by the media both in terms of active advertising campaigns for junk food or sedentary games and the passive portrayal of unattainable body shapes and sizes in magazines and by celebrity culture. How- ever, more than this, health messages are competing against a variety of cultural values, social, and personal norms that may well go against messages that encourage certain behaviours. What is more is that ultimately individuals have the power and autonomy to make their own choices about diet and exercise. Stakeholders need to ensure that people are in a position to make an informed decision and not one where their judgement is clouded by an array of contradicting messages. There is also a responsibility to ensure that indivi- duals are able to act on advice given and to provide advice that is relevant and tailored to individual circumstances. It is easy to understand why parents on a low income may struggle to incorporate ‘‘5 a day’’ into their families diets when they perhaps don’t have access to a car and the nearest shop selling fresh fruit and vegetables is several miles away. Ensuring people know that frozen fruits and vegetables are just as good and, in some cases better, is a far more useful and usable message. Comparisons with past research The objective of this study was to explore children’s understandings of obesity in terms of diet and physical activity; the children included were consid- ered high risk because of their socio-economic status. To meet this objective, focus group data was analysed using thematic analysis. This analysis produced key themes pertaining to the understand- ings of the participants. There is not a wealth of prior research in this domain and it was for this reason thematic analysis was chosen to analyse the data. The method proved to be particularly useful in generating these exploratory data that are discussed here in relation to previous findings. The theme of knowledge has previously been identified by Hesketh et al. (2005) in terms of information and awareness that is pertinent to children’s perceptions of healthy eating, activity, and preventing obesity. Increasing knowledge relat- ing to diet and physical activity cannot prevent obesity but it can encourage children to make informed choices. This study, as have others (Hesketh et al., 2005; Borra et al., 2003; Musaiger, Mater, Alekri, & Mahdi, 1991), identified misunderstandings in chil- dren’s knowledge as barriers to healthful behaviour. It might be useful to address this issue, particularly with younger children who are developing their knowledge. Previous literature has identified young Children’s understandings’ of obesity children often consume their recommended daily intake of fruit but fall well short when it comes to vegetables (Dennison, Rockwell, & Baker, 1998). Government campaigns encourage people to eat five portions of fruit and vegetables a day (www.5a- day.nhs.co.uk); however, nutritionists would encou- rage three portions of vegetables and two of fruit* fruit having high sugar content. There was no evidence in the transcripts that any of the children were aware of or understood this distinction. This needs further investigation; however, education should encourage an understanding of fruit and vegetables as separate entities to help increase the consumption of vegetables (Gibson, Wardle, & Watts, 1998). The evidence in this study suggests children grasp the causes of obesity, overeating, and low levels of physical activity; however, there was a general lack of understanding of the underlying physiological pro- cesses. There was a limited understanding of the concept of energy balance or that there might also be medical reasons for the obesity. Bell and Morgan (2000) demonstrated providing medical explana- tions for obesity can have a positive effect on children’s attitudes to obese individuals. Overweight individuals were generally stigmatised by the parti- cipants in this study, so providing better medical information could help to alleviate these negative attitudes. It is fair to say those children who did have more in-depth knowledge of obesity were more sympathetic in their considerations of overweight individuals acknowledging the difficulty in making lifestyle changes. The influence of parents concerning diet and exercise behaviours is well documented (Prout, 1996). Hesketh et al. (2005), Borra et al. (2003), and Young-Hyman et al. (2000) consider parental influence to be a determining factor in children’s attitudes and understandings of obesity. It is clear this influence can be as detrimental as it can be beneficial. Previous research (Borra et al., 2003) argues interventions need to be developed that consider the role of the parent. Children cannot be expected to apply the information they receive at school to themselves if it is not reiterated at home. Nutritional education and physical education have not formed a core or extensive part of school curriculums in the United Kingdom in previous years, and there is now a generation of young parents who do not have the skills to attractively present appropriate foods (Tuttle & Truswell, 2002) or who regularly take part in sport themselves. The impact of this on their children’s behaviour is that they don’t always have examples of healthy behaviour to model their own on. Citation: Int J Qualitative Stud Health Well-being 2011; 6: 7170 - DOI: 10.3402/qhw.v6i3.7170 11 (page number not for citation purpose)