Centre for Physical Activity and Nutrition ResearchCentre for Physical Activity and Nutrition Research
Parental concerns about childhood obesity
David Crawford* and Tony Worsley
*NHMRC/NHF Career Development Fellow
Centre for Physical Activity and Centre for Physical Activity and Nutrition ResearchNutrition Research
Burden of disease in Australia
0 2 4 6 8 10 12
High Cholesterol
Low fruit & veg
Obesity
Hypertension
Physical inactivity
Tobacco
% risk factor burden
Trends in obesity-related media coverage
Note: Figures represent IFIC tracking of U.S. and International (English-speaking) wire reports and print articles on the issue and do not necessarily reflect the true number of stories.
Centre for Physical Activity and Centre for Physical Activity and Nutrition ResearchNutrition Research
Obesity in Australian children (1995/97)
NSW SFPAS NNS HYOVSBoys Girls Boys Girls Boys Girls
Acceptable
Overweight
Obese
Overweight/obese
79.9
14.9
5.2
20.1
78.7
16.3
4.9
21.3
80.7
14.4
4.9
19.3
77.7
16.9
5.4
22.3
78.9
15.8
5.3
21.1
76.4
17.8
5.7
23.5
Booth et al, ANZJPH 2001
Centre for Physical Activity and Centre for Physical Activity and Nutrition ResearchNutrition Research
Trends in childhood obesity
Prevalence has probably doubled over the 10-year period 1985-95
In a cohort of 1438 Victorian children aged 5-10 years at baseline, between 1997-2000/01:
10% became overweight 2% became obese
Hesketh, Wake, Waters, Carlin, Crawford, Pub Health Nutr. (In press)
Centre for Physical Activity and Centre for Physical Activity and Nutrition ResearchNutrition Research
Children’s eating and physical activity behaviours have changed
Centre for Physical Activity and Centre for Physical Activity and Nutrition ResearchNutrition Research
Percent change in amount of food and energy density of food 1985-95
-5
0
5
10
15
20
boys 10-11y boys 12-15y girls 10-11y girls 12-15y
amount of food (g)
energy density kJ/g
Centre for Physical Activity and Centre for Physical Activity and Nutrition ResearchNutrition Research
How active are Australian children?
Centre for Physical Activity and Centre for Physical Activity and Nutrition ResearchNutrition Research
Children’s physical activity habits
We don’t know how activity levels have changed over time Walking and cycling to school has declined Fitness levels have declined
Likely that children’s activity levels have declined
Our data suggest children engage in relatively low levels of physical activity
Centre for Physical Activity and Centre for Physical Activity and Nutrition ResearchNutrition Research
Average time (mins/day) spent in moderate intensity activity
0
50
100
150
200
250
5-6 year olds 10-12 year olds
Boys
Girls
Min
s p
er d
ay
Centre for Physical Activity and Centre for Physical Activity and Nutrition ResearchNutrition Research
Average time (mins/day) spent in vigorous intensity activity
0
5
10
15
20
25
30
35
40
45
5-6 yr olds 10-12 yr olds
Boys
Girls
Min
s p
er d
ay
Centre for Physical Activity and Centre for Physical Activity and Nutrition ResearchNutrition Research
The world we live in has changed(Jeffery and Utter, Obesity Research, 2003)
Overall cost of food has decreased
Foods prepared away from home/
Availability of energy dense foods/drinks
Portion sizes of some foods have increased
Marketing of foods and drinks
Urban sprawl and urban design
Availability of private versus public transport
The number of two-income families
The time spent in paid employment
Place of physical education in the curriculum
Centre for Physical Activity and Centre for Physical Activity and Nutrition ResearchNutrition Research
CHILD WEIGHT STATUS
Child characteristics and child risk factors*
Gender Age
Familial susceptibility to weight gain
Parenting styles and family characteristics
DIETARY INTAKE
SEDENTARYBEHAVIOR
PHYSICALACTIVITY
Parent food preferences
Parents dietary intake
Nutritional knowledge
Ethnicity
Child feeding practices
Types of foods available in the home
Family leisure time activity
Parent preferencefor activity
Family TV viewing
Parent activity patterns
Peer and sibling interactions
Parent encouragement of child activityParent weight
status
Community, demographic,and societal characteristics
Leisure time
Socioeconomic status
Crime rates and neighborhood
safety
Accessibility of convenience foods and restaurants
Work hours
School lunch programs
Accessibility of recreational facilities
School physical education programs
Parent monitoring of child TV viewing
Contextual influences on childhood obesity
Davison & Birch (2001). Obesity Reviews, 2, 159-171.
