AFIC Symposium on Food & Safety Initiatives in Asia/Pacific, 29 April 2009, Singapore. www.afic.org

1. Tackling Childhood Obesity
..the role of GOOD communication
Presented by Beverley Postma
AFIC Symposium on Food Safety Initiatives in Asia/Pacific.
SINGAPORE - April 29, 2009

2. Overview
• Childhood obesity: a global challenge
• Some basic facts
• The role of good communication
• An Irish case study
• Taking action in Asia

3. 1. A GLOBAL CHALLENGE

4. “Obesity is one of today’s most blatantly
visible – yet most neglected – public
health problems. If immediate action is
not taken, millions will suffer from an
array of serious health disorders”
World Health Organisation, 2009

5. A Global Epidemic
WHO and International Obesity Task Force:
300 million people around the world
are obese (BMI>30)
At least 155 million school-age
children are overweight or obese
(BMI>25)

6. Obesity Trends* Among U.S. Adults
BRFSS, 1985
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%
Source: CDC Behavioral Risk Factor Surveillance System.

7. Obesity Trends* Among U.S. Adults
BRFSS, 1986
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%
Source: CDC Behavioral Risk Factor Surveillance System.

8. Obesity Trends* Among U.S. Adults
BRFSS, 1987
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4”
person)
No Data <10% 10%–14%
Source: CDC Behavioral Risk Factor Surveillance System.

9. Obesity Trends* Among U.S. Adults
BRFSS, 1988
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%
Source: CDC Behavioral Risk Factor Surveillance System.

10. Obesity Trends* Among U.S. Adults
BRFSS, 1989
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%
Source: CDC Behavioral Risk Factor Surveillance System.

11. Obesity Trends* Among U.S. Adults
BRFSS, 1990
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%
Source: CDC Behavioral Risk Factor Surveillance System.

12. Obesity Trends* Among U.S. Adults
BRFSS, 1991
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
Source: CDC Behavioral Risk Factor Surveillance System.

13. Obesity Trends* Among U.S. Adults
BRFSS, 1992
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
Source: CDC Behavioral Risk Factor Surveillance System.

14. Obesity Trends* Among U.S. Adults
BRFSS, 1993
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
Source: CDC Behavioral Risk Factor Surveillance System.

15. Obesity Trends* Among U.S. Adults
BRFSS, 1994
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
Source: CDC Behavioral Risk Factor Surveillance System.

16. Obesity Trends* Among U.S. Adults
BRFSS, 1995
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
Source: CDC Behavioral Risk Factor Surveillance System.

17. Obesity Trends* Among U.S. Adults
BRFSS, 1996
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
Source: CDC Behavioral Risk Factor Surveillance System.

18. Obesity Trends* Among U.S. Adults
BRFSS, 1997
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% ≥20%
Source: CDC Behavioral Risk Factor Surveillance System.

19. Obesity Trends* Among U.S. Adults
BRFSS, 1998
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% ≥20%
Source: CDC Behavioral Risk Factor Surveillance System.

20. Obesity Trends* Among U.S. Adults
BRFSS, 1999
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% ≥20%
Source: CDC Behavioral Risk Factor Surveillance System.

21. Obesity Trends* Among U.S. Adults
BRFSS, 2000
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% ≥20%
Source: CDC Behavioral Risk Factor Surveillance System.

22. Obesity Trends* Among U.S. Adults
BRFSS, 2001
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
Source: CDC Behavioral Risk Factor Surveillance System.

23. Obesity Trends* Among U.S. Adults
BRFSS, 2002
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
Source: CDC Behavioral Risk Factor Surveillance System.

24. Obesity Trends* Among U.S. Adults
BRFSS, 2003
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
Source: CDC Behavioral Risk Factor Surveillance System.

25. Obesity Trends* Among U.S. Adults
BRFSS, 2004
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
Source: Behavioral Risk Factor Surveillance System, CDC.

26. Obesity Trends* Among U.S. Adults
BRFSS, 2005
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Source: Behavioral Risk Factor Surveillance System, CDC.

27. Obesity Trends* Among U.S. Adults
BRFSS, 2006
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Source: Behavioral Risk Factor Surveillance System, CDC.

28. Obesity Trends* Among U.S. Adults
BRFSS, 2007
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Source: Behavioral Risk Factor Surveillance System, CDC.

29. A Global Epidemic
WHO and International Obesity Task Force:
300 million people around the
world are obese (BMI>30)
At least 155 million school-age
children are overweight or
obese (BMI>25)
Source: Behavioral Risk Factor Surveillance System, CDC.

30. 2. SOME BASIC FACTS

31. Defining Obesity
• Obesity means an excess amount of body fat.
• No general agreement exists on the definition of
obesity in children as it does for adults.
• Most professionals use published guidelines
based on the body mass index (BMI)

32. Definitions for Adults
• An adult who has a • An adult who has a
BMI between 25 and BMI of 30 or higher is
29.9 is considered considered obese.
overweight.

