BEHIND THE HEADLINES: Can we address our obesity problem?
CHILDHOOD obesity is one of the biggest threats to public health not only in Wales, but across the UK.
When a case such as that of the 10 stone, five-year-old girl taken into care by Newport council hits the headlines, cliched and knee-jerk reactions of blame are depressingly familiar and more importantly, unhelpful.
While parents have perhaps the key role to play in ensuring their children get the best possible start in life in terms of eating the right food in a balanced diet, there are barriers to this, especially in economically deprived areas, where financial necessity can result in the cheaper, less healthy food options being taken.
Also, there already exists an obesity problem generally that needs to be addressed in tandem with prevention programmes.
And this is an urgent problem.
Obesity already costs the NHS in Wales more than £73 million a year (£14.6m a year in Gwent) and that figure will continue to rise for the foreseeable future.
Childhood obesity is an issue that can affect the rest of a person’s life, in terms of their overall health, both physical and mental.
Put simply, overweight and obese children are more likely to become obese adults, and as obesity is difficult to treat once it sets in, prevention and early intervention are vital.
But experts recognise that this is a problem that will not be solved, or even eased, overnight, and improvement will require the efforts not only of the NHS, but the education sector, the food industry, governments, and others, not least ourselves as individuals and as parents.
Figures on the prevalence of childhood obesity make for alarming reading.
The latest Welsh Health Survey indicates that in 2011, 35 per cent of Wales’ children were classified as overweight or obese, with almost one-in-five (19 per cent) obese.
For boys and girls at 11, 13 and 15 years old, prevalence of overweight and obesity according to self reported measures, is higher in Wales than the average among countries taking part in such surveys.
Among 15-year-olds in Wales, prevalence of overweight or obesity is in the top four of 39 countries for girls, and in the top eight for boys.
Wales’ new Child Measurement Programme also provides some stark figures.
According to those released in July, based on height and weight measurements of four- and five-year-olds during 2011/12, one-in-eight of these children in Gwent is obese.
Overall in Gwent, 12.5 per cent of four/five-year-olds were measured as obese in terms of their Body Mass Index (BMI), but in Blaenau Gwent and Torfaen that figure rose to 14 per cent, closer to one-in-seven.
The prevalence of overweight and obese children in Wales, at 28 per cent, is well above that in England (23 per cent) and higher than any individual English region.
The Assembly’s children and young people committee is holding an inquiry into childhood obesity.
Gwent’s Childhood Obesity Forum and Aneurin Bevan Health Board have contributed, and included in their submissions are forthright views on existing programmes that seek to address childhood obesity. and on what needs to happen to tackle it on a wider basis.
For several years, the MEND healthy lifestyle programme has been a valuable means of helping educate and empower children and their families on issues relating to weight and exercise, and healthy eating.
Programmes targeting seven-13 year-olds, and latterly also five-seven year-olds who are above a healthy weight, focus on getting children more active and on parents and their children learning together about healthy eating and issues such as the sugar and fat content of foods, and how to properly read calories and other information on food labels.
In evidence to the inquiry, the obesity forum and the health board have identified that MEND is an important programme, but that something similar is needed to help under-fives and over-13s.
They also believe the way the programme is funded - not up front, but on the delivery of a course - is challenging for the NHS in “straitened financial times.”
The Welsh Government-backed Change4Life and Appetite For Life programmes are also considered to have a valuable role, but it is stressed that “no single project will have the capability to change obesity levels alone.”
In the case of the latter, the forum and the health board believe that its effectiveness “will only be fully realised when it is finally legislated and schools have to fully comply with the standards.”
These relate to such issues as healthy lunchbox policies and improved canteen facilities.
Clare Norris, clinical manager for dietetics with Aneurin Bevan Health Board, said that while many people are aware of the health risks associated with overweight and obesity, for all the publicity it receives “it frequently isn’t recognised by parents in their own children.”
“Healthcare staff need to accept that obesity is everybody’s business and to be trained and equipped with the knowledge and skills to sensitively and supportively raise the topic with parents, children and family members,” she said.
“The All Wales Obesity Care Pathway identifies the need for action at a number of levels, from prevention and early intervention, all the way to the management of complex patients.
“Dietitians can be involved in the training and education of those working with and caring for children in various settings, in delivering interventions like the MEND programme and as part of a team of health care specialists including exercise and psychology experts.
“It is important to find ways of influencing the next generation of parents whether through school-based initiatives, in ante-natal care or early years care, and to provide support for those who are already parents to provide the role model, healthy diet and lifestyle to help their children to achieve healthy weight.
“Whilst prevention has to be key over the longer term, those children who are overweight or obese now require access to evidence-based interventions for weight management.”
For more about the MEND healthy lifestyle programme go to mendcentral.org
We must work together to tackle obesity, says expert
POOR school attendance and attainment, and reduced prospects of finding work, are key disadvantages for young people who are obese.
And these factors combine with health complications such as early onset Type Two diabetes, respiratory problems, and musculo-skeletal disorders, to make it more likely that their obesity will continue into adulthood.
Dr Nadim Haboubi, who runs Wales’ only NHS-funded obesity clinic, at Ysbyty Aneurin Bevan in Ebbw Vale, has previously advocated a tax on fatty foods and fizzy drinks as one possible weapon in the battle against obesity.
Earlier this year, he told the Argus that the cost of treating obesity and related issues will have doubled by 2050 as the problem develops across future generations, as poor diet is compounded by less active lifestyles.
“It is everybody’s business, not just down to doctors,” he said.
“Agriculture, food, education, housing, environment, all sectors must work together. When and how I don’t know, and sadly I don’t think it will be any time soon.
“There are lots of guidelines and reports published, but none is supported with money. Nobody wants to pay the bill.”
Course helped youngster improve her diet
THE MEND programme has helped a Newport schoolgirl on the way to becoming a more confident and healthier person, said her father.
Naomi - not her real name - and her family got involved with MEND last spring after she had suffered problems with her ankles and knees, and had also been bullied because of her size.
By the end of the course, she had lost eight pounds, but just as important, had begun to take part in more activities - and the family had learned the value of eating more healthily, armed with knowledge such as how to work out how much sugar and fat there are in foodstuffs.
“She is a lot more active, walking a lot more, and is more confident, especially about making friends,” said the 11-year-old’s father.
“And it has carried on since the course finished in August. For instance, she likes to sing, but would never sing in front of others. But she did it in class recently and her teacher and classmates were complimenting her. That’s come from her confidence improving.
“As a family we’re healthier too. We’ve changed our eating habits and learned a lot more about what goes into food.
“It is simple things, like not eating after a certain time in the evening, eating a healthy breakfast, having fruit instead of sweets.
Her father said Naomi loved MEND, and was always the first to turn up at a session.
“I think other children and families would benefit because you learn so much. I’m glad we went along,” he said.
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