RECIPE FOR CHILDHOOD OBESITY: 21ST CENTURY
By
Judith Duffy, Health Correspondent
For the first time since infectious disease was conquered, children’s lifespan is shortening. But it’s not just illness that’s killing our kids … it’s their lifestyle
AT EIGHT years old, Connor McCreaddie should be able to enjoy running around and playing with his friends. Instead, he struggles with everyday tasks such as dressing and washing himself and regularly misses school. His life is at risk because of his health problems.
Yet Connor is not suffering from a disease or illness. He is, however, massively overweight.
Until recently, Connor weighed in at 15st 8lbs, nearly four times the weight of a healthy child of his age. Last week, a child protection conference decided against putting him into care, although doctors warned that he was facing an early death unless he lost lots of weight. Consultant paediatrician Dr Michael Markiewicz said: "As far as I'm concerned this is a form of child abuse - not intentionally done, but the result is child abuse."
While the case sparked an outcry over modern parenting, Connor's 35-year-old mother, Nicola McKeown, in turn blamed doctors for failing to help the family. "They've tried to say that I've neglected Connor and he should come under the child abuse act, and I think it's really disgusting," she told one interviewer. "Through Connor's weight gain, there's been no-one there to step in."
Connor's case may be an extreme example, but more and more children are packing on the pounds. One in three youngsters under 12 is classed as overweight in Scotland, and dire warnings have been issued that this will be the first generation where, as a consequence of obesity, children die before their parents.
For centuries children faced killers such as measles, cholera and smallpox until modern medicine successfully tackled these diseases; now it appears that being fat is the biggest threat to children's health in the UK.
It's easy to blame the individual parents, but Louise Diss, managing director of The Obesity and Awareness Solutions Trust (Toast), argues that the rapid escalation in weight problems in the past few decades points to common triggers in the wider community.
"It is interesting, as it obesity is not like something which is an infectious disease," she says. "You have then got to look at what other things have been happening in society at the same time."
Diss argues that a variety of different factors contribute to the problem, including a rise in fast-food outlets, cheap takeaway foods and increasingly sedentary lifestyles. It is a combination often described as an "obesogenic" environment, which encourages the over-consumption of energy-rich foods and consequent weight gain.
But she points out that individuals do not gain weight for the same reasons. "For some people, obesity is about eating a little bit more than their body needs every day," she says. "Some are binge eating, others are using food as a type of self-harm. There is a whole range of different things - there are even people who are overweight because they eat when they are happy.
"The consequences of being severely obese are severe psychological and physical health problems, but it happens very, very easily."
Helen Stracey, a registered dietician with the British Dietetic Association, says generations have missed out on the basics of nutrition.
"In the 1970s people would have school meals that were plated up, but then it became a cafeteria culture, where kids were given money to go and buy food and would end up just buying the cheapest thing or a bag of chips," she says. "There is a lot more advice about nutrition now, and when I talk to schoolkids they know this and that - but there is still a major gap.
"There are too many misconceptions and misunderstandings about food. I talk to people who say they eat lots of vegetables, then I find out that they have a tablespoon of peas and think that is a lot of vegetables. I tell them half their plate needs to be vegetables."
In an alarming description of Connor's life, his family admitted that he eats "chips with everything" and snacks on "junk food all day long at the computer".
While Stracey stresses that Connor's behaviour is not the norm, she says she has seen cases where children "live on crisps and cola" or are given money for takeaways every night by parents. However, she also believes a lack of physical activity is a major part of the problem.
She says: "We are a push-button society, where kids sit at computers and televisions, they don't walk as much or go out to play as much.
"In my day we didn't have morning TV, but now they wake up and the television is on from 6am to whenever at night, and they can sit there all day and watch it if they want."
Dr David Haslam, a GP and clinical director of the National Obesity Forum, agrees these factors contribute to the problem, but argues that the earliest years of a child's life are also crucial.
"Breastfeeding levels in the UK are just about the worst in Europe - not only the number of mums breastfeeding, but the duration of breastfeeding," he says. "Breastfeeding protects baby and mother against future obesity.
