Fighting Childhood Obesity: What Really Works And How You Can Help – Yes, You!
Fighting Childhood Obesity:
The British government recently published its Obesity Strategy, to very mixed reviews. Critics say that the plan has been watered down and won’t be effective to fight against the worrying rise of obesity in the UK, especially childhood obesity. It factored in a sugar tax and encouraged by the food and drink industry to take more care of the nation’s health but stopped short of any restrictions on junk food marketing and advertising
I was recently invited to examine exactly this topic for the project Hearty Lives in Carrickfergus. Hearty Lives is a partnership between the British Heart Foundation, the Northern Health & Social Care Trust, Carrickfergus Borough Council and the Public Health Agency.
The aim of the project was to educate communities in order to reduce the impact of cardiovasular disease in the region. As the summary of the project states, “Heart disease unfairly affects certain populations within the UK, particularly those living in areas of high socio-economic deprivation and certain geographical regions.”
I was invited at the closing event to give stakeholders an overview of the impact of the project, which lasted three years.
At the close of this three-year period, it would be interesting to see what had actually worked and what hadn’t to fight obesity – especially these days, when everybody has an opinion on the Obesity Strategy.
The programme was built on wide-ranging research that established a clear link between obesity and heart disease: fighting obesity was an obvious step to reduce cardiovascular disease. Tackling childhood obesity would have an even greater impact, setting children up to become healthy adults.
Fighting obesity comes with lifestyle changes that are very much in people’s control. If our genes make us susceptible to heart disease, there is little we can do. But if it is our weight that puts us in danger, there are many cheap and accessible ways we can fight back.
So, after three years of the Hearty Lives programme in Carrickfergus, what were the lessons learned? Did any strategy emerge to combat obesity effectively?
How bad is the childhood obesity trend?
Let’s have a look at the numbers
The numbers around obesity, childhood obesity and heart disease are staggering and sobering.
1 in 4 children
This number is probably the scariest of all. According to the latest Health Survey of Northern Ireland (2014-2015), more than 1 in 4 pre-school children are overweight or obese. Naturally, it’s more likely that obese children will become obese adults. As far back as 2004, Richard H. Carmona, Surgeon General for the U.S. Public Health Service, provided this testimony in the US Senate:
“Because of the increasing rates of obesity, unhealthy eating habits, and physical inactivity, we may see the first generation that will be less healthy and have a shorter life expectancy than their parents.”
That’s the total amount that the NHS (National Health Service) spent on cardio-vascular disease in Northern Ireland in 2013-2014. This money is spent solely reacting to the issue: it’s not spent on education, employment or improving the lifestyle of the people of Northern Ireland.
Coronary heart disease is the number 1 killer in Northern Ireland. It’s also the leading cause of death worldwide.
That’s the proportion of people who have diabetes, but are undiagnosed, according to the Global Diabetes Community. This means almost one in two diabetes sufferers actually don’t know they have the disease! Diabetes is on the rise, it has significant long term health effects and can drastically affect lifestyle choices. And yet half of sufferers are not doing anything to combat the disease because they don’t know they are sick.
$5.60 / $1
This is the return that a community-based preventative programme could offer, according to a report published by “Trust for America’s Health”. Investing just $1 would result in savings of $5.60, in terms of health costs. According to the authors of the report, “an investment of $10 per person per year in proven community-based programs to increase physical activity, improve nutrition, and prevent smoking and other tobacco use could save the country more than $16 billion annually within five years. This is a return of $5.60 for every $1.” When money is spent efficiently in problem areas, the return on investment is very strong.
For the Hearty Lives Carrickfergus project, approximately £230,000 were spent to benefit over 6000 local people over three years. This equates to £37.09 per person: this is the equivalent of about five pilates classes (with this trainer for example – this link is for illustration purposes only) or six trips to Weightwatchers (again, the link is only for illustration purposes – I am not affiliated to any of these providers).
I have attended Pilates classes, and I’ve been to Weightwatchers meetings: they are certainly beneficial, but the impact is quite short-lived unless you have the discipline to follow up. Instead, the Hearty Lives programme brought tangible, long-term results for the same cost, over three years – not six weeks.
