Oral Submission to the Health Committee on the Inquiry into Obesity and Type Two Diabetes.
Today Professor Barry Taylor and Dr Nikki Blair presented an oral submission to the health committee on behalf of the Paediatric Society of New Zealand.
The Paediatric Society is a multi disciplinary organisation of over 400 health professionals. They believe all children have the right to attain optimum physical, mental and social health and well being.
In 2003 the rates of overweight and obese children had reached 30% in New Zealand. This mirrors that in most OECD countries.
The rapid escalation of childhood obesity poses major problems both in childhood but also is a costly and major threat to long term adult health.
The Paediatric Society urges the NZ government and regional authorities, as well as NGO's, DHBs and all citizens to act to address this issue now.
The evidence base for effective intervention to prevent or treat childhood obesity is not well developed. In this context, it is important that as much attention is paid to evaluation and research into effective programs as it is to plan and put in place a co-ordinated national strategy. If this is not done, potentially a lot of money will be wasted and we will not learn from the experience. It is important to develop programmes which are effective for Maori and Pacific families, as prevalence of over-weight and obesity, and the consequences thereof, appear larger in this group.
Overseas experience is that multi-faceted family based programmes involving nutrition, exercise, reduction in sedentary activity and behavioural components are effective in weight management, with the key being a motivated family and child. Such a programme requires an intense collaborative service comprising of dietary, activity, medical and behavioural expertise and at least 6 months duration. At the time of a national review of programmes addressing the treatment and prevention of childhood obesity conducted in 2004 by Dr Nikki Blair, only a few DHBs had access to a multi-faceted weight management programme, most had insufficient resources and funding to provide all the components, the intensity of intervention, or the capacity to meet the needs of their communities, or the ability to adequately evaluate the efficacy of their programme.
The Society believes a national system of evaluating and monitoring, with the ability to integrate research to allow us to learn rapidly what works and what doesn't, is needed.
It suggests for the purpose of monitoring, integrating into the well child check and immunisation or hearing and vision screening events at 4 and 11 years the routine measuring of height, weight and waist measurement. These values could be reported into a national database (linked to the immunisation database) so we can monitor down to a DHB level.
Considering the difficulties of weight management in children as in adults, it is essential that much of the national strategy focus on prevention and community wide interventions.
At a Public Health level we think society is now obliged to restrict advertising of "energy dense" (fatty and sugary) food and drinks to children.
At a community level, we support the plan that there be regulations adopted by schools around appropriate food and drinks consumed at publicly funded schools in New Zealand.
Finally - there needs to be changes to the environment which is currently 'obesogenic' in that it encourages the intake of energy dense food and low activity levels. There is a responsibility for planners and architects at governmental, regional and city council level to ensure that the environments we live in encourage healthy living. Our public buildings, streets and facilities need to be designed and/or modified to encourage and enable increased activity including active transport (walking and cycling) to work and school, use of stairs and improved access to all to sporting facilities and parks. Improved access to healthy foods in particular vegetables, fruit and milk, especially for low-income families, could be improved with Government subsidies.
Professor Barry Taylor
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