Friday, November 10, 2006

The fattening of a generation

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Photograph from the ABC

A confronting question from Sydney University's Dr Michael Booth, the state's top expert on childhood obesity, asks whether the greatest child abuse of our time will be the fattening of a generation?

Unless you've been under a rock, you can't help but be aware of the increasing rates of obesity in children and the potential costs in terms of increased rates of type-2 diabetes, hypertension, cardiovascular disease, cancer and osteo-arthritis. With 25% of Australian school-age children overweight or obese, the implications are enormous.

Dr. Booth says although there other issues to be taken into consideration, a diet of junk food could easily be considered a form of abuse.

"It is actually doing their life's chances very great harm. Failing to provide adequate nourishment to your children is a form of abuse, like failing to provide adequate shelter or education or sleep or safety."

Dr. Booth attributes this to parents being in denial about the effects of junk food, to laziness, to time-poor parenting, where it's often about getting food on a plate quickly rather than nutritional content.

The results of a new study by Dr. Booth are frightening, showing obesity begins to cause disease when Australians are still in their teens. Blood samples were taken from 500 Sydney year 10 students to assess risk of diabetes and cardiovascular disease and whether fatty liver disease was present.

15% had elevated insulin levels, a precursor to Type 2 diabetes.
10% of boys and 5% of girls had liver damage.
20% of boys had high blood pressure.

Importantly, the study showed that while children were actually increasing their amount of physical exercise, they were eating more junk food.

Earlier this year, the 10th International Congress on Obesity was held in Sydney. Dr William H. Dietz, director of the Division of Nutrition and Physical Activity at the United States-based Centers for Disease Control and Prevention, spoke about the worldwide problem of childhood obesity.

"Childhood obesity now constitutes a major threat to the health and welfare of populations worldwide. Sixty per cent of overweight five- to 10-year-old children have at least one additional risk factor for cardiovascular disease, and 25 per cent have two or more. Recent data suggest that 15 per cent of adolescents who develop Type 2 diabetes will have end-stage renal disease in 15 years."

Dietz outlined strategies the CDC have found to be useful including physical activity, reduced television viewing, breastfeeding, increased fruit and vegetable consumption, reduced sugar-sweetened beverage consumption, and reduced portion size.

Two approaches, largely based on common-sense practices, that address some of these strategies were also highlighted:

Weightwatchers' Healthy Parent Healthy Child

Weightwatchers is one of the best known weight-loss services but it's not as simple as rolling out the program to children. Research conducted in Sweden concluded that the adult-based program was not suitable. Therefore, Weightwatchers joined forces with pediatricians in the US to put together this pilot program, which puts the Weightwatchers program into a family setting. The basis of the program is setting up a healthy-weight home, a home where everyone who lives there has a lifestyle that encourages them to be at a weight that is right and healthy for them.

The program is based on five simple rules:

1) A focus on wholesome, nutritious foods.
2) Inclusion of treats.
3) A limit on non-homework screen time to two hours (or less) per day.
4) Increased activity - an hour or more per day.
5) The rules apply to everyone in the home.

While the program is not presently available in Australia, Weightwatchers hopes to roll it out within the next year. However, the book of the program is available.

The Mend Program

A healthy Mind, sufficient Exercise, good Nutrition and a balanced Diet. Developed by Dr Paul Chadwick and pediatric nutrition consultant Paul Sacher, the community-run program has had great success in Britain where it is running at 24 sites around the country. Sacher is also the author of From Kid to Superkid, a book which outlines the principles behind the MEND program.

"The key to MEND's success is its integrated approach, combining all the elements the medical community knows to be vital in preventing and treating obesity: family involvement, increasing physical activity and reducing inactivity, dietary education and behavioural modification. The challenge for us is how quickly we can bring MEND to Australia."
Paul Sacher

Child obesity frightening
Obese kids are headed for heart attacks


Sarebear said...

SWEET! Er, NEATO! They both sound like good approaches. I think the figure of kids at risk or obese is a good bit higher here in the U.S.

It's sad to say that it's a problem anywhere. Good to see inclusion of treats on that list, when you eliminate things thatyou love, sometimes you just break down and eat way too many then.

Moderation is good!

jumpinginpuddles said...

ironically the healthy eating programn has just hit our school unironically the menu is one the kids hate wopnt order and the only thing that is being ordered is the unhealthiest of all snacks, frozen yoghurts.
Perhaps giving kids some choices that are healthy are better than one choice they hate hey

Anonymous said...

In the UK, Jamie Oliver has been lobbying the government to reassess school dinners and replace all of the low-grade crap presently available, with nourishing, hot meals made from higher quality ingredients. During the trials, most of the kids turned up their noses in disgust, as have many of the parents! I can't get over why anyone would have an issue with being fed well! (Crazy as snakes, the lot of 'em!) In the same programme about the school dinners, some 10 year olds didn't even know what celery or leeks were when asked to identify them! There seems to be wide-spread ignorance of basic life skills here. Nutrition and food-preparation ought to be a greater part of every child's curriculum. Though what to do about negligent parents... I don't know, aside from educating them and asking them directly, "Do you WANT your child to die?" or "Do you WANT your child to have a lifetime of health problems?" My guess would be that 100% of the parents would say "Absolutely NOT!"

Anonymous said...

I can't help but wonder about the aspect of the weightwatchers program that involves including "treats" - I'm think that I remember Dr. Yolanda Martins of Flinders University (researcher in food, eating and body image) saying in a lecture earlier this year that teaching children to place different values in food, such as calling a food like a chocolate bar a "treat" (placing high value on it) can teach children that some foods are 'better' than others - and often food that shouldn't be. I can imagine this would lead to older children wanting to go and buy junk, both because of it's high value and its 'forbidden' status.

Just a thought.
On the whole, I think it's extremely important to tackle the issue of child obesity! I would just want to see what the longer-term consequences of these sorts of programs to childrens body images and eating behaviours are.
I think it would be a lot better for parents to teach their children healthy lifestyle and eating patterns from an early age, without the punitive connotations that weight loss programs seem to have.

healthpsych said...

Hi Sarebear,
It's a problem in most Western countries to varying degrees. I think the idea of not excluding any particular food group is good but I share the view of Anonymous that the word 'treat' is possibly counterproductive.

Hey JIP,
Having similar issues with our local canteen. Healthy choices are all well and good but they have to be presented in a way that is still attractive to kids.

Hi Little Blue Petal,
Thanks for visiting. I never was a big fan of Jamie Oliver until recently but his school dinners program, along with his Fifteen program, changed my mind about all that. When I was at school in Britain, we always had cooking classes (with disastrous results usually in my case!), I guess some of these things have gone now (giving my age away). Mind you, I also have to wonder about the nutruitional content of some of our school dinners (spam fritters?!) :)

Hi Anonymous,
Thanks for your comments. I think you're spot on when you talk about making items 'treats' and giving food items unintentionally a higher food value. As you also say, tackling the problem of childhood obesity has to be done carefully else we'll end up creating a whole heap of other problems down the track.

Anonymous said...

Obese Children are becoming an epidemic! Where are the parents?