Centre for Physical Activity and Nutrition Research Centre for Physical Activity and Nutrition Research Parental concerns about childhood obesity David

Centre for Physical Activity and Nutrition ResearchCentre for Physical Activity and Nutrition Research

Parental concerns about childhood obesity

David Crawford* and Tony Worsley

*NHMRC/NHF Career Development Fellow

Centre for Physical Activity and Centre for Physical Activity and Nutrition ResearchNutrition Research

Burden of disease in Australia

0 2 4 6 8 10 12

High Cholesterol

Low fruit & veg

Obesity

Hypertension

Physical inactivity

Tobacco

% risk factor burden

Trends in obesity-related media coverage

Note: Figures represent IFIC tracking of U.S. and International (English-speaking) wire reports and print articles on the issue and do not necessarily reflect the true number of stories.


Obesity in Australian children (1995/97)

NSW SFPAS NNS HYOVSBoys Girls Boys Girls Boys Girls

Acceptable

Overweight

Obese

Overweight/obese

79.9

14.9

5.2

20.1

78.7

16.3

4.9

21.3

80.7

14.4

4.9

19.3

77.7

16.9

5.4

22.3

78.9

15.8

5.3

21.1

76.4

17.8

5.7

23.5

Booth et al, ANZJPH 2001


Trends in childhood obesity

Prevalence has probably doubled over the 10-year period 1985-95

In a cohort of 1438 Victorian children aged 5-10 years at baseline, between 1997-2000/01:

10% became overweight 2% became obese

Hesketh, Wake, Waters, Carlin, Crawford, Pub Health Nutr. (In press)


Children’s eating and physical activity behaviours have changed


Percent change in amount of food and energy density of food 1985-95

-5

0

5

10

15

20

boys 10-11y boys 12-15y girls 10-11y girls 12-15y

amount of food (g)

energy density kJ/g


How active are Australian children?


Children’s physical activity habits

We don’t know how activity levels have changed over time Walking and cycling to school has declined Fitness levels have declined

Likely that children’s activity levels have declined

Our data suggest children engage in relatively low levels of physical activity


Average time (mins/day) spent in moderate intensity activity

0

50

100

150

200

250

5-6 year olds 10-12 year olds

Boys

Girls

Min

s p

er d

ay


Average time (mins/day) spent in vigorous intensity activity

0

5

10

15

20

25

30

35

40

45

5-6 yr olds 10-12 yr olds

Boys

Girls

Min

s p

er d

ay


The world we live in has changed(Jeffery and Utter, Obesity Research, 2003)

Overall cost of food has decreased

Foods prepared away from home/

Availability of energy dense foods/drinks

Portion sizes of some foods have increased

Marketing of foods and drinks

Urban sprawl and urban design

Availability of private versus public transport

The number of two-income families

The time spent in paid employment

Place of physical education in the curriculum


CHILD WEIGHT STATUS

Child characteristics and child risk factors*

Gender Age

Familial susceptibility to weight gain

Parenting styles and family characteristics

DIETARY INTAKE

SEDENTARYBEHAVIOR

PHYSICALACTIVITY

Parent food preferences

Parents dietary intake

Nutritional knowledge

Ethnicity

Child feeding practices

Types of foods available in the home

Family leisure time activity

Parent preferencefor activity

Family TV viewing

Parent activity patterns

Peer and sibling interactions

Parent encouragement of child activityParent weight

status

Community, demographic,and societal characteristics

Leisure time

Socioeconomic status

Crime rates and neighborhood

safety

Accessibility of convenience foods and restaurants

Work hours

School lunch programs

Accessibility of recreational facilities

School physical education programs

Parent monitoring of child TV viewing

Contextual influences on childhood obesity

Davison & Birch (2001). Obesity Reviews, 2, 159-171.


Preventing childhood obesity

We have a poor understanding of the drivers of the obesity epidemic Lots of candidates - little evidence

A huge range of prevention strategies have been proposed Education strategies to promote physical activity

and healthy eating Changes to urban environment to make it safer for

children to walk Policies to ban advertising to children or taxes

certain kinds of foods


Community views of childhood obesity?

Parent’s views on causes and what to do to prevent it not widely canvassed!

This is despite evidence that many parents are concerned about their child’s weight

Understanding community views is important: To establish support for preventive

initiatives To identify where these is a need to

educate the community about the epidemic


Our research…

Aimed to examine community views: Causes of childhood obesity Beliefs about prevention

Surveyed 315 adults randomly recruited at a major shopping centre

Assessed views of importance of: 25 possible causes of obesity 13 potential preventive measures


Causes: Lack of physical activity

0 5 10 15 20 25 30

Lack of physical activityat school

Lack of physical activityoutside of school

%


Causes: Overconsumption of food

0 5 10 15 20 25 30 35 40 45 50

Eatin too many high fatfoods at home

Eating oversizedservings of foods

Eating too many high fatfoods at school

Children have too muchmoney to spend on

unhealthy food

Overconsumption of fastfoods

%


Causes: Children’s lack of knowledge and motivation

0 5 10 15 20 25 30

Children don't careabout eating healthy

Children don't knowabout the dangers of

obesity

Children don't careabout being physically

active

%


Causes: Physical activity environment

0 5 10 15 20

Lack of safe cycling andwalking paths

Lack of other safeplaces to be physically

active

%


Causes: The food environment

0 5 10 15 20

Healthy foods areexpensive

Healthy foods oftenaren't available

%


Causes: Parental responsibility

0 5 10 15 20 25 30

Parents don't know howto promote healthy

eating

Parents don't know howto promote physical

activity

Parents don't care aboutbeing physically active

Parents don't care abouteating healthy

Parents aren't aware ofthe dangers of obesity

%


Causes: Modern technology & media

0 5 10 15 20 25 30 35 40 45 50

Watching too muchtelevision

Eating in front of the TV

Modern technology (egcars, computers, video

games)

Media promotion ofunhealthy foods

%


Prevention: Government action

0 5 10 15 20 25 30 35 40

High-fat foods should have an additional 5% tax

Give 5% tax incentives to manufacturers ofhealthy food

Advertising of high fat foods ahould be bannedduring children's viewing hours

The government should build more safe cyclingand walking tracks

Obesity prevention actions should only bedirected to children who are overweight, but not

yet obese

%


Prevention: Children’s health promotion

0 5 10 15 20 25 30 35 40 45 50 55 60

Healthy eating should bepromoted on children's

TV

Obesity preventionactions should be

directed to all children

More healthy foodshould be served in

schools

More healthy foodshould be served in

schools

Daily physical educationin school should be

compulsary

%


Conclusions

Community recognises the causes to be multi-factorial

Key causes: overconsumption of unhealthy food; parental responsibility; modern technology; TV viewing and the mass media

Less community support for government regulation than for health promotion

There is likely to be widespread support for health promotion activities aimed at preventing childhood obesity


For more information…

Take a look at our paper:

International Journal of Obesity 2003; 27: 1465-1471

Email me at:

[email protected]

See our website:

www.hbs.deakin.edu.au/HealthSci/Research/default.asp

Documents

Centre for Physical Activity and Nutrition Research Centre for Physical Activity and Nutrition Research Parental concerns about childhood obesity David