The obese Obesity Essay - better version

8/7/2019 The obese Obesity Essay - better version

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Achievement standard 3.5 / 90743

Examine (Critically analyse) a current physical

phenomenon impacting on New Zealand Society


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Contents page

Section: Page Number:Introduction 3A: What Childhood obesityis and reasons why it mightexist

4 - 10

B: What ChildhoodInactivity is and reasonswhy it might exist

10 - 14

C: The relationship between

Childhood obesity andinactivity

15 - 18

D: If and why childhoodobesity and inactivity areissues for New ZealandSociety and what the impacton society might be

18 - 23

E: What are possible

solutions; How might thesesolutions be actioned; Whatmight the possibleimplications be of the resultsof the action now and in thefuture

24 - 28

F: What influences currentlyexist that will help thesolution/s to work and whatinfluences might make itdifficult to be successful

29 - 33

Conclusion 34Bibliography 35


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Inactivity and obesity: Are Kiwi kidsbecoming fat and lazy? What does this meanfor New Zealand society?

The scientific knowledge and focus on overweight people and obesity is nowhuge. The term Obesity epidemic is a common phrase used in society,particularly by health professionals and doctors, who emphasise their concernfor our society and future generations health. Undoubtedly, there are NewZealanders, both adults and children who are obese, but can we consider thisan epidemic?

The word epidemic is rather emotive as it has medical connotations giving the

implication that mass amounts of people are suffering from some kind ofcondition or disease. Epidemic means to be spreading rapidly andextensively by infection and affecting many individuals in an area or apopulation at the same time. While we may consider some people obese, itmay be an overstatement to categorise obesity among plagues such as influenzaand smallpox. However, there are those who would argue against this analysisof the epidemic to be an exaggeration since some statistics do confirm thatobesity and childhood obesity has in fact increased.

Epidemic or no epidemic there is indeed a need to change something - evenmultiple things in order to improve the well-being of New Zealand children. Todetermine possible solutions to this problem it is important to understand whatobesity and inactivity is, and why it may exist. Is it something that always has,and always will due to pre determinants or have we created childhood obesitythrough our own choices?

Throughout this essay, I am going to attempt to answer and evaluate many ofthe questions and opinions I have out lined above. I will also critically analysethe following: Possible causes of childhood obesity and inactivity, therelationship between childhood obesity and inactivity, and reasons as to whythey are issues of concern for New Zealand. From this information, I will

discuss possible solutions to these issues and implications of the possibleoutcomes. Additionally, whether current influences surrounding New Zealandare likely to enable and allow these solutions or act as barriers to prevent them.


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Section A:

ObesityIt is associated with heart disease, diabetes, stroke, high blood pressure and

some cancers, however it is not surprising that this one English noun causesmuch confusion, worry and concern amongst society; our definition for theword is unable to be determined by our means of identifying it. The NewZealand Ministry of health defines obesity as an excessively high amount ofbody fat (adipose tissue) in relation to lean body mass. To contradict, howeverslightly, we identify this health problem by the use of a Body mass index(BMI) which does not calculate an excessively high amount of body fat inrelation to lean body mass, but measures weight adjusted for height and iscalculated by dividing weight in kilograms by height in metres squared(kg/m2). For children and teens, BMI is age and sex-specific and is oftenreferred to as BMI-for-age. The BMI number is plotted on the CDC BMI-for-agegrowth charts (for either girls or boys) to attain a percentile ranking. Below arethe BMI-for-age weight status categories and the matching percentiles:

Weight Status Category Percentile Range

Underweight Less than the 5th percentile

Healthy weight 5th percentile to less than the 85thpercentile

Overweight 85th to less than the 95th percentileObese Equal to or greater than the 95th

percentile

There are limitations to the BMI which will be discussed more soundly insection C. However to date, this is likely to be the best measure of childhoodobesity when considering both accuracy and practicality.

Why does childhood obesity exist?

There are many factors that contribute to childhood obesity coming from avariety of sources. Primarily, Society itself plays a large part in fueling this

problem; an article on Med India writes that eating fast food is no longer afashion. It is now a necessity. It is the most attractive solution in the fast-pacedlife as it is inexpensive, tastes good and is made and served fast. Societysemphasis on instant gratification and our consumer driven lifestyles means weoften look for easy, convenient options when it comes to consuming food.


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Generally, children do not have the authority to make their own decisions whenit comes to food preferences and quantities, but unfortunately, what parentsand caregivers are feeding their children is often what is easiest and what doesnot demand much effort or time. Food that fits this description is often highlyprocessed, low nutrition and high in energy. According to the 2006 /07 New

Zealand Health Survey, Seven out of ten (70.9%) children had eaten fast foodin the past seven days. One in seven (13.6%) had eaten fast food twice in thepast seven days and one in 14 (7.2%) had eaten fast food three or more times inthe past seven days. Limitedly, this survey merely looks at Fast food; it isprobable that these children are consuming other processed foods that are highin fat and low in nutrition, obtained by the means of a supermarket. It is mucheasier to heat up a box of pies with frozen chips than to venture into preparinga healthier alternative such as a salad, which can involve washing, peeling,chopping and time.

Time is of course in an economic sense, a limited resource and societyspriorities in relation to how we use this resource often comprises of passiveleisure activities (mentioned further in section B) and as stated earlier, is aboutinstant gratification. A scenario that demonstrates this well is becomingincreasingly familiar amongst New Zealand families- a scenario where bothparents work, who come home exhausted and run down, who then do not feelthey have the time to prepare a meal and instead order some form of fast-food.This is not to imply that parents are becoming lazier and do not care forthemselves or their family but to discern that we simply do not value our healthperhaps as well as we should. Because the fatter we get, the fatter our children

will get. A recent study, carried out at the University of California, showed thatobesity spreads within social networks and that people with fat friends are 50per cent more likely to be overweight than those who hang out with skinnypeople. Moreover, our children are subconsciously taking in the habits andlifestyle choices we make. By indulging in the wrong types of food, we are notonly increasing passing on societys instant way of life but also increasingchances of obesity in New Zealand children.

Dr Hamish Meldrum, head of the British Medical Association claimed in aninterview that fat people are simply greedy and obesity is caused by overeating. And that "We are in danger of over-medicalising the problem." This

remark caused much controversy and The Independent (British onlinenewspaper) writes that:

Obesity experts were immediately outraged, and said that Dr Meldrum's remarkswere unhelpful and anachronistic, as well as politically incorrect. The 88,000 peoplewho were prescribed with anti-obesity prescriptions for drugs like Xenical and Reductil


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last year, and the one in four Brits who, according to the World Health Organisation,are obese, no doubt felt similarly affronted.

How, they probably wondered, could Dr Meldrum, a medical man, not understand thattheir problem is genetic, an illness, a cruel compulsion. How could he fail to understand

that what fat people need is medical intervention and drugs, and that if this was asimple matter of eating less then they wouldn't be in this position in the first place?And many would also say, what is wrong with being fat anyway?

If you are not one of these people, then let me ask you this. How many of you havewatched an obese person chowing down on a double hamburger with double fries and atriple cola and thought "Why don't you get it?" How many of you have stood in anewsagent watching an overweight person forcing their overweight hands into a family-sized bag of Doritos and thought "You shouldn't be eating that."

