|
|
Report on the Childhood Obesity Summit |
The incidence of childhood and adolescent obesity has trebled over the last decade. Many of these children progress into adult obesity. Currently over half of our adult population is overweight or obese. New disorders presenting in obese adolescents include type 2 diabetes, hypertension, hyperlipidaemia, fatty liver, sleep apnoea, asthma, orthopaedic complications including postural imbalance and excessive weight bearing, and poorer psychosocial functioning and reduced self-esteem levels.
Australian children are eating more, with a 10% increase of caloric intake of 10-15 year olds between 1985 and 1995. Children and adolescents are less physically active and now spend more time watching television or playing computer games.
The summit
In September I attended Parliament House in Sydney to attend the Childhood Obesity Summit, representing the Australian Divisions of General Practice. A variety of diverse groups were represented including dieticians, paediatricians, adolescent physicians, representatives from public health and research, academics, the childhood sector, education, transport, sport, various advertising and media associations, parents, young people and government including the Health Minister himself.
It was suggested that bringing together this diverse range of people would help put forward a broad range of solutions to address this complex problem. The summit was modelled on the previous NSW drug summit in 1999 and at its completion a communiqué was handed to the Health Minister to be tabled in Parliament.
The reasons why the summit occurred at this time is anybody’s guess. The innocent amongst us would believe that the above sorts of statistics released about the epidemic of childhood obesity in Australia has prompted NSW Health to act earnestly and address the issue. The more cynical of us might wonder whether this issue has been taken up now as it could be a winner for an up coming State election.
Health working party
Through the summit various working groups were formed and each group proposed a variety of resolutions, which were brought back to the summit for approval into the final draft of the communiqué. I attended the health-working group. Prof Stephen Leeder, the dean of the University of Sydney’s medical faculty chaired this. There was no other general practice representation in this group. Although there were others in the group who were grassroots primary health care providers to children and young people, my concern was that there was a tendency for the academic, research and government views to predominate. A variety of resolutions from the health working party were included in the final communiqué.
I believe that the most likely of these, which will be funded, is a “centre of excellence” that will be developed for overweight and obesity research. I am sure that this was already on the agenda before the summit and will be a good political winner for the current government. My concern with this is that it will be based in Sydney and mostly be an academic institution and have little practical effect on childhood and adolescent obesity in most of the rest of NSW, or Australia for that matter. I pushed for an addition to this motion to include research into health promotion in rural and remote areas of NSW. In addition to biological factors I argued that there be research into the behavioural and social causes of obesity.
Supporting GPs
I also managed to get a motion into the communiqué that NSW Health work more closely with, and support divisions of general practice and GPs to promote a better relationship between them and dieticians and other relevant childhood and youth workers. It was suggested that this might be done through the newly developing Australian Healthcare agreement between State and Commonwealth Health and also use the existing EPC item numbers.
Fast food advertising
At the summit one of the most controversial areas of discussion centred around fast food television advertising to children. A recently formed national coalition of health organisations (including the ADGP) called CFAC (Coalition on Food Advertising to Children) addressed the summit on this issue. There were a number of areas of disagreement between CFAC and the various representatives from the media and advertising industry. These included discussions about the amount of time that children are actually exposed to food advertising in “C” and “G” programs, the degree to which a premium (eg. a toy) is being used to sell the product in the advertisement, and whether current regulatory mechanisms were adequate for investigations of complaints and monitoring. Although there has been some suggestion that there should be a ban of food advertising during children’s viewing times, the outcome from the summit was that there would be an independent investigation into this area to report on these issues. I expect that this issue will be topical for some time.
Another positive and likely outcome of the summit is that there will be mandatory rules to restrict the amount of junk foods available to children in canteens across NSW schools.
Family responsibilities
A common theme that was expressed through the summit was that parents and families themselves must take more responsibility for providing healthier food choices and promoting more physical activity to their children. One concern that I have about this is that unfortunately many adolescents have already grown beyond the family influence. It is therefore important I believe for the community and the health sector including GPs to develop more innovative ways to support our young population to adopt a healthy diet and adequate exercise. Sadly I felt that this was left largely unconsidered at the summit.
Rob Trigger practises in Byron Bay. He is a member of the division’s board and manager of the youth health project. If anyone would like to obtain a copy of the final communiqué please contact Rob through the division.
|
|
|
|
