Fighting obesity – raising healthy kids

You are much more likely to be obese than your parents were at your age, an Australian report has revealed. While that’s hard to hear, here’s another fact, obesity levels among our very young children have almost doubled in the past two decades.

This has spurred calls for tighter restrictions on marketing junk food to children, encouraging people to curb their intake of the abundance of cheap burgers, chips, pizza and fizzy drinks, regulation of sugar sweetened drinks and greater assistance for breast feeding mothers. 

Statistics released by the Australian Institute of Health and Welfare (AIHW) report Overweight and obesity in Australia: a birth cohort analysis¹ use historical data to determine a person’s likelihood of being obese based on their year of birth.  Looking at obesity in this way, helps better understand whether the generation a person is born into may put them at greater risk of obesity.

“Adults in 2014–15 were significantly more likely to be obese than those of the same age 20 years earlier,” says AIHW spokesperson Dr Lynelle Moon.

“For instance, when looking at people born in the mid-1990s, we found that about 15% were obese at age 18–21. This is almost double the proportion of obese 18–21 year olds who were born two decades earlier (8%).

A similar pattern held true for very young children. At age 2–5, about 9% of children born in the early 2010s were obese, compared with about 4% two decades earlier.

“Obesity is a risk factor for many chronic health conditions, so its presence at younger ages among those born more recently is likely to lead to higher rates of these conditions at younger ages,” Dr Moon says.

Comprehensive overview of obesity in Australia

A second report, released simultaneously brought together a range of data providing a comprehensive overview of obesity in Australia.

A picture of overweight and obesity in Australia reaffirms the message of the growing problem of obesity, showing that nearly 2 in 3 (63%) Australian adults were overweight or obese in 2014–15, up from 57% in 1995. This rise been largely driven by a shift towards Australian adults being obese (rather than overweight but not obese), with fewer now in the normal weight range.

Of particular concern is the growing rate of severe obesity—that is, a body mass index (BMI) of 35 or more. In 1995, 5% of Australian adults were severely obese, but this almost doubled to 9% in 2014–15.

The report looks at groups of people at particular risk of being overweight or obese and shows major differences across groups. For example, people who are in lower socioeconomic groups and those living outside of major cities are more likely to be overweight or obese than others.

Dietician and Research Fellow at Queensland University of Technology Dr Rebecca Byrne says that once an adult is overweight or obese, it is very hard to lose weight and maintain weight loss and this is why investment regarding obesity prevention in children and families is so important. 

She says supporting parents to establish healthy lifestyle behaviours among very young children is vital to support a healthy growth trajectory.

Dr Byrne says the AIHW Overweight and obesity in Australia report specifically states that governments of all levels, business and community leaders, school, childcare, and health-care professionals and individuals must work together to create a supportive environment that encourages healthy behaviours that prevent obesity.  

“Notice how individuals are last in a long list of organisations and people that need to come together to support families? 

“Parents are raising kids in a really tough environment.  It is not as simple as telling parents not to buy unhealthy food or just say ‘no’.  Unhealthy food is cheap, readily available, and directly marketed to children – we need to give parents a fighting chance.

“Regulation of sugar-sweetened beverages and marketing of unhealthy foods to children, support for women planning a pregnancy as well as during their pregnancy, plus structural support for infant feeding i.e. longer paid maternity leave and flexible work arrangements such that women can breastfeed for longer (use of formula and rapid growth in infancy is associated with obesity).  

“There is a strong socioeconomic gradient in health.  Individuals who do not have regular work and not enough money for food, don't have the luxury of prioritising health behaviours.  

“How do Governments, business and community leaders, school, childcare, and health-care professionals better support them?”

Growth chart misunderstanding

Dr Byrne says there is also a fundamental misunderstanding among many parents around growth charts and that a ‘chubby baby is a happy baby’.

Baby weigh-ins are a rite of passage for parents, but some parents are left with a feeling of failure when their child is sitting below the 50th percentile.

Many parents think a baby tracking above the 50th percentile is good, and below is bad, but by definition, half the population has to be above the 50th, and half below. It is the trajectory which is important.

“Some really neat research from the United States presented several growth charts to parents.  Each chart had a (theoretical) child’s growth mapped on it and parents were asked to rate which growth patterns they preferred, or considered most ‘healthy’,” Dr Byrne says. 

“The majority of parents preferred infants to track at higher percentiles compared with normal growth trajectories on lower percentiles.  This suggested that people think a baby tracking above the 50th percentile is good, and below is bad, while they are unaware that tracking roughly along the same percentile (any percentile) depicts ‘normal’ growth. 

“The ‘chubby baby is a happy baby’ association is one of the few beliefs consistent across cultures, countries, and socioeconomic status. 

“Universally parents tend to underestimate their child’s weight i.e. labelling babies or children in the healthy weight range as underweight, and for those children that have been objectively classified as overweight, parents tend to perceive them as a healthy weight.  

“This makes a lot of sense, given most of human history has been a time of food scarcity. Extra weight, especially in infancy, conferred a survival advantage. 

“Now, our children are born in to an 'obesogenic environment'. Unhealthy food is cheap and readily available, and our surroundings encourage us to move less and sit more.  

This means it is vitally important that we feed children in a way that lets them stop eating when they are full, rather than teaching them to ignore their body's signals, or eat for reasons other than hunger.   

“This doesn’t mean that having a chubby baby is bad.  If we think about the growth charts again for a moment - percentiles by definition, mean that half the population has to be above the 50th, and half below.   

“So there are always going to be people of different sizes.  If your dad is a rugby forward, you will most likely be a bigger baby than one whose dad is a jockey.  

“Measuring weight, length and head circumference over time, with the support of a trusted health professional is the best way for a parent to be reassured their child is growing well.”

1 Australian Institute of Health and Welfare 2017. Overweight and obesity in Australia: a birth cohort analysis. Cat. no. PHE 215. Canberra: AIHW.