit & vegActive 150minutes inweekActive lessthan 30minutes inweekOverweight orobese0 or 1 945-642092225503769271365 1131721404363239By sex:By age:By WIMD deprivation quintile (age-standardised):Quintile 1 (most deprived)281015184245663015Quintile 224817174740642512Quintile 31771822543462239Quintile 41661829572757227Quintile 5 (least deprived)1352128592655149By Local Health Board (age-standardised) (b):Betsi el Dda1982025592659228Abertawe Bro Morgannwg21820245037602312Cwm Taf21717204144652913Aneurin Bevan19818215333652511Cardiff & 819718235334602210By year:National Survey for Wales, 2017-18a) See definitions below for explanations of age-standardisation and socio-demographic factorsb) Figures for LHBs are based on two years of data combined (2016-17 and 2017-18)14

DefinitionsSmokingThe survey asked adults whether they smoked (daily or occasionally), used to smoke (daily oroccasionally), or had never smoked. Throughout the report, ‘current smokers’ are those who respondedsaying they smoked either daily or occasionally, ‘ex-smokers’ are those who responded to the surveysaying that they used to smoke daily or occasionally and ‘non-smokers’ were those who responded to havenever smoked and ex-smokers.For e-cigarettes, respondents were asked if they currently used or had ever used an e-cigarette andwhether this was daily or occasionally.Alcohol consumptionThe survey asked adults a set of questions about their alcohol consumption.As announced in the UK Chief Medical Officers’ Low Risk Drinking Guidelines during 2016, a weeklyalcohol guideline was recommended to replace the former daily guidelines. This new guideline for both menand women suggests drinking no more than 14 units a week on a regular basis, therefore this releasemeasures responses to alcohol intake against this weekly guideline. The former guidelines suggested thatmen should not regularly drink more than 3 – 4 units of alcohol per day, and women not more than 2 – 3units. Details of daily consumption are included in the additional tables.Respondents were asked how often they drank alcohol in the past 12 months and, if never, whether theyhad always been a non-drinker.Respondents were asked to indicate how often they had consumed each type of alcohol during the past 12months, and how much they had usually consumed; they were also asked how many measures of eachtype of alcohol they had consumed on their heaviest drinking day the previous week. The following tablewas used to calculate the average weekly units drunk, and the units drunk on the heaviest drinking day inthe previous week.Some respondents who did drink stated that their usual weekly consumption was none – this may lead toan underestimate in weekly drinking estimates.15

Type of drinkNormal strengthbeer, lager, stout,cider or shandyStrong beer, lager,stout or ciderWineSpirits or liqueursSherry or martiniAlcopopsAlcoholunitsMeasurePintsLarge cansSmall cansBottlesPintsLarge cansSmall cansBottlesLarge glass (250ml)Standard glass (175ml)Small glass (125ml)Bottles (750ml)221.51.54322321.591Measures or shots(single measure)GlassSmall canStandard bottle (275ml)Large bottle (700ml)11.51.53.5Weekly consumption of each type of drink was calculated by multiplying the units usually consumed on aday when that type of alcohol was drunk by a factor representing the frequency with which it was drunk.The results for each type of drink were added together to give an overall weekly figure. The frequencymultipliers used were:Drinking frequencyMultiplying factorAlmost every day7.05 or 6 times a week5.53 or 4 times a week3.5Once or twice a week1.5Once or twice a month0.375Once every couple of months0.115Once or twice a year0.029Health-related behaviours can be a complex area to measure and there may be some differences betweenwhat people report and what they do (for instance, they may tend to underestimate their alcoholconsumption). However, survey data still provides a reliable means of comparing patterns for thesebehaviours between different groups and over time.16

Fruit and vegetable consumptionThe survey asked adults questions about a range of food items to determine the overall amounts of fruit,vegetables and pulses consumed the previous day.For each food item, respondents were asked whether they had eaten it and, if so, how much they hadconsumed. Everyday measures were given for each food item: for example, tablespoons of vegetables,small bowls of salad, or medium sized fruit (such as apples). Each question provided a definition of whichfoods were to be included. Guidelines recommend eating at least five portions of a variety of fruit andvegetables each day. To conform with these guidelines, the questions and analysis were based on theconcept of portions of 80g each and the information collected was converted into standard portions at theanalysis stage.The table that follows shows portion sizes for the different food items included in the questions.Food itemPortion sizeVegetables (fresh, frozen or tinned)Pulses3 tablespoons3 tablespoonsSaladDishes made mainly from vegetables or pulsesVery large fruit, such as melonLarge fruit, such as grapefruitMedium fruit, such as apples, bananas, orangesSmall fruit, such as plums, satsumas1 small bowl3 tablespoons1 average sliceHalf a fruit1 fruit2 fruitsVery small fruit, such as grapes, berriesDried fruit, such as raisins, apricots2 average handfuls1 average handfulFrozen/tinned fruitDishes made mainly from fruit such as fruit salad or fruit pies3 tablespoons3 tablespoonsFruit juice1 small glassAt the analysis stage, rules for certain foods were applied: respondents could obtain no more than oneportion of their daily intake from fruit juice, one portion from pulses, and one portion from dried fruit. Theserestrictions are in line with guidelines, which emphasise that a variety of fruit and vegetables should beconsumed.Health-related behaviours can be a complex area to measure and there may be some differences betweenwhat people report and what they do. However, survey data still provides a reliable means of comparingpatterns for these behaviours between different groups and over time.Physical activityPhysical activity guidelines recommend that adults should aim to do at least 150 minutes of moderateactivity during the week. Alternatively, comparable benefits can be achieved by 75 minutes of vigorousactivity, or an equivalent combination of the two.The questions asked respondents on what days in the previous week they walked, completed somemoderate physical activity and completed some vigorous physical activity for at least 10 minutes at a timeand then they were asked how much time, on average, they spent doing these activities each time. Therespondents were also asked about their walking pace and the effort involved. Walking was included as a17