"Even during pregnancy, with mums who eat badly, the unborn baby is imprinted with metabolic processes that will lead it to become fat later in life."
Haslam also points out that since the end of war rationing in 1954, food has been in constant and plentiful supply in the UK.
"We are the first generation ever that hasn't had any shortage of food," he says. "At all times of the day or night, in fast-food restaurants and 24-hour filling stations, there's always food available."
IN Scotland, there has been a sustained campaign for a number of years to improve the country's notoriously poor diet. However, a 2006 report on the Scottish Diet Action Plan revealed that little progress had been made a decade on from the launch of the initiative, with most Scots still eating foods high in sugars and saturated fat. Ministers have also introduced a range of high-profile moves in recent years to try to prevent children's waistlines from expanding, such as improving school meals, banning fizzy drinks in schools and increasing the numbers of hours of physical education.
But while much of the focus has been on prevention, what about the youngsters whose waistlines have already expanded? An investigation by the Sunday Herald has uncovered a scarcity of specialist NHS services for obese children, with the amount of help available varying depending on where you live.
Some areas - including Lothian, Shetland, Fife and Forth Valley - generally only offer referrals to community dieticians. In Glasgow, Ayrshire and Arran, and the Western Isles, outpatient clinics have been set up for overweight children. In Lanarkshire an eight-week pilot project to help children with weight problems is running at one primary school, with a view to rolling it out further, and NHS Borders says it is hoping to develop a treatment programme for overweight children.
One initiative that has made an impact in England is the Mend (Mind, Exercise, Nutrition, Do It!) programme, a free-to-families nutrition and exercise scheme aimed at helping overweight children aged from seven to 13 to lose weight. It secured an £8 million grant from the Big Lottery Fund last year, allowing it to expand in England, but it is not yet available in Scotland.
A Mend spokeswoman said it hopes to run programmes in Scotland as soon as possible. "We are having discussions about finding venues, but nothing is finalised at this point," she says. "As soon as funding and facilities become available, we will be there."
She agrees that it has been historically difficult to get funding for the initiative from government or health board sources. "Resources are always so stretched, there is never enough money to go round," she adds.
"But I think people are starting to realise something definitely needs to be done. It is not going to go away by itself."
Dietician Laura Stewart, who opened Scotland's first private weight-loss clinic for children in Edinburgh last year, points out that tackling the issue can be a sensitive one for mothers and fathers. She says she is approached by many parents who want advice but feel their children aren't ready to actually attend the clinic to address the problem.
"One of the first things we do is discuss with the child how important they feel it is to make the changes," she says. "Top of the list for most children is being called names, being bullied at school, not being able to get into clothes they would like, and wanting to run faster.
"It is that process of getting the child on board, because it is never going to work unless that happens."
She also claims parents can face difficulties when trying to make changes to their children's lifestyles if they don't have the full support of family and friends.
"The parent might say we are not going to buy chocolate biscuits', for example," she says. "But then they go and visit the grandparents, who are saying you aren't having chocolate biscuits at home, let me give you some'."
And while the answer to losing weight would appear to be simple - eat less, exercise more - experts point out that getting people to actually change their behaviour is not so easy. Aberdeen University researchers are carrying out a three-year project to identify the best ways of preventing adults becoming obese. Among the solutions they are examining are advice from GPs and free gym membership on the NHS.
Luke Vale, senior research fellow at the university, says: "You learn and build up your behaviours throughout your life. If you are obese as a child or a young adolescent, the chances are you are not going to fare too well as an adult.
"We can devise lots of different and wonderful ways to help people lose weight, but none of them will really work if they are not going to get the outcomes people want, when they want them."
Whatever the result of the study, it is clear some kind of answer is desperately needed. Vale highlights statistics which show around 24 million men and women are overweight or obese in the UK - around half the population - costing the NHS and society billions of pounds every year, a situation that could deteriorate as chubby children become fat adults.
"The number of overweight or obese people has trebled in the past 25 years," he says. "We're trying to stop the problem getting any worse, but it is probably now about as bad as it could get."
Childhood Obesity
This seems like a pretty negative report.....no solutions given. Would have been nice seeing much more of a balance.
Linear Mode