Centre for Physical Activity and Centre for Physical Activity and Nutrition ResearchNutrition Research
Preventing childhood obesity
We have a poor understanding of the drivers of the obesity epidemic Lots of candidates - little evidence
A huge range of prevention strategies have been proposed Education strategies to promote physical activity
and healthy eating Changes to urban environment to make it safer for
children to walk Policies to ban advertising to children or taxes
certain kinds of foods
Centre for Physical Activity and Centre for Physical Activity and Nutrition ResearchNutrition Research
Community views of childhood obesity?
Parent’s views on causes and what to do to prevent it not widely canvassed!
This is despite evidence that many parents are concerned about their child’s weight
Understanding community views is important: To establish support for preventive
initiatives To identify where these is a need to
educate the community about the epidemic
Centre for Physical Activity and Centre for Physical Activity and Nutrition ResearchNutrition Research
Our research…
Aimed to examine community views: Causes of childhood obesity Beliefs about prevention
Surveyed 315 adults randomly recruited at a major shopping centre
Assessed views of importance of: 25 possible causes of obesity 13 potential preventive measures
Centre for Physical Activity and Centre for Physical Activity and Nutrition ResearchNutrition Research
Causes: Lack of physical activity
0 5 10 15 20 25 30
Lack of physical activityat school
Lack of physical activityoutside of school
%
Centre for Physical Activity and Centre for Physical Activity and Nutrition ResearchNutrition Research
Causes: Overconsumption of food
0 5 10 15 20 25 30 35 40 45 50
Eatin too many high fatfoods at home
Eating oversizedservings of foods
Eating too many high fatfoods at school
Children have too muchmoney to spend on
unhealthy food
Overconsumption of fastfoods
%
Centre for Physical Activity and Centre for Physical Activity and Nutrition ResearchNutrition Research
Causes: Children’s lack of knowledge and motivation
0 5 10 15 20 25 30
Children don't careabout eating healthy
Children don't knowabout the dangers of
obesity
Children don't careabout being physically
active
%
Centre for Physical Activity and Centre for Physical Activity and Nutrition ResearchNutrition Research
Causes: Physical activity environment
0 5 10 15 20
Lack of safe cycling andwalking paths
Lack of other safeplaces to be physically
active
%
Centre for Physical Activity and Centre for Physical Activity and Nutrition ResearchNutrition Research
Causes: The food environment
0 5 10 15 20
Healthy foods areexpensive
Healthy foods oftenaren't available
%
Centre for Physical Activity and Centre for Physical Activity and Nutrition ResearchNutrition Research
Causes: Parental responsibility
0 5 10 15 20 25 30
Parents don't know howto promote healthy
eating
Parents don't know howto promote physical
activity
Parents don't care aboutbeing physically active
Parents don't care abouteating healthy
Parents aren't aware ofthe dangers of obesity
%
Centre for Physical Activity and Centre for Physical Activity and Nutrition ResearchNutrition Research
Causes: Modern technology & media
0 5 10 15 20 25 30 35 40 45 50
Watching too muchtelevision
Eating in front of the TV
Modern technology (egcars, computers, video
games)
Media promotion ofunhealthy foods
%
Centre for Physical Activity and Centre for Physical Activity and Nutrition ResearchNutrition Research
Prevention: Government action
0 5 10 15 20 25 30 35 40
High-fat foods should have an additional 5% tax
Give 5% tax incentives to manufacturers ofhealthy food
Advertising of high fat foods ahould be bannedduring children's viewing hours
The government should build more safe cyclingand walking tracks
Obesity prevention actions should only bedirected to children who are overweight, but not
yet obese
%
Centre for Physical Activity and Centre for Physical Activity and Nutrition ResearchNutrition Research
Prevention: Children’s health promotion
0 5 10 15 20 25 30 35 40 45 50 55 60
Healthy eating should bepromoted on children's
TV
Obesity preventionactions should be
directed to all children
More healthy foodshould be served in
schools
More healthy foodshould be served in
schools
Daily physical educationin school should be
compulsary
%
Centre for Physical Activity and Centre for Physical Activity and Nutrition ResearchNutrition Research
Conclusions
Community recognises the causes to be multi-factorial
Key causes: overconsumption of unhealthy food; parental responsibility; modern technology; TV viewing and the mass media
Less community support for government regulation than for health promotion
There is likely to be widespread support for health promotion activities aimed at preventing childhood obesity
Centre for Physical Activity and Centre for Physical Activity and Nutrition ResearchNutrition Research
For more information…
Take a look at our paper:
International Journal of Obesity 2003; 27: 1465-1471
Email me at:
See our website:
www.hbs.deakin.edu.au/HealthSci/Research/default.asp