moderate activity for those walking at a ‘fairly brisk’ or ‘fast’ usual pace. For those aged 65 and over,walking at any pace was included if the effort was enough to make them breathe faster, feel warm orsweat. The information was combined to provide an estimate of the equivalent number of moderateminutes of activity undertaken the previous week. Those with the equivalent of 150 minutes or moremoderate activity were classed as meeting the guidelines. Results for those who were inactive are alsoshown, which for the purposes of this report was defined as those with the equivalent of less than 30minutes moderate activity the previous week.Health-related behaviours can be a complex area to measure and there may be some differences betweenwhat people report and what they do (for instance, they may tend to overestimate their levels of physicalactivity). However, survey data still provides a reliable means of comparing patterns for these behavioursbetween different groups and over time.Body Mass IndexThe survey asked adults to report their height and their weight. In order to define overweight or obesity, ameasurement is required which allows for differences in weight due to height. The Body Mass Index (BMI)is calculated as weight (kg) divided by squared height (m²). However, BMI does not distinguish betweenmass due to body fat and mass due to muscular physique, nor does it take account of the distribution of fat.BMI was calculated for all respondents, excluding pregnant women, with valid height and weightmeasurements and classified into the following BMI groups:BMI (kg/m2)Less than 18.518.5 to under 2525 to under 3030 and over40 and overDescriptionUnderweightHealthy weightOverweightObeseMorbidly obeseHeight and weight of respondents are self-reported, and there is evidence to show that some people tendto under-report weight and/or over-report height, resulting in an under-estimation of the prevalence ofoverweight and obesity 1 2.Welsh Index of Multiple DeprivationThe Welsh Index of Multiple Deprivation (WIMD) is used as the official measure of deprivation in Wales.Deprivation is a wider concept than poverty and refers to wider problems caused by a lack of resources andopportunities. The WIMD is constructed from eight different types of deprivation. These are: income,housing, employment, access to services, education, health, community safety and physical environment.Wales is divided into 1,909 Lower-Layer Super Output Areas (LSOA) each having about 1,600 people.Deprivation ranks have been worked out for each of these areas: the most deprived LSOA is ranked 1, andthe least deprived 1,909. Respondents to the survey have been split into five groups based on the LSOAthey live in (with 20 per cent of LSOAs allocated to each group). Results are compared for the five groups.1World Health Organization, Geneva, 2000: http://whqlibdoc.who.int/trs/WHO TRS 894.pdfRoberts, RJ. (1995) Can self-reported data accurately describe the prevalence of overweight? Public Health; 109 (4):275-284 [Used Welsh data]218

Age-standardisationAge standardisation has been used in selected analysis in order to enable groups to be compared afteradjusting for the effects of any differences in their age distributions. When different sub-groups arecompared in respect of a variable on which age has an important influence (such as health), anydifferences in age distributions between these sub-groups are likely to affect the observed differences inthe proportions of interest.Age standardisation was carried out using the direct standardisation method. The standard population towhich the age distribution of sub-groups was adjusted was adapted from the 2013 European StandardPopulation. Calculations were done using Stata. The age-standardised proportion 𝑝′ was calculated asfollows, where 𝑝𝑖 is the age specific proportion in age group 𝑖 and 𝑁𝑖 is the standard population size inage group 𝑖:p' Np NiiiiiTherefore 𝑝′can be viewed as a weighted mean of 𝑝𝑖 using the weights 𝑁𝑖 . Age standardisation was car

health related lifestyles and behaviours of adults living in Wales from the National Survey for Wales 2017-18. This includes one of the 46 National Indicators. The full questionnaire is available on the National Survey web pages. Additional tables can be accessed via StatsWales and the National Survey webpages. 53% In this bulletin