And how many of you listened to Dr Meldrum and thought "He's absolutely bloody

spot on."

This article does not regard New Zealanders, nor is it about children; however,it does give insight into westernized societies views on obesity. Dr Meldrumsstatement comes across as harsh and offensive even; so why is it outrageous tosuggest that energy in exceeding energy out is the cause of obesity? It is simplemath yet deeply rooted in our society and human nature is the desire to placeblame on everyone and everything except ourselves. Our society is constantlycreating more illnesses and diagnosing more people with disorders that wedeem responsible for our obesity. There is however, those of us like Dr

Meldrum who think suck it up, stop over eating and stop blaming everyoneelse for your problems. There is a noticeable weight debate amongst NewZealand society, thus perhaps obesity is becoming more prominent withinchildren amongst those of us who disregard obesity to be a health issue andtake a more PC approach, seeing it as a bit of extra puppy fat or blaminggenetics.

In addition, economic factors determine many of the choices we makeinvolving our children and the food they eat. Numerous studies indicate thatplaces with fewer economic and social resources have higher rates of obesity.

The 2006 /07 New Zealand Health Survey investigated the impact ofsocioeconomic status on levels of obesity amongst children and found thefollowing:

y 13.9% of children living in areas of deprivation had had fast food threeor more times in the past seven days, contrasting to only 3.4% of childrenin areas of low deprivation.


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This data supports the assumption that The fattest of us are also the poorest-an observation made by an article in the Listener, November 2003. This is mostlikely due to takeaway and highly processed foods often being cheaper thanfruit and vegetables, meat and dairy foods.

Undoubtedly, prices of food dictate to an extent what we choose to eat and foodprices in New Zealand have been rising rapidly. The Consumers Price Index forthe food group showed an annual rise of 5.1 percent in the year to the March 2008

quarter. Price increases for grocery food have been particularly noticeable. In the year tothe March 2008 quarter, grocery food in the Consumers Price Index rose by 8.7percent. - Statistics New Zealand. This increase is largely driven by rapid risesin dairy and grain products- products that are part of the two lower tiers of thethree-tier food pyramid; products that we are told to eat X amounts of perday to remain healthy. However, when money is scarce, prices become thecrucial factor in buying food not what is going to keep us healthy.

Currently, in some of the developing countries such as Mexico and Brazil theprices of corn and soya have increased due to their usage as biofuels Thus

limiting the healthy choices of the individuals in those countries even morethan is already the case. Staple foods which are creating healthy habits inhabitual ways, are becoming much more expensive and will be replaced bypackaged foods, which are typically full of added sugar, fats and salt.

The problem is that processed packaged food is often much cheaper and moreeconomical for producers to produce than healthier food such as fruit andvegetables. Producing fresh food often relies on natural endowments such as

Obesity of children by Degree of Deprivation

0

2

4

6

8

10

12

14

16

18

least

deprived

2 3 4 most

deprived

Level of deprivation

Percentage

Boys

Girls


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soil and climate, and large associated costs of transportation and preservation;packaged food has a much longer shelf life than fresh food. Therefore, healthierfoods are often more expensive for the consumer. For example, wholegrainbread is usually $3-4 per loaf, compared to budget bread, which is less than $2.Sausages, beef patties all processed meats, are cheaper that fresh meat. A box

of small Soho rice crackers costs more than a large bag of potato chips.

How is it that today the people with the least amount of money to spend on food arethe ones most likely to be overweight? -An article from the New York Timesproves partially why exactly the above statement is so. Drewnowski went on amission- to purchase as many calories as he could. He discovered that he couldbuy the most calories per dollar in the middle aisles of the supermarket, among thetowering canyons of processed food and soft drink. Drewnowski found that a dollarcould buy 1,200 calories of cookies or potato chips but only 250 calories of carrots.Looking for something to wash down those chips, he discovered that his dollar bought

875 calories of soda but only 170 calories of orange juice.

Conclusion: If you are eating on a small budget, the most rational economicapproach is to eat poorly and get fat.

The environment in which we live unquestionably affects our behaviours andhabits, what we value in life and our attitudes. To an extent, the familyenvironment children grow up in influences the likelihood of childhoodobesity. The risk of becoming obese is greatest among children who have twoobese parents (Dietz, 1983). This may be due to powerful genetic factors or toparental modeling of both eating and exercise behaviours, indirectly affecting

the child's energy balance through an obesogenic environment. Expectationsand family values can determine obesity amongst children because childrenbuild their own viewpoints and values based on what they see and are taught directly and indirectly by those they look up to more than often parents orother persons close to them. A study of 120 young children, who were allowedto "buy" food from a pretend grocery store, proves that even 2-year-old childrentend to mirror their parents' usual food choices. During the shopping game, itwas noted that children who stocked up on sweets, sugary drinks and saltysnacks generally had parents whose typical grocery list featured these items.Similarly, children with the healthiest shopping habits seemed to be copying

their parents' lead as well. The findings, reported in the Archives of Pediatrics& Adolescent Medicine, suggest that it is not by chance that young childrenreach for sweets and unhealthy snacks when given the chance. Rather, theyseem to form food preferences and decisions potentially lasting ones, basedon their parents' shopping carts.


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"The data suggest that children begin to assimilate and mimic their parents' foodchoices at a very young age, even before they are able to fully appreciate the implications

of these choices," writes the researchers, led by Dr. Lisa A. Sutherland ofDartmouth Medical School in Lebanon, New Hampshire. Thus, parents may becreating an obesogenic environment without realizing, purely based on their

own lifestyles and preferences.

Although the chances of obesity developing among children who are exposedto the likes of poor decisions and an obesogenic environment is relatively high,individuals do respond differently to food and exercise once genetics comesinto play. Some people store more energy as fat in an environment of surplusfood whilst others lose less fat in an environment of a lack of food. Thedifferent responses are mainly due to genetic variations between individuals.Although it is rare for people to have mutations in single genes, which result insevere obesity at infancy, it is possible for genetics to predispose people to

being larger. Fat stores are regulated over long periods of time by complexsystems that involve input and feedback from fatty tissues, the brain andendocrine glands like the pancreas and the thyroid. Thus, Obesity can resultfrom only a small energy surplus over a long period of time. Possibly, childrenwho have always been slightly larger than their peers and considered to merelybe carrying some puppy fat are just children who habitually carry surplusenergy due to their genes. Additionally, children with a family history ofobesity may also be predisposed to gain weight.

Historically, the predisposition to store energy in the form of fat is thought toresult from thousands of years of evolution in an environment amid tenuousfood supplies. Those who could store energy in times of plenty were morelikely to survive periods of famine and to pass this tendency to their offspring.Therefore, in todays society where food is plentiful we may actually beinstinctively storing more energy than is necessary.

