Time to Solve Childhood Obesity

Childhood Obesity

Childhood obesity hit the news yesterday with the publication of a special report.  The headlines sensationalised a recommendation that snacking should be banned on buses and trains.  This was a special report by the outgoing Chief Medical Officer, Professor Dame Sally Davies and happened to contain another 48 recommendations to solve the problem.

Like many other people (judging by the comments on FaceBook, and elsewhere), I wondered how on earth this was going to be policed.  Was this just more nanny state-ism?  Ok, we do have a problem with obesity…

Before I dismissed it out of hand though I decided to have a read and, you know what?  It is detailed, useful and if it can be implemented, even if only in part, will make a huge difference to the health of adults as well as children.

It starts by pointing out that childhood obesity has doubled in the 30 years since the UK started weighing children at age 10/11 in school in 1990.  There was a problem then – it is worse now.

The Problem

1990

  • Obese – 5%
  • overweight – 10%
  • normal weight – 83%
  • underweight – 2%

2017/18 and a new category introduced – severely obese

  • severely obese – 4%
  • obese – 16%
  • overweight – 14%
  • normal weight – 64%
  • underweight – 2%

Let’s have a look at what has happened to adult obesity in that time:

The takeaway from this is, total percentage of adults in 1993 overweight or obese – 52.9%.  2017 – 64.3% – an extra 11%  compared to an extra 19% of children.

What Went Wrong?

Economic factors are playing a part in the increase as children from deprived areas are more likely to be overweight or obese than those who are from wealthier areas.  Environmental factors are also causing concern as children do not have the same access to open space and safe play areas as they have done in the past.

The report makes the point that politicians have a responsibility to pass laws which protect children.  We no longer expect our children to go down mines or up chimneys thanks to legislation.  Everyone has to wear seat belts in cars.  We have to protect children from developing weight problems in childhood to save them from poor health as adults.

Laws have to be passed to change society and reverse the rise in obesity.

Health Consequences

Negative Consequences of Childhood Obesity on Health (report p5)

  • Type 2 diabetes
  • asthma
  • musculoskeletal pain
  • mental health problems eg depression
  • sleep apnoea
  • fatty liver disease
  • increased risk of broken bones in lower limbs

The first reported case of type 2 diabetes in a child was in 2000.  Before that point it was known as adult onset diabetes.  Today there are over 700 children with the disease and OVER 100 more are diagnosed every year.

Recommendations

The report also points out that healthy food is three times the price of unhealthy food.  Portion sizes are increasing both in pack size that we buy and in what we see as normal to put on our plates.  Also, VAT added to foods does not always support healthy food choices.  Because the sugar tax has been successful in getting drinks manufacturers to reformulate their products, more can be considered.

Broadly speaking the recommendations cover:

  • wider access to tap water in public spaces
  • increasing opportunities for exercise through play
  • access to healthy meals in schools and nurseries
  • access to bariatric surgery for eligible children (90,000 teenagers are eligible but fewer than 10 operations are carried out a year on this age group)
  • better support and feedback to families of overweight or obese children
  • greater promotion of breastfeeding

The report makes a total of 49 recommendations under 10 principles.  The recommendation seized on by the media (recommendation 2.3, p17) says

“prohibit eating and drinking on urban public transport, except fresh water, breastfeeding and for medical conditions.”

It won’t prevent people taking a packed lunch with them on long train or bus journeys.  Because this doesn’t mean that you have to take the car rather than the bus.  It’s saying that we can wait to get home rather than snacking on the 10 minute journey home from town and most of us probably do that anyway.

Conclusion?

Professor Dame Sally Davies, I think I am right behind you on this one.

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