Compare this to the cost of childhood obesity, as reported by Duke Global Health Institute and Duke-NUS Graduate Medical School in Singapore: childhood obesity ends up costing $19,000 per child over a lifetime. I think we can talk about a satisfying ROI here…
All is not lost, though: this number is really encouraging. It’s the decline of heart disease deaths in Northern Ireland since the 1960s. In other words, today the number of people dying from heart disease is only one quarter of what it was fifty years ago. Cardiovascular disease deaths in Northern Ireland have been reduced to a quarter of what they were in the 1960s.
This is another encouraging result: between 2008 and 2012, full compliance with school lunch nutritional standards increased from 66% to 69%. The same report from the Food in Schools programme established that children are having less unhealthy snacks at breaks, and that these are replaced by healthy snacks.
In other words, the challenges are many, they are big, and they are life-threatening (literally), but awareness of the issue is growing and preventative public measures are building momentum – and showing results.
So how did the Hearty Lives Carrickfergus programme do,
in view of these mighty challenges?
The programme consisted in several projects, aimed at soon-to-be parents and mums, young mums and families with very young children (under 4). They included walks, “buggy workouts”, cookery classes, communication with pharmacists and healthcare professionals, and information distributed in the form of leaflets, posters and toolkits. The emphasis was very much on helping young parents give their children a healthy start in life in order to fight against childhood obesity.
The results of the projects were very positive.
Did people lose weight? Yes, they did – but that’s not even the best part of it.
Non-quantifiable benefits magnify the narrowly understood benefits
During my discussions with the key stakeholders and wide research around the theme, I felt it imperative to examine the non-quantifiable benefits of such a project.
Large social impact on communities
With Hearty Lives Carrickfergus Community Events, communities worked together with the objective of making things better for the next generation. Parents engaged with medical professionals, children played with their neighbours, new grandparents met other new grandparents.
Whole communities came together and forged deeper bonds, all in the pursuit of a better, healthier future for themselves and their children.
Collective confidence boost from remarkable achievements
People lost weight, learned new recipes and ways of cooking, and felt better able to cook healthy, nutritious and cost-conscious meals. They built confidence taking their babies and young children through activities that helped their development.
Building trust throughout the community
The project put a strong emphasis on two-way communication between the public and healthcare professionals. New parents were able to turn to knowledgeable professionals with any questions about their baby’s health and development, and medical professionals reached a greater understanding of the issues that parents face today. Children made new friends in their area.
Several segments in these documentaries are filmed in local parks, to illustrate physical activity. Apart from the all-important issues of lifestyle changes, health and healthcare issues, what struck me was the way family exercise and family activities are an irreplaceable way of making memories. Fathers playing ball and running with their children. A mother walking her unsteady toddler with a baby strapped to her chest. A couple walking hand-in-hand taking turns at throwing a stick for a dog. This is what family exercise looks like!
Good habits start early
It’s far too early to consider this aspect of the project, but good household habits picked up during the Hearty Lives campaign are very likely to endure and be passed down to children, who will then implement them in their own lives as adults. I conducted an interview with a mother of young children and it really brought home that there isn’t any standardized formal training for how to feed your children. Very often the way we know is “what we were used to at home”. Better habits learned during the programme are very likely to be replicated in the households of the children of Hearty Lives participants.
Being part of a group with the same objective is essential to success
Over the years, I’ve found myself as part of many communities; the business world, the Irish abroad, the CFA institute, women who want to make a global difference, building teenagers careers, communication and confidence as well as personal ones.
There are countless benefits to feeling part of a larger group, being among people who understand your dreams and challenges. It’s essential to our success to be able to turn to somebody we can trust when we’re feeling uncertain and overwhelmed, or when we want to celebrate an achievement.
This project created a community of people who wanted to learn how to create healthier environments to bring up their kids; it brought together different members of a community through a most positive common connection.
The health benefits will grow and multiply over time: healthy eating is how you achieve lower rates of unhealthy blood pressure and cholesterol, diabetes, cardiovascular disease, osteoporosis and many other diseases.
Finally of course, this project gave rise to
– a community wide conversation,
– that led to action,
– that led to change
– that will lead to lifelong results for all those concerned.
Childhood obesity: it starts with me – it starts with you
Once I had delivered my presentation, I could have given myself a mental pat on the back and go back to whatever I was doing. It would have been easy for me to walk away and think that this didn’t really affect me. After all, I’m not a mother of young children, so what has childhood obesity got to do with me?