33. Impact on Children
PHYSICAL HEALTH EMOTIONAL HEALTH
• • Low self-esteem
Type 2 diabetes
• • Negative body image
Hypertension
• • Depression
Dyslipidemia
• Hepatic steatosis (fatty liver) SOCIAL HEALTH
• Cholelithiasis (gallstones) • Stigma
• Sleep apnea • Negative stereotyping
• Orthopedic problems • Discrimination
• Asthma • Teasing and bullying
• Heart Disease • Social marginalization

34. Impact on Society
Estimates of Obesity-related
Health Care Costs (USA)
– U.S. Government $110 billion
– American Obesity
Association $237 billion

35. Contributing Factors
• Increased use of motorised transport
• Fall in opportunities for recreational physical activity
• Increased sedentary recreation
• Greater quantities & availability of energy dense foods
• More use of restaurants and fast food outlets
• More frequent and widespread food purchasing
opportunities
IOTF report to the WHO

36. ENERGY
ENERGY IN VS
EXPENDITURE
• More energy dense foods • Motorised transport
• More use of restaurants • Less physical activity
• More purchasing • More sedentary
opportunities recreation

37. Balancing the Energy Budget
FOR CHILDREN:
Maintain energy balance at a healthy
weight - while protecting health, growth,
development, and nutritional status

38. Diverse Diets
• Some years ago the photographer Peter
Menzel took pictures of 30 families in 24
countries, depicting the food they eat in
one week

39. GERMANY

40. USA (North Carolina)

41. ITALY

42. GREAT BRITAIN

43. KUWAIT

44. MEXICO

45. USA (CALIFORNIA)

46. CHINA

47. POLAND

48. EGYPT

49. MONGOLIA

50. ECUADOR

51. BHUTAN

52. CHAD

53. 3. GOOD COMMUNICATION

54. Evidence-Based Communication
• Negative messages rarely work
• Demonising food can be unhelpful
• Mixed messages are confusing
• Focus on empowering parents
• Equip children with a new LIFE SKILL

55. A Collaborative Effort
• Governments • NGOs & Charities
• Health professionals • Community groups
(practitioners & researchers)
• Employers
• Food industry
• Media
• Schools & childcare
• Parents
providers
• Individuals

57. 4. AN IRISH CASE STUDY

58. Estimated EU prevalence of overweight & obesity
18% of adults are
>300,000are
39% children
obese
areoverweight or
overweight
obese
The report of the National Taskforce on obesity force (2005)

59. Children & Teenagers
• In 2007, there were • Children 5-12 yrs*
1,056,947 children in 11% overweight
Ireland under the 11% obese
age of 18yrs
• Teenagers 13-17yrs**
(24.5% of the 11% overweight
population) 8% obese
(IUNA dietary surveys, *2005 and **2008).

60. Family Role Models
• 89% of all eating • Children with active
occasions for 5-12 year parents are 1.5 times
olds are at home* more likely to be
active than children of
inactive parents.
• Children of normal weight
parents are more likely to
• If BOTH parents are
be normal weight**
active, their children
are 5.8 times more
likely to be active.**
*Gibney and Burke, National Children’s Survey, 2005
**IUNA Dietary Surveys 2005, 2008

62. Positive Collaboration
• National Taskforce on Obesity (est. March ‘04)
made 93 recommendations
• It recognised that a multi-sectoral approach was
necessary
• Greater co-operation with food industry
• Need to engage both EU and global level

63. Leadership in Action
The EU food industry has made 200
commitments (covering: food labelling;
education; physical activity; promotion;
advertising and product reformulation)
Irish food industry is at
the forefront of EU
activity

64. Nutrition & Health Foundation
• Multi-stakeholder organisation
• Industry-funded
• First of its kind in Europe
• Bringing together Government &
non-government stakeholders
• Communicating evidence-based
information on healthy lifestyles

65. Guideline Daily Amounts (GDAs)
• The one, truly pan-European scheme
• Key information on calories, sugars,
fat, saturated fat & salt (sodium)
• Front of pack icons enable quick
decisions
• Irish uptake: 50% of branded food;
90% of retail own-brand products.

66. Consumers’ Verdict
• 75% of consumers find
GDAs easy to
understand
• 88% find GDA
information useful
• 87% feel GDAs help
you select healthier
choices
• 81% would like to see
GDA labels on more
food products.

67. 5. TAKING ACTION IN ASIA

68. Obesity in Asia
“The rapid modernisation of China & other Asian countries
has produced an alarming spike in the rate of obesity and
diabetes.
Rates of childhood obesity are rising at 1% each year -
roughly the same rate as Britain, the US and Australia.
Asia currently has aprox two-thirds of the world's diabetics,
around 90 million people”
Paul Zimmet, Chairman of
the International Obesity
Task Force (IOTF), 2006

69. Keys to Success
• Invest in positive collaborative solutions
• Insist on GOOD communication
• Equip young people with a new LIFE SKILL
• Empower parents and care-givers
• Demonstrate leadership
• Take action NOW

70. ….Is obesity on your agenda?
Thank You.
Any Questions?