|
|
A global, national and regional update on childhood obesity |
Childhood obesity has finally been recognised as a serious epidemic as is evidenced by the amount of publicity it now receives. Whether political support to deal with the problem will follow remains to be seen. The cynics would say there are no votes in asking children to eat less and move more. The Australian government has certainly shown no interest whatsoever in banning TV advertising of junk food aimed at children.
However any government organisation with the long term health and wellbeing of its community in mind will need to give the broad topic of childhood obesity the highest priority. The morbidity that will follow if the problem is ignored is enough to overburden the health system of even the most affluent of countries.
Childhood obesity is increasing in both developed and developing countries according to a report presented to the World Health Organisation prepared by a special International Obesity Task Force working group (1). With the help of expert groups including the Federation of International Societies of Gastroenterology, Hepatology and Nutrition and the International Paediatrics Association problematic social trends were identified including:
- Increase in use of motorised transport, eg. to school;
- Fall in opportunities for recreational activity;
- Increased sedentary recreation;
- Multiple TV channels around the clock;
- Greater quantity and variety of energy dense foods available;
- Rising levels of promotion and marketing of energy-dense foods;
- More frequent and widespread food purchasing opportunities;
- More frequent use of restaurants and fast food outlets;
- Larger portions of food (supersizes) offering better value for money;
- Increased frequency of eating occasions;
- Rising use of soft drinks to replace water, eg. in schools.
The report concludes that the domination of obesogenic environmental factors means that treatment is unlikely to succeed without strategies to deal with the prevailing environment through a broad based public health campaign. Such prevention strategies will require a coordinated effort between the medical community, health administrators, teachers, parents, food producers, retailers and caterers, advertisers and the media, recreation and sports planners, urban architects, city planners, politicians and legislators.
While in some developing countries childhood obesity was most dominant in wealthier social groups, it is also rising among the urban poor as those with previous undernutrition are exposed to Westernised diets. Children in lower income families in developed countries are particularly vulnerable because of poor diet and limited opportunities for physical activity. The report found that in the USA overweight figures rose twice as fast in Hispanic and Africana American pre-teenage children compared to white children during the 1990s.
The report called on the WHO to help countries develop national obesity action plans to prevent childhood obesity. Action is needed to:
- provide clear and consistent consumer information, eg. on food labels;
- encourage food companies to provide lower energy, more nutritious foods marketed for children;
- develop criteria for advertising that promotes healthier eating;
- improve maternal nutrition and encourage breast feeding of infants;
- design secure play facilities and safe local neighbourhoods;
- encourage schools to enact coherent food, nutrition and physical activity policies;
- encourage medical and health professionals to participate in the development of public health programs.
Co-Chair Professor Louise Baur, who is based at the Sydney University Department of Paediatrics and Child Health, in discussing the report, commented that almost daily news reports are coming in of younger and younger children having type 2 diabetes. This alone should make it imperative that all nations take urgent action to address key issues affecting the growth of obesity.
So what about the national situation regarding obesity rates? Last month Michael Booth, co-director of the NSW Centre for Overweight and Obesity, University of Sydney, gave a keynote address to the ‘Preventing Obesity in Children and Young People Northern Rivers Planning Day’. The figures are alarming according to the NSW Schools Fitness and Physical Activity Survey. The survey looked at 5,518 in the 2-17 year old age group and showed 20-21% overweight/obesity rates in figures up to 1997. Between 1985-97 the overweight/obesity rates doubled.
So what about now - seven years later? Although the figures are not yet official he estimates the rates currently being analysed are about 30-33%. What’s worse he suggests the trends are not just rising but accelerating and unless something changes we may be looking at figures of 50% by 2020. The health consequences of being overweight/obese becoming the norm is of great concern.
On a more positive note the planning day, which was coordinated by the NRAHS Division of Population Health and Planning, is aimed at developing regional strategies to deal with the problem. Jillian Adams, childhood obesity prevention co-ordinator will contribute some articles in future obesity sections of GPSpeak to keep us all involved in the challenging task of dealing with the issue of childhood obesity at a local level.
(1) Lobstein T, Baur L, Uauy R for the IOTF Childhood Obesity Working Group, Obesity in children and young people: A crisis in public health. Obesity Reviews 2004 (Suppl 1): 4-85
|
|
|
|