The marketingand large amounts of advertising for poor quality food productspsychologically affect consumer choice. These products are promoted partlybecause many of the packaged, added salt and fatty foods are heavily subsidised by theEU agricultural ministries and others, as well as by the companies which all make

money out of processed food. It is much easier to make money out of these foods

than fresh foods due to the associated costs of transport and preservation. Afew decades ago food and beverage companies realized that they could better reach theirgoal to increase sales by targeting a nearly untapped market children and

adolescents. Children are particular vulnerable to advertising because beforethe age of twelve a childs cognitive development is limited and as a result theycannot differentiate between the truth and advertising. They trust and believethe persuasive statements made in commercials. As one Heinz brand manager


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stated, "You want that nag factor so that 7-year-old Sarah is nagging Mum inthe grocery stores to buy Funky Purple. We're not sure Mum would reach outfor it on her own." These tactics along with joint promotions where children'sentertainment characters and role models are associated to fast food meals orother low-nutrition foods is certainly responsibility to some extent for

childrens dietary preferences of fatty, salty and sugary foods.

www.dreamstime.com/junk-food

Section B:

What is childhood inactivity?

Put simply, inactivity is the state or quality of being inactive It is habitualindisposition to action or exertion; want of energy and sluggishness. Aninactive lifestyle is one that is sedentary or passive with little or no physicalactivity. Determining physical activity is difficult because people have differentviews on what they consider exercise, depending on their own personalphilosophies. However, in general, childhood inactivity occurs when multiplechildrens lifestyles are filled with passive leisure activities, which require asmall amount of energy output, and does not raise the childs heart rate.

Why does childhood inactivity exist?

Similar to childhood obesity, many factors contribute to childhood inactivity.Technology is constantly evolving and todays society is very muchtechnology-enhanced often leading to sedentary, couch-potato lifestyles, toomuch TV, video games, computers, and a reliance on the car. Ultimately, we arenot moving enough. Because we value entertainment to keep us content, many


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of us, (children included) seek passive leisure activities such as watchingtelevision for some entertainment. "TV remains the dominant free-time activityin America." The 2006/07 New Zealand ministry of health survey found thatTwo out of three (64.1%) children aged 5-14 years usually watched two ormore hours of television a day, which equates to 368,700 children.

It is not only the television promoting inactivity among children, simpleinventions such as escalators and elevators that we take for granted, designedto suit our increasingly fast lifestyles are second nature to todays children,embedding attitudes condemning active lifestyles - who wants to climb thestairs when an escalator can do the climbing for us? A study at the University ofGeneva has shown how something as small as taking the stairs instead of theelevator can have a big impact on your health. The study started with 69participants who had a relatively sedentary lifestyle, (they did less than twohours of exercise each week and climbed fewer than 10 flights of stairs each

day). Over the 12 weeks of the study, participants were asked to take the stairsinstead of the elevator, increasing their average number of flights from five to23. After three months, tests showed they had better lung capacity, cholesteroland blood pressure levels, their fitness level improved and they lost weight.Researchers say that these results reduced their risk of dying young by 15percent. Although larger-scale studies would need to validate these results,they are very promising and prove that small factors that promote inactivitycan have a big impact in the long run.

Our reliance on technology for transportation can increase levels of childhoodinactivity also. The attitude of why walk or bike anywhere when I can usesome form of motorized transportation which will get me there much faster? isone entrenched amongst many of us and consequently being indirectly passedon to our children. Research reveals that one in five parents very rarely walkanywhere. In addition to our reliance on motorized vehicles to get us from Ato B, parents' perceptions of the risks outside the home have severely controlledchildren's ability to carry out active ways of transportation such as walking,biking, and skateboarding. Despite 77% of todays parents walking to school whenthey were children, the percentage of primary school children walking to school hasdropped to just over half. The majority of primary school children live less than oraround a mile from their school, but at peak times of the day one in five cars on the road

is doing the school run. These statistics from a walk to school organization in theUnited Kingdom demonstrates how times have changed and it is now moresocially acceptable and common for schoolchildren to be dropped off at schoolin a vehicle. A survey carried out by a New Zealand organization Safe routesto school (SRTS) found the following:


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As children, 77% of parents either walked or cycled to school, comparedwith 30% of their children who do so now.

The modal shift has been from walking as the dominant mode oftransport to school for parents (65%) to that of the car being so forchildren (66%).

There has been a 4.5 fold increase in the numbers of children travelling toschool by car compared to the numbers of parents who travelled toschool by car as children.

These statistic confirm that New Zealand children today use considerably moreinactive forms of transport than previous generations.

Worryingparents limits childrens activities and the ability to be active. Justgo play outside is often no longer a viable option. Some may even argue thatfriendly neighborhood games of dodge ball and soccer are memories of anearlier era. Parents have raised their concerns about busy streets and childpredators. We dont raise kids to lose them early we raise them to bury usone man who drives his granddaughter to school each day declared. Onewoman, on the subject of her child walking to school said, I admit I wasworried, I made him stop at my sister-in-laws house and call me halfway whenhe got there. It is possible that parents mollycoddling is limiting possible

exercise and activity for their children. Besides, is there even a legitimate reasonbehind the over protecting of parents? The answer is likely to be No. In thisage of Amber alerts and reports of child predators, a sort of mass hysteria has beencreated.There are no more incidents today than in the past of kids being abducted,one parent said, (based on statistics she has seen.) Thus, protective parents maybe doing more harm to their children than good.


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Most children spend at least six hours a day, 30 hours a week at school or someother similar institution, so it is vital that they receive some form of exerciseduring school hours. However, in many primary schools, there is often a lack ofspace, equipment and specialist PE teachers, limiting the amount of physicalactivity children receive. The tighter school budgets become and greater

academic requirements can force many schools to push physical education classto the bottom of the priority list. The 2003 National Child Nutrition Survey foundthat the amount of physical education being taught inNew Zealand schools hasdeclined. According to the survey, one out of fivechildren between five and sixand seven to 10 years of age had no physicaleducation class over the sevendays of study (Ministry of Health 2003). Often in New Zealand schools, it is theindividual teacher who decides on the content, duration and frequency ofphysical education as compulsory physical education is not required. Therefore,a teachers own enthusiasm, interests and knowledge on physical educationsolely determines the amount and type of physical activity that their students

are receiving at school. The irony is that despite our knowledge of theimportance of physical activity to children and strongly advocated campaignsaimed at children and schools such as Push play, not all children are gettingsome form of exercise during school hours and we are the ones preventing it.Additionally, there is evidence to suggest that the teaching of physical activitiesis often of poor quality, which is understandable; schoolteachers are primarilyhired, based on their skills in academic teaching and are not usually trained inareas of physical education. If a child is experiencing physical education of poorquality, taken by a teacher who is rather unenthusiastic, then chances are thechild will not enjoy the lesson and their views on physical activity may form

negatively, increasing chances even further of inactivity in the individual.Undeniably, the lack of specialist Physical education teachers and to someextent willingness amongst teachers does allow for childhood inactivity.

The environment children grow up in, especially the family environment is astrong determinant of childhood inactivity. Children build many of their corevalues and morals as they grow based on what their parents say and do it ishuman nature. As discussed earlier in section A, even very young childrenbegin to form opinions and preferences based on their parents. If a child isfamiliar with an obesogenic environment, where parents speak negatively ofexercise, see physical education in school as a waste of time and are a classicexample of a couch potato, then chances are the child will follow suit. It ispoignant, because for some children an inactive lifestyle is all they have everbeen exposed to, hence subconsciously, that is all they know how to do.