But I wanted to think hard about what I could do, as an individual. I could write an article, send it to those who read my newsletter and share it on social media with a view to raising awareness.
However, I realised that I can make a very concrete, tangible impact by, for example, rethinking my house gifts. It’s easy to pick up a bottle of wine or a cake to give to the host when I’m invited to a dinner party or a catchup coffee. It sounds innocuous – but it adds up.
Instead of the cake or the wine, I can get some gourmet food. If I’m visiting a friend who does have young children, it’s quite likely that they haven’t a minute: I could make some healthy, nutritious dinners that could be spread over three nights. Does it sound weird actually bringing cooked food to a host? It feels weird because it’s a new behaviour – and behaviours are exactly what we need to change, if we want to have a chance against childhood obesity. I tried this out and I got a most gracious response!
Another idea was to use my social media platform to promote healthy eating. For example, I always stay at the Ballylagan Organic Farm when I’m in Belfast as it has the most faboulous home-made food, all grown on their own farm. When I was in Chicago, I came across LYFE and they have a very interesting concept: at their restaurants you can get your food “under 9 minutes, under $9, under 900 calories”. I also love the fabulous, fresh, diverse salad offering that the people of Chopped have brought to various parts of Dublin.
Finally, I can be a good “peer”, applying positive, non-judgmental peer pressure in the form of “nudges”: if I choose the fish or the grilled option when ordering in a restaurant, I tacitly encourage my dinner companions to do the same. How often have you chosen the “unhealthy” option because “you didn’t want to be a killjoy”? If somebody else at the table orders the healthy food, it can be enough to steer us in the right direction when making a split-second decision. If, at a coffee meeting, I politely decline the scone with “No thank you”, I’m empowering others to do the same and not feel that it would be rude to say no. If I share positive stories of exercising, of finding it fun, I can give other people ideas for sports or types of exercise to try out that they hadn’t previously considered.
We very often underestimate the impact we can have at a very personal level. The task seems enormous (and for childhood obesity it can certainly seem to be), so we discount any tiny step that we could take. A more realistic approach is to admit that we don’t know everything. You certainly never know who you can influence simply by living well!
And at the community level?
So that’s the very granular level of what you and I can do: small individual steps that all add up. How about the higher level of entire communities and institutions? If fighting cardiovascular disease and childhood obesity is achieved through personal lifestyle changes, how is that a concern of institutions? Can institutions help individuals?
1. Entrepreneurs and businesses could work with universities to commercialise research. It’s likely that there are key strategies, tools, services, that have already been developed to improve peoples’ health and lifestyles. They’re sitting on the shelves of universities and research institutions all over the world, but they need some help reaching the wider public. There is a lot of funding available to make this happen through Innovation Partnerships.
2. Policy makers can use the resources of the European Association for the Study of Obesity as well as engage with the organization to inform and influence how the body goes about its work. The Association organises a plethora of conferences all over Europe that discuss the subject and deliver masterclasses.
3. Companies can seek to take part in the convenience trends that are creating new commercial opportunities. We’ve heard the “X is the new Y” mottos: each of them is an opportunity waiting to be tapped in the form of new products, apps, utensils, you name it. For example, “souping is the new juicing”, according to Global Food Forums while “sugar is the new fat” and “sitting is the new smoking”. If the business community sits up and takes note, they can anticipate patterns that are forming right now, and they can participate in profitable trends.
4. According to Jenna Hall, Programme Director for the National Charity Partnership, “young families often have the unhealthiest shopping baskets”. This sad fact can have many causes, but it can also have many solutions. How about employers presenting new parents or expectant mothers about to go on maternity leave with healthy food hampers, complete with recipes, ingredients and storage instructions? As the Carrickfergus project has shown, targeting pregnant women and young mums is crucial to tackle childhood obesity. We need to do everything we can to help out young mums: grocery shopping and meal planning take time and energy that new parents, and especially new mums, simply don’t have.
5. Team leaders can’t always afford to give their staff time off, but they can empower them with time saving benefits at home. If a pay rise isn’t possible, companies could invest in a health box subscription, like that offered by Life Kitchen, as a benefit for staff. Employees would get healthy, nutritious, freshly prepