Childhood Obesity - Where are we now?
Posted by:Kelly Crawford
Wed 20 June 2012
Childhood obesity is a pressing issue for many countries, including Australia. Healthy Kids Association is a health promotion charity that aims to influence and promote healthy food choices for children. We aim to reduce childhood overweight and obesity and the incidence of diet-related diseases in children. The purpose of this article is to educate the public on childhood obesity and where we go from here.
Obesity: What is it?
Overweight and obesity are states of the body that exist when people are carrying more weight than they should for their height. Health professionals will often use growth charts to track a child’s weight and height, noting what percentile the child is falling within. Children who fall within the 85th to 95th percentiles for weight are considered to be overweight while children falling above the 95th percentile for weight are considered to be obese.
Alternatively, a health professional may use a Body Mass Index (BMI) calculation to chart a child on a BMI percentile chart. BMI is a number calculated from a child’s weight and height. Again, if the BMI percentile is 85th to 95th, the child is considered to be overweight while 95th percentile and above is considered to be obese. If BMI is high, additional tests may be conducted to fully determine the child’s weight status (CDC, 2011).
How bad is it?
In Australia, 17% of children ages 12 through 16 are overweight and 6% are obese (2007 National Children’s Nutrition and Physical Activity Survey). Childhood overweight or obesity in the 1960’s was 5% but in 2010, it rose to 23%. The numbers in NSW are very similar. According to the Schools Physical Activity and Nutrition Survey 2010 (SPANS), 17.1% of NSW children are overweight and 5.8% are obese for a combined total of 22.8%. This means that around 250,000 children in NSW are overweight or obese. If obesity prevalence increases over the next 20 years in line with current trends, there will be 6.9 million obese Australians by 2025.
Recent reports from Australia, the United States, France, Sweden and New Zealand have noted stabilisation in childhood overweight and obesity rates over the last five to ten years. In Australia, prevalence has flattened in the last decade. However, evidence shows that adult overweight and obesity prevalence continues to rise (Olds et. al, 2010). Even with this plateau, the current childhood overweight and obesity figures bring significant physical and mental health issues (Olds et. al, 2010).
If we do not reverse the trend of childhood obesity, the health problems children will face are staggering. This will also lead to huge healthcare costs. Recent figures suggest that the “total direct cost of overweight and obesity in Australia in 2005 was $21 billion" (Colagiuri et. al, 2010). This figure does not include indirect costs, which elevate the total per year to over $50 million. This figure will only increase if the current obesity rates continue.
Complications of Childhood Obesity
The complications of childhood obesity go far beyond physical appearance. Childhood obesity brings an increased likelihood of:
- Psychosocial difficulties such as depression and decreased socialisation. Overweight or obese children can be bullied in school, which can contribute to low self-esteem and lack of confidence.
- Hyperlipidemia-increased fat in the blood, which can lead to cardiovascular disease.
- Hypertension-high blood pressure.
- Hyperinsulinemia, which is an increased level of insulin (a hormone) in the blood, which can lead to Type 2 diabetes.
- Fatty liver disease, where there is a build up of fat in the liver that replaces healthy cells.
- Respiratory problems such as asthma and sleep apnoea.
Why has it gotten worse?
People become overweight when the energy that they consume through food and beverages is more than the energy that they expel during physical activity. There is no one person or place to blame for childhood obesity. Over time there have been significant changes in our environment. More people are eating out and are eating out more often. There is an increased reliance on “convenience foods” which are often higher in fat, sodium, and sugar than cooking something from scratch. There is also an increased availability of energy dense, nutrient poor food and beverages, which are often available at a low cost.
With both parents working, there is less time to prepare meals and there are dozens of activities that pull children away from the dinner table and into eating on the run. Children spend more time in front of screens such as television, computer, and video game screens and less time being physically active. Marry this with larger portion sizes, junk food marketing to children, and driving to places where we used to walk to and you have heavier and less active children.
Recent figures show that less than half of NSW children in years K, 2 and 4 met Australian physical activity guidelines (at least 60 minutes of physical activity per day) (Hardy, 2011). In Western Australia, type 2 diabetes incidence from 1990-2002 increased 27% annually for children under the age of 17. Over half of these children were of Aboriginal or Torres Strait Islander descent (Davis, 2004). In NSW, from 2001-2006, 11% of newly diagnosed diabetes in children ages 10-18 were type 2 diabetes cases. Over half of these children were from minority groups (Craig et. al, 2007).
Inadequate vegetable consumption and an increase in consumption of sugar-sweetened beverages are also risk factors for childhood obesity and diet-related diseases. According to data from the NSW Population Health survey, only 43.1% of children ages 2 through 15 consume the recommended amounts of vegetables. In addition, 15.3% of children consume 6-10 cups of sugar-sweetened drinks per week and 13.5% of children consume 11 or more cups of sugar sweetened drinks per week (NSW Child Health Survey, 2010). These statistics are especially concerning because “each can of soft drink consumed per day increases the rate of being obese by 60%” (Joint WHO/FAO Expert Consultation, 2003).
Who’s responsibility is it?
The childhood obesity epidemic is being tackled from a variety of angles from the individual level all the way to public policy. There are educational programs targeted at parents and children, state governments have implemented guidelines for canteens to follow regarding what food and beverages are sold in the canteen, food companies are trying to scale back their advertising to children and some food companies are even reformulating products to make them healthier. Schools are introducing gardening and cooking programs to increase food literacy in children and urban planners are trying to redesign cities to make them easier to walk and cycle in. Although these things are all good, more is needed to bring down the childhood obesity levels and ensure a healthy future for our children.
There are many things that you can do to help with this issue. If you are a caregiver, you can:
- Model healthy eating yourself. Children are far more likely to eat what they see the adults in their lives eating.
- Limit extra foods such as confectionary and soft drink.
- Choose a variety of foods from the main food groups: vegetables and legumes, fruit, dairy food, lean protein from meat, poultry, fish, eggs and nuts, and wholegrains from breads, cereals, rice and pasta.
- Be physically active with your family. Go for walks, play outside, turn off the TV.
- Limit your child’s screen time. Don’t allow your child to have a TV in his or her bedroom.
- Get children involved in the kitchen. Children are far more likely to eat what they have helped to prepare. Plus, by teaching them how to prepare food, you will give them the skills they will use for their whole lives.
- Provide an array of healthy snack options that are easily accessible to your children.
- Encourage your children to try new foods, including fruits and vegetables.
- Don’t pressure your children to finish what is on their plates. Most children will stop when they are satistfied.
- Avoid using food as a reward for good behaviour and don’t restrict certain foods when giving punishment. This can develop feelings around food that can later cause unhealthy habits.
There are numerous other ways to get involved in preventing childhood obesity:
- Advocate to your local representative to fund programs that assist parents, schools and your community to create a healthy environment for children.
- Support organisations such as Healthy Kids Association that are doing something to help fight childhood obesity and diet-related diseases in children.
- Get involved in the canteen in your local school. Help to prepare healthy menu options for students.
- Contact your local council to encourage them to keep green spaces green and limit development on them so that children have safe spaces to play.
In the end, we want our children to have fullness of life and good health far into adulthood. They will be robbed of this unless more is done to prevent and reduce childhood obesity.
Access Economics 2008 as referred to in: “Obesity in Australia” Accessed from the Preventative Health Taskforce at: http://www.preventativehealth.org.au/internet/preventativehealth/publishing.nsf/Cont ent/E233F8695823F16CCA2574DD00818E64/$File/obesity-2.pdf.
Australian National Children’s Nutrition and Physical Activity Survey. 2007. Accessed from: http://www.health.gov.au/internet/main/publishing.nsf/Content/health-pubhlth- strateg-food-monitoring.htm#07survey
CDC. 2011. “About BMI for children and teens.” Available at: http://www.cdc.gov/healthyweight/assessing/bmi/childrens_bmi/about_childrens_bmi. html.
Colagiuri, S., Lee, C.M.Y., Colagiuri, R., Magliano, D., Shaw, J.E., Zimmet, P.Z., Caterson, I.D. 2010. “The cost of overweight and obesity in Australia.” MJA: 192 (5).
Craig, M.E., Giuseppe, F., Vitali, B., Lloyd, M., and Howard, N.J. (2007). “Type 2 Diabetes in Indigenous Children and Adolescents in NSW.” MJA, 186 (10) 497-499.
Davis, E. (2004). “Increase in Type 2 Diabetes in WA Kids”. http://ama.com.au/node/1635.
Hardy, L. (2011). “SPANS 2010: NSW Schools Physical Activity and Nutrition Survey, Executive Summary”. http://www.health.nsw.gov.au/pubs/2011/pdf/spans_2010_summary.pdf.
Joint WHO/FAO Expert Consultation. (2003). “Diet, Nutrition and the Prevention of Chronic Diseases.” Geneva, WHO in “Soft Drinks, Weight Status and Health: A Review”.
Olds, T.S., Tomkinson, G.R., Ferrar, K.E., Maher, C.A. “Trends in the prevalence of childhood overweight and obesity in Australia between 1985 and 2008.” International Journal of Obesity (2010) 34, 57-66.
NSW Health-Population Health. 2012. “NSW Child Health Survey: 2009-2010 Summary Report.” Available from: http://www.health.nsw.gov.au/resources/publichealth/surveys/hsc_0910pub.pdf