Differences in Priorities manipulate the rate of childhood inactivity also. Factorssuch as cultures, personalities and interests mean different people will value thesame things to different extents. Similarly, to the above, how much a parent


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prioritizes being active is likely to influence a childs view on physical activityalso and no doubt there are some parents who do not rate activity particularlyhigh on their list of priorities. Thus, they are unwilling to spend disposableincome on activity- sporting equipment and sports fees and the child misses outon exercise. Those in lower socio-economic groups in particular are possibly

unable to afford sporting equipment and pay sports fees, who thenunfortunately overlook activity and exercise when in reality lack of money doesnot largely hinder an active lifestyle. Playing around outside or kicking a ballaround are much cheaper leisure activities than watching television, howeverthere are people who will happily pay for Sky television each month yet statethey are unable to pay for sports fees. This is a prime example of how physicalactivity rates poorly on peoples priorities, and ultimately leads to childhoodinactivity.

Section C:

Relationships between childhood obesity and inactivity


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Childhood obesity and childhood inactivity often go hand in hand and to someextent share a cyclical relationship.

The diagram above shows in a simplistic form the way in which childhoodobesity and inactivity are linked. Children who are considered obese are likelyto find it difficult being active due to the excess weight they must now carry,leading to preferences for passive leisure alternatives. They may also be inactivedue to the nature of physical activity and what it entails. Obese children can beincredibly vulnerable to bullying while taking part in physical activities,predominantly within schools. Consequently, the thought of ridicule andmockery is associated with physical education, putting children who often needthe exercise the most, off physical activity. Children who are inactive, throughhabits and choices are at a greater risk of becoming obese due to the energy in,energy out equation. Inactive children are not dispensing many kilojoules of

energy, therefore if they are consuming food at a greater rate than what they areburning off they will hold surplus energy, which is likely to turn into fat. Whenour supply of energy is in surplus, the process of metabolism stores excessenergy by converting it into body fat. It is also knowledge that people who areless active are likely to have a slower resting metabolic rate. This is becausephysical activity increases lean body mass and muscle; and the addition ofmuscle mass on an individual will cause an increase in the number of kilojoules

Lack ft at n t

x cise

InactivityObesity

Passiveeisurealternatives

Unhealthf

ch icesLargef

rtions

A surplusofkilojoules

Difficulties withovement ue to

size


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Fitn nd Fatn and ri k of mortalit

0 0.5 1 1.5 2 2.5 3 3.5

Obese

u f t

Obese

f

t

Over

eight

u

fit

Over

eight

fit

N

rm

eight

u

fit

N

rm

eight

fit

Ri

k factor

that are consumed at rest. Muscle burns calories, while fat does not. Hence,inactive children are often obese.

However, this cyclical relationship between obesity and inactivity is not foulproof. It does not take into account the complex inter-relationship between

energy balance and genes, behaviours, environment and other biologicalfactors. The graph below demonstrates that although a positive relationshipexists between fitness level and healthy body weight, normal weight in termsof appearance does not automatically correlate to being fit, likewise beingclassified as obese does not necessarily mean unfit.

Year 13 Physical education, NCEA Level 3 Workbook page 177. Original contentfrom: Wei, M.D, Kampert, Relationship Low Cardiorespiratory Fitness and Mortalityin normal-weight, overweight, and obese men. JAMA. 282 : 1547-1553.

An assumption often made by society is that slim and normal weightedchildren are healthy whereas bigger or obese children are less so. Often weoverestimate the strength and reliability of the relationship between obesity and

inactivity, overlooking the fact that physical fitness may be a more powerfulmeasure of health. For example, a child who is extremely inactive, makesunhealthy food choices but does not eat excessively, and does not have ahistory of obesity in their family or the genes to trigger weight gain may remainin a weight range considered normal, but surely, this child cannot beconsidered healthy. This analysis shows just how complicated the issues ofchildhood obesity and inactivity really are.


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Part of the reason that the relationship between childhood obesity andinactivity is not always consistent, (such as the above data) is due to themeasure of obesity body mass index (BMI) calculation and its limitations indefining someone as obese. BMI does not distinguish between body fat and

muscle mass. As lean body mass weighs more than fat, children who havelower body fat percentages and have larger muscles may be defined as obeseaccording to the BMI calculation, when in reality they are relatively healthy.Ethnicity is also a factor providing limitations to the BMI. Studies used todevelop the BMI classification system were derived from predominantly Caucasianpopulations in the USA and Europe. [1] Studies have shown that ethnic groupsmay vary in their level of total body fat at a given BMI, their fat distributionpatterns, and their extent of health risk. As New Zealand comprises of variousethnic groups, this is a major limitation in defining who is fat and who isnt,and although it has been suggested to have different BMI cut-off points

depending on race, this is much more difficult than it appears, as many childrencome from ethnic intermarriages and have various ethnic backgrounds. Inaddition, ethnicity is primarily based on self-identity and culture, and does notnecessarily have a genetic link. These limitations mean that the relationshipbetween childhood obesity and inactivity is not as inter-related as one mightthink.

Recent New Zealand research indicates that at the same BMI value, femalechildren (aged 514 years) of Pacific Island and Maori decent have a lowerpercent fat mass compared to their New Zealand European peers [2]. In another

study using a larger sample size, however, no clinically significant difference inthe relationship between BMI and body composition was found between youngchildren (510.9 years) of Maori, Pacific Island, or European descent. Thus,further research clarifying the relationship between BMI and percentage ofbody fat percentage according to ethnicity among the New Zealand youthpopulation is necessary. [3]

Biology Fixed Ethnicity ender

Age enetics Family Personality?

Environment unfixed Foodavailability Advertising

Economics availabilityofmoney Surrounding Cultural

viewsandmorals Upbringing

Behaviour Habits Attitudes Self

perception Expectations Personal

moralsandviews

Priorities Emotions

Determines


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Just under half (47.0%) of children aged 5-14 years usually use activetransport to get to and from school (walking, biking, skating or usingother forms of physical activity). Common reasons given by parents forwhat stops their children walking, biking or skating to school live too

far from school, busy traffic/main road, too dangerous for reasons otherthan traffic, takes too long.

Of children aged 2 to 14 years: One in twelve were obese (8.3%) One in five were overweight (20.9%). Adjusted for age, Pacific boys and girls were at least 2.5 times more

likely to be obese than boys and girls in the total population. Maori boys and girls were 1.5 times more likely to be obese than boys

and girls in the total population. There has been no change in the average (mean) BMI for children aged 5-

14 years since 2002. There has been a decrease in average BMI for Maori children.

Is this an Epidemic?

The above statistics show that yes, obesity does exist amongst New Zealandchildren. However, the final two statistics are particularly intriguing as theyindicate that childhood obesity in New Zealand is not the epidemic it hasbeen made out to be obesity has not been spreading rapidly. Though toconfound the situation even more, between 1989 and 1997 obesity levels rose

from 3% to 12.6% in males, and from 2% to 5.3% in females who were agedbetween 15 and 18 years [1]. Therefore, over an 8-year period, obesity levelsincreased by 300% for males, and a 160% increase for females, thus anepidemic. It is even thought that this comparison may under represent thetrue increase in obesity because the 1989 Survey used a lower BMI cut-off value(30 kg/m2) to define obesity among individuals of Maori and Pacific Islanddescent in comparison to 1997 (32 kg/m2). [2]Although the latter informationmay be less reliable as it is untimely, a huge contrast between the two sets ofdata exists. This is possibly due to the differences in ages, and for that reasonmuch older children are the likely cause for the label epidemic. Additionally,

the statistic suggesting that just over 20% of children are overweight isparticularly alarming because if current trends continue, in time these childrenare likely to progress to an obese stage later in life. All in all, epidemic is amatter of opinion; no specific guidelines or figures exist which can detectwhether something has reached epidemic rates. However, the health of NewZealand children remains a concern, especially considering the direconsequences that can result, if not now then later in life.


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The NZ medical journal, originally from [1] Russell D, Parnell WR, Wilson NC, et al. NZ Food: NZ People. Key results of the1997 National Nutrition Survey. Wellington: Ministry of Health; 1999.[2] Russell D, Wilson N. Life in New Zealand Survey: Executive Overview.

Wellington: Hillary Commission; 1991.

Impacts of childhood obesity and inactivity on NewZealand Society

Obesity statistics show that obese children, particularly adolescents have a 70%chance of being obese as adults, and that percentage increases to 80% if eitherone or both of the childs parents are obese as well [1]. Thus, inactive and obesechildren do not only create detriments for themselves and society at present but

also stand to be a future burden for New Zealand society when they reachadulthood. Unhealthy children will cost New Zealand, now and in the future agreat deal on many levels: in monetary terms, socially and emotionally toindividual persons and families.

As a nation, we must forego spending a large amount each year on areas thatshould be of high priority such as economic growth and education due to thelarge costs associated with obesity health related issues. It is estimated thatobesity health care expenditure in New Zealand is NZ$303 million per annum.[2]

This is a large burden for the taxpayer, and an unnecessary one, mainly createdthrough the likes of those living amid an obesogenic environment. Althoughmany of the health costs associated with obesity, do not occur until lateadulthood, if our children are becoming much larger physically andincreasingly unhealthy then inevitably, they too will one day be largecontributors to New Zealands health care expenditure costs. However, thismay not even be a solely future issue; evidence is now suggesting that childrenare now developing diseases of old age such as type 2 diabetes, which iscaused from a lack of exercise and poor diet. New estimates indicate 500 youngpeople aged between 10 and 18 years have the disease that was, only a few

years ago, virtually unknown in this age group. It used to be a disease thatonly affected adults over 45 years old, but not any more, says Mike Smith,president of Diabetes New Zealand. Its our own inaction that is allowingType 2 diabetes to become an epidemic. The fact that type two diabetes is oftenpreventable makes the whole idea of a diabetes epidemic even more tragic.Type 2 diabetes and other diseases caused by obesity and inactive lifestylessuch as coronary heart disease, hypertension, and some types of cancers impact


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New Zealand society in an economic sense but culturally and socially also.

Physical inactivity in New Zealand ranks behind smoking as the second highestmodifiable risk factor for poor health, and is associated with 8% of total deaths.[3] Furthermore, it has been predicted that todays generation of children may

be the first generation not to out-live their parents. If todays children arebecoming increasingly unhealthy and consequently sick, then this is likely topose as a huge emotional burden for communities and families. A sicknessculture concerns a phenomenal amount of people not just the individualsdirectly affected. It creates a large economic burden for families to afford healthcare and can be emotionally draining caring for a sick family member advanced cases of type 2 diabetes can involve coming to terms with blindness,amputation and kidney failure, a horrendous ordeal for anyone to got through.Sickness and disease is saddening for society in general, having to deal withillnesses that were not necessary in the first place.

In the future, when todays children enter the workforce, New Zealand mayexperience a greater loss in productivity than present if obesity and inactivitycontinues to rise. Presenteeism is the loss of productivity that occurs whenemployees come to work, but are not fully performing to the standard expecteddue to an illness or injury. It is potentially a bigger problem than absenteeism,which may also stand to be a future problem. Lost productivity andabsenteeism has a direct impact on a businesss bottom line, depleting NewZealands rate of growth and potential competitiveness with the rest of theworld.US research has found the cost of presenteeism corresponds to

approximately 3% of a companys gross payroll.[6]

Another study, this timeAustralian, showed that workers with a high HWB (health and well being)score worked approximately 143 effective hours compared to 49 effective hoursworked per month for a worker with a low HWB score. [7] The table belowshows how the unhealthier someone is the greater liability they are to abusiness.

Unhealthy worker Healthy worker

Self-rated performance of 3.7 out of 10

49 effective hours worked (full time)per month

Self-rated performance of 8.5 out of 10

143 effective hours worked (full-time)per month

High-fat diet Healthy diet


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Unhealthy worker Healthy workerLow energy levels and poor

concentration

Fit, energetic and alert

Obese or overweight Normal body weight

Irregular sleep patterns More attentive at work, better sleeppatterns

Poor stress management techniques18 days annual sick leave

Actively manages stress levels2 days annual sick leave

[6]

Living with obesity at a young age can affect the well-being of a child,decreasing their quality of life and not only through physical factors. Generally,obese children tend to have a poor body image, partially caused by the bullyingculture often seen in schools and amid children. Bullying can be incrediblyworrying for children and lead to psychological problems such as Stress andanxiety, Depression, and behavioural learning problems, social exclusion andan overall decrease in happiness.

Studies have shown that physically fit students are more content and performbetter academically. [4] Physical activity builds character, pride, self-esteem,teamwork, leadership, concentration, dedication, fair play, mutual respect,social skills, and healthier bodies; help keep children in school; help developacademic skills to do better in school and in life; and increase access to higher

education. This long list of benefits is all things that New Zealand children willnot be receiving to the extent that they should be, due to childhood obesity andinactivity. Additionally, increase in rates of childhood inactivity may contributeto the negative culture within New Zealand such as gangs, as children who donot experience the benefits highlighted above look for alternative ways to gainsocial interaction, acceptance or appreciated in some way. Arguably, childhoodobesity and inactivity may be partially responsible for many seeminglyunrelated issues to New Zealand society today. Studies have shown thatteenagers who participated in team sports are less likely to have unhealthyeating habits, smoke, have premarital sex, use drugs, or carry weapons. [5] It all

comes down to the well-being of a person, particularly ones emotional andmental state. Exercise releases endorphins into your body that reduce stress,and is highly recommended as both a prevention strategy and cure fordepression and emotional difficulties. Possibly, obesity and inactivity arecontributing causes to the growing rate of mental illnesses in New Zealand,which we are now told affects one in five New Zealanders, undoubtedly a largeproportion of society. Additionally, depletion in physical activity may


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contribute to a culture of unhappiness amongst society, which may soundasinine and slightly ridiculous, but it is nevertheless, a negative impact.

[1] United states department of health and human services.[2] Ministry of Health. Health Eatingy Healthy Action Oranga kai OrangaPumau: ABackground. Wellington: Ministry of Health; 2003.[3] Ministry of Health. DHB Toolkit: Physical Activity. To increase physicalactivity. Wellington: Ministry of Health; 2001.[4] Ca. Dep't of Education, Press Release, Dec. 10, 2002.[5] Russell R. Pate et al., Sports Participation and Health-Related BehaviorsAmong US Youth, Archives of Pediatrics and Adolescent Medicine[6] Goetzel R.Z., Long S.R., Ozminkowski R.J., Hawkins K., Wang S. and W.Lunch (2004), Health, absence, disability and presenteeism. Journal ofOccupational and Environment Medicine[7] Source: The health of Australias workforce, November 2005, MedibankPrivate

Section E:

Chil hoodi d

i i i

r i :Overall well-being Emotionalstate Happiness Valueon life Valueonyourself

Leadstoa Causing

Decreaseinsocietys well-beingasawhole

Increaseofnegativeculture. I.e.angs,

passiveleisureculture


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What are possible solutions to reducing childhood obesityand inactivity; how might these solutions be actioned;what are possible implications of these solutions nowand in the future?

Educatingpeople children and especially parents, about healthy lifestylechoices and the negative implications associated with obesity and inactivitymay be the most vital and effective way to cease obesity period. Knowledge, ingeneral provides people with insight so that they can discern what is best andmake informed decisions. If parents were more knowledgeable about ideas andconcepts relating to wellbeing, how to avoid obesity and the effects obesity andinactivity can have on a person then it would create a personal solution to theproblem, as they would be more conscientious about providing a healthyenvironment for their children. It is much easier to prevent obesity than to treat

it, and prevention largely relies on parent education. In infancy, parenteducation should focus on promotion of breastfeeding, recognition of signals ofsatiety, and delayed introduction of solid foods. In early childhood, educationshould include proper nutrition, selection of low-fat snacks, goodexercise/activity habits, and supervising television viewing. In cases wherepreventive measures cannot totally overcome the influence of hereditaryfactors, parent education should focus on building childrens self-esteem andaddressing psychological issues.

There are many means available to educate parents that will appeal to each

individual differently. Generally, there are ways to communicate with all kindsof parents. One form of education is through community-based seminars andnewsletters / periodic magazines, where those who are knowledgeable aboutparenting and health related issues can give practical advice to parents.Additionally, this could be subsidized by the Government, making theseeducational resources free or of an optional donation, giving parents an evengreater incentive to show interest. Community gathering type events can alsocreate a highly positive atmosphere where parents exchange advice and sharetheir own personal experiences. Situations like these also create accountabilityamong persons inter-personal strategies. Another alternative is more subtle,

through means of television advertisements a great way to reach those whoare more passive when it comes to finding out information. Well recognizedorganizations such as plunket could put their name to advertisements,providing parents with facts and ways to eat healthily and encourage childrento participate in less sedentary activities. Television advertisements may onlybe 30 seconds long but they have managed to assist selling burgers and fries inthe past, so it is surely an effective way to influence a persons viewpoint.


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Educating children is also important, even though a childs choices are limited;their ability to make decisions concerning themselves only increases as theygrow, thus the more knowledge they hold the better. Schools should teachchildren about health and fitness, how to make good food choices and theimportance of being physically active. A set curriculum would ensure

sensitivity when covering these topics, preventing any psychological problemsthat may arise such as bad body image and eating disorders. Futureimplications of this may include healthier food choices amongst children and agreater desire to endeavour in some form of physical activity, leading to anincrease in overall well-being. (See diagram on page 23.)

Many societal strategies can be put in place to solve the current levels ofinactivity and obesity among children. The Government holds a great deal ofpower, thus impacting New Zealanders directly and indirectly when it comesto decisions they make which then influence levels of obesity and inactivity

(Diagram 1 section 3). Government policies often influence the level ofindividuals disposable incomes and as it has been established that low levels ofincome is a cause of childhood obesity and inactivity it is vital that Governmentpolicies ensure families have the monetary means to live relatively healthylifestyles income and price must be in equilibrium.

It has been previously suggested thatGST (Goods and services tax) is takenoff the deemedhealthy foods in order to promote these food groups andmaking it easier for lower socio-economic families to purchase healthy foods.This may well be an effective societal strategy to reducing childhood obesity

provided that those who do eat poorly due to economic reasoning are capableof changing their habits and lifestyles, which although often easier said thandone, with other solutions in place such as emphasis on parental education, itmay be highly feasible. Removal of GST tax will particularly benefit those inlower socio-economic families more so than tampering with other taxes becauseGST is a regressive tax. Someone on a low income is forced to spend a largerproportion on goods (e.g. food), and thus ends up spending a higher proportionof their income on GST than someone on a higher income, who for example willhave money left over to invest.

It would be no easy task developing a gradedGST system without grey areas.Determining what foods are healthy and what is not is difficult, however agrading system similar to the heart foundations heart foundation tickcampaign with standards set that are specific to each food group may be ideal.In general, foods with GST removed should have low levels of bad fats(saturated and trans), salt and kilojoules, and contain positive nutrients such asfibre and calcium. The Government would have to employ nutritionists toanalyse all foods and decide whether they are qualify as GST removable or


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not. Although it may be tedious to firstly launch the idea, in the future whenthe policy has been established, it will only be new food products that need tobe checked out which will be much less time consuming.

Another way to decrease costs of healthy foods in proportion to the cost of

unhealthy foods is for the Government to focus on giving subsidies toproducers who produce fresh produce and getting the money to do this bytaxing producers who produce unhealthy packaged foods. Although thesame issue arises, where it is controversial and difficult to determine healthyand unhealthy, once this is overcome (e.g. from similar ideas to above) it islikely to have many benefits now and in the future. When subsidies and taxesare placed on producers, part of the benefit or burden is passed on toconsumers. Since food is a necessity with no substitutes and therefore highlyinelastic, consumers will bear more of the tax and receive more of the subsidythan the producers as the difference between the price consumers pay and the

initial market price is greater than the difference borne by producers. With thebig rise in the cost of food over the last few years (food prices increased by 8.2percent from June 2007 to June 2008), the subsidizing of fresh food is likely togreatly benefit all families especially those who currently struggle to affordnutritious food. Possible implications of these two Government interventionsare children on a more nutritious diet, better levels of concentration and focusin school and less malnourishment. The current habitual lifestyles many low-income families lead indulging in low nutrition foods may be reversed, thusincreasing the physical and emotional well-being of children, decreasing hyper-activity and increasing longevity. In the future, the children of today are likely

to make these healthier lifestyles part of their own, setting an example forfuture generations to come. Additionally, because the subsidies and taxes makeit relatively more profitable to produce fresh produce than packaged unhealthyfood (which is likely to be taxed), producers may decide to switch resources into producing healthier fresh food benefiting society by creating a healthierenvironment.

Implementing new policies and guidelines will help counter rates of childhoodobesity and inactivity only to an extent, because in the end it all stems back to achilds home life and their upbringing. you can lead a horse to water but youcan not make it drink. Children with greater health problems often come fromfamilies who are not as well off families often living off financial handouts.(See graph page 6) A possible solution to childhood obesity is to give thesefamilies, vouchers for fresh food instead of solely money. This would have to bedone with great caution and sensitivity because otherwise society may get theimpression that bureaucracies are taking over and limiting individuals ownability to make decisions. A way of doing that would be to not eliminatefinancial handouts drastically but decrease the quantity slightly, and bring in


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food vouchers to compensate. The quantitative amount of the vouchers shouldbe in proportion to number of people living in a household, the householdincome and their expenses. Whether these families appreciate the change or notthey are still, to some degree, highly likely to eat healthier foods because theysimply do not have the monetary means to buy what they like. This may lead to

healthier eating among beneficiaries, as over time they are habituated withhealthy eating and learn to appreciate such foods to some extent. In the future,this could lead to lifestyle changes and priority changes, leading to happierhealthier children (see diagram page 26). Although this analysis may be overlyoptimistic and wishful thinking, it is definitely an idea worth giving a go, ifdone properly with careful planning, positive implications are likely to follow.

A way in which the Government can intervene to decrease levels of childhoodinactivity is to promote sports clubs, especially in places that are of highdeprivation. This can be done in many practical ways. Firstly, subsidizing

sports clubs that are already established would make sports more affordablefor families and therefore a more desirable activity alternative for their children.Secondly, money could be funneled directly though to sports equipment andspace (e.g. fields, gyms; predominantly natural environments) in schools, clubsand communities. This would make physical activity a more viable option forschools and communities because of the ease of resource availability. If childrenbegin to engage in more physical activity due to the ease of financial costsassociated and greater resources available to them natural and man madethen there are likely to be many positive implications. Estimates indicate that a5% increase in physical activity levels could result in a saving of NZ$25 million

per year. Additionally, $160 million each year could be saved if all NewZealanders were to become physically active to levels that afford health benefits6. This release of financial burden for New Zealanders is huge, and may lead toan increase of economic growth in the future. In addition, childrens overallwell-being is now likely to be a lot higher, hence less health problems andproportionately more health care professionals available to treat other patients,thus a decrease in the levels of waiting lists and neglected patients a greatbenefit for society overall.


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An increase in natural environment available for children to engage in physicalactivity may lead to children developing an enhanced mental and spiritualwell-being as it has been verified that green spaces are linked to improved

mental health. For example, symptoms of ADD are relieved after contact withnature. 6 Additionally, parks and schools can offer activity and socialization; ithas been proven that the strength of social ties is important predictors of well-being and longevity. 6

6 Bauman A. Potential Health Benefits of Physical Activity in New Zealand.Wellington:Hillary Commission; 1997.

Decrease inhealth

problems

Enhanceddoctor to

patient ratios

Individualsreceiving improved

health careCyclical

effect

Overallincrease inwell-being


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Section F:

What influences currently exist that will enable thesolutions and what influences might act as hindrances?

InfluenceThe online dictionary definition states that an influence is the capacity or powerof persons or things to be a compelling force on or produce effects on the actions,

behavior, opinions, etc., of others. As a verb an influence is to move or impel (aperson) to some action. From this, we can recognize that influences are oftenpowerful; a force of some sort which manipulates and persuades. Everyone isconstantly under the influence of something to what extent though willdepend on their personality and viewpoints, how easily someone is persuaded

and what persuades them. The diagram below shows in a simplistic way, howinfluences work, though in reality it is often far more complex. It demonstratescyclical effects and the way in which we form our own ideas and beliefs.

Societ

External influences Ideas created in theoutside world &

through other people

Internal

influences Ideas formed within

ones self

Personalviewpoints

Societal beliefs

The Ideology we

base our livesown


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External influences are influences created from what is outside the self. Externalinfluences can include the media and advertising, legal restrictions e.g. Speedlimit and drinking age, setting, culture, parents/family, friends and role models e.g. Celebrities. Internal influences are ideas formed within ones self, basedon thoughts and feelings and ones innate personality traits. Internal influences

can include fears, desires, knowledge, curiosity and ones level of sensitivityand awareness. These dissimilar influences then form our own personalviewpoints, but to the extent that each one affects an individual is alwaysunique as it is determined largely by our personalities Personality is a solid coreof traits, reflecting the unique essence of a particular human being. Some people areaffected largely by intrinsic ideas whereas others focus more on what is aroundthem and are influenced extrinsically, having a tendency to place emphasis onexternal matters instead of on more philosophical truths. Intrinsic thinkingtends to focus on morals and ethics whereas extrinsic thinking is inclined tostress the external adherence of laws and principles. This complex mix of

diverse views and ways of thinking ultimately penetrates through to society tocreate societal beliefs common ideas of mainstream society. These ideas thenform the ideologies we base our lives on in various areas of society i.e. inparliament and schools, which in turn affect society. Influences form, grow andultimately impact. I am going to use the idea of an influence to discuss currentenablers and barriers existing amongst society today that will impinge onpossible solutions (section E) and their effectiveness.

Enablers

Currently, there are projects, ideas and plans set in place that are likely to helpthe solutions suggested in section E to work. Many of these influences wereoriginated from central Government.Recently the Government launched a $67 million four-year campaign aimed atraising physical activity and reducing New Zealand's growing obesity rates,targeting schools in particular. The campaign titled "Mission-On" was aimed atschools in particular and involves the Health Ministry working with the foodindustry and advertisers in order to reduce the advertising of unhealthy food tochildren. This initiative acts as a positive external influence toward obesityprevention as it has created an environment that condemns advertising of

unhealthy foods. This atmosphere is influencing society indirectly andaffecting individual ideas and beliefs, ultimately presenting people with a moreconcerned approach towards the prevention of obesity and inactivity.Additionally, because the advertising of unhealthy foods is in the process ofbeing reduced, children in particular will be less susceptible to commercialbrainwashing. Therefore, they are likely to desire less unhealthy foods, notbecause their tastes and preferences for fats and sugar have changed but


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because they are no longer surrounded and enticed by it. This would enablesolutions to work, particularly solutions involving price changes. In situationswhere price changes may seem too small to influence a radical change in theway people spend their money such as GST exclusions, advertising or lack ofadvertising can aid this change. Society will not be faced with such pressures of

unhealthy advertising to counter the efforts made, by a reduction of prices. Inthe future, if this campaign runs successfully and advertising of unhealthyfoods is significantly reduced, it would enable suggested solutions to work; anegative external influence would have been taken out of the current situation.

The natural tendency to maintain general health embedded in human beings islikely to influence the effectiveness of possible solutions. Everyone holds somedegree of self worth and because it is common knowledge that obesity andinactivity can cause negative effects on ones overall well-being and evenhappiness, people are likely to respond positively to various solutions, because

ultimately they are here to help, not to harm. Intuitively, we all want to feelgood about ourselves; internal influences formed innately will differ buteveryone cares to some degree what they are shoving in their mouth. Evenpeople who live on poor diets have a conscience letting them know that toomuch food is not a good thing, but their diet is based on other influences: tastesand feelings, habits and costs. Solutions that reduce the impact of negativeinfluences such as high costs and lack of resources (external influences),makes way for our innate desire to do well for ourselves to over power. Forexample someone who is currently living on a poor diet may decide to changetheir eating habits for the better if a subsidy of fresh foods came in to play, not

merely because fresh food is now cheaper, but because the one barrierpreventing them from doing what they instinctively knew was best for themhas now been removed. This is not to say that if healthy food had always beenmore accessible previously our natural instincts would have led us to makehealthy choices; in general, human beings have always expressed unlearnedpreferences for fat-associated textures and flavours. It is merely to say thatembedded in everyone is the desire to be happy and feel good aboutthemselves, hence maintaining good health.

Barriers

Apathy of individuals (children and adults), and society in general may act as abarrier to many of the solutions outlined in section E. Undoubtedly there arepeople who lack concern for the issues raised of obesity and inactivity, evenapathy toward health in general. This indifference is likely to be due to both alack of knowledge, and due to a general lack of interest and personalphilosophies. Apathy will mainly affect the first solution suggested child and


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parental education, due to the nature of educating. If community seminars wereorganized and parental magazines put forward, it merely gives parents anopportunity to learn but they are under no obligation to do so. Consequently, ifa general lack of interest toward obesity related issues is implied then few willmake an effort to learn, hindering the potential effectiveness of the solution.

This idea correlates to children also, possibly limiting the effectiveness ofteaching within schools and practical physical education. As stated previously,you can lead a horse to water, but you cannot make it drink.

The media and advertising is a significant part of the external influencescomponent and with current trends in advertising, it is likely to act as abarrier, making it difficult for various solutions to be successful. The Food andNutrition Monitoring Report in New Zealand shows that fast-food chains andcafes spent $67 million on advertising, whereas only $6.2 million is spentadvertising fruit and vegetables. Along with increased intakes of foods high in

fats and empty kilojoules in the last two decades, advertising of unhealthyfoods has increased also. This is likely to act as a major hindrance if furtheraction relating to advertising is not taken, simply because advertising works;and it definitely influences. It is even more of a concern for children becausebefore the age of twelve a childs cognitive development is limited and as aresult they cannot differentiate between the truth and advertising (Section A).Currently, the average household spent $6.50 a week on confectionary over thepast year, compared with $5.90 on fresh fruit. Possible solutions such as priceincentives has been suggested, aiming to counter the previous statementhowever, if current advertising trends continue then society may continue to

make unhealthy choices; the media is a powerful manipulator.

Financial means will largely determine the likelihood of solutions working andwhether they can even be instigated to begin with. Because money is a scarceresource and unable to satisfy our unlimited wants and needs, a lack of funds islikely to act as a major hindrance to solutions. Many of the solutions suggestedin section E involve laws and policy changes involving money. These changesmay be costly to the taxpayer or other parties. For example, one possiblesolution was that the GST on healthy foods be removed, if this strategy was putinto place the Governments overall revenue would decrease. Consequently, theGovernment may react to this loss of income by increasing other taxes, (e.g.

Income tax.) Therefore, the theoretical benefit of cheaper healthy food will nownot be so because income tax has risen at a rate that is in proportion to thedecrease inGST countering the benefits of the solution.


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Enablers or barriers

Initiating new ideas often means using money that was previously being usedelsewhere. This can cause controversy, as people will prioritise the variouspossible uses for money differently. For example, if the Government were tosubsidise sports clubs and funnel money directly through to providing sportsequipment then this money would either have to come from one of two places.Firstly, taken out of another area of spending or secondly, taxes and forms ofGovernment revenue would need to increase to accommodate for the increasein Government spending. There are people who would agree with the idea, asthey either intrinsically or extrinsically feel that childrens sport needs to begiven more attention and improvements should be made. This viewpoint depending on the strength, will act as an enabler, influencing the wider societythat it is of importance. However, others who will be opposed to the idea, theirviewpoints disagree with the solution and they too will influence wider society

shaping others views in a way that hinders the likelihood of the solutionworking. Whether viewpoints act as an enabler or barrier is often dependant onthe status and power held in each group. Well-recognized influentialindividuals, such as celebrities and people who have political power hold agreater influence over controlling societys views than the average person.Therefore, the views of such individuals will ultimately determine whetheropinions act as an enabler or barrier.

A negative example of the idea above is as below:

In 2003, The Labour party planned to bring in a health tax on fast food.National Health Spokesperson Dr Lynda Scott believed that this initiativeshowed that the Government had gone tax mad. "This tax is patently ridiculous.If you eat any food in too high a quantity, you will put on weight. 'It is people'schoice what they eat without Government interference. If the Governmentbelieves that people are eating too many burgers then regulation and taxation isnot going to reduce consumption. This opinion no doubt influenced thepublics views on the health tax idea to some extent. Although Scott does makea fair point when she says, It is people's choice what they eat withoutGovernment interference overall, her comment is irrational and untrue. Tosuggest that if you eat any food in too high a quantity, you will put on weightis absurd, as eating mass amounts of a food item relatively low in kilojoules willnot result in the gain of weight. The consumption of 20 bananas equates to wellunder the recommended daily intake of energy, however, people who takeScotts comment at its face value may now also believe that the Governmenthas gone tax mad. Hence, this situation would hinder the possibleeffectiveness of solutions to reducing childhood obesity and inactivity.


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Conclusion:

Obesity has reached epidemic proportions globally, with more than 1 billion adultsoverweight - at least 300 million of them clinically obese - and is a major contributor tothe global burden of chronic disease and disability. (The world health organization)

and unfortunately we as New Zealanders, are contributors to these statistics.Contributors sure, but are Kiwi kids becoming fat and lazy? Yes, I believe theyare. We may not rank alongside the Americans or the English, when it comes toour childrens weight, but that does not make us healthy. Being better thanothers, does not automatically mean good, we can compare ourselves all welike, but the fact remains that proportionally speaking, our children are gettingfat.

Throughout this essay, I have covered various angles and views on childhoodobesity and inactivity. Many views and opinions may contradict one another,

though it remains in mutual agreement that throughout New Zealand obesechildren do exist. While issues surrounding obesity and inactivity remaincontroversial, it undoubtedly grants some concern. Now that it has beenestablished that it is an issue, and awareness of the problem amongst society isrelatively high, it is vital that suggested solutions to the problem are seriouslyconsidered.

The Ministry of Health estimates that poor diet contributes to 30% of all deathsin New Zealand. If we want our children, and our childrens children to livelong contented lives then changes must occur, because current trends suggest

the contrary.

Ultimately, it comes down to the value we place on our lives, and whether weare willing to change.

Change will not come if we wait for some other person or some other time. We are theones we've been waiting for. We are the change that we seek. - Barak Obama


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Bibliography:

The following, are resources I used in writing this essay

Books:

Year 13 Physical Education NCEA Level 3 Workbook

Campos, P. (2004). The Obesity Epidemic: Why Americas Obsessionwith weight is Hazardous to your Health.

Death By Supermarket: The Fattening, Dumbing Down, and Poisoningof America.

Websites:

www.sparc.org.nz/admin/ClientFiles/f8119e6f-65ee-4492-8c6a-7bbe8041cf35.pdf

http://herbalremedies.freeblog.co.nz/2008/12/12/child-obesity-effects-causes-and-solutions/

www.walktoschool.org.uk/

www.csmonitor.com/2004/1014/p11s02-ussc.html

www.nytimes.com/2007/04/22/magazine/22wwlnlede.t.html?fta=y

www.moh.govt.nz/moh.nsf/indexmh/obesity

www.nzma.org.nz/journal

www.medindia.net/news/healthwatch/Fighting-Obesity-While-Sticking-to-Fast-Food-is-It-Possible-43078-1.htm

www.independent.co.uk/news/uk/this-britain/size-matters-the-great-british-weight-debate-462748.html

www.stats.govt.nz/

www.nzherald.co.nz/nz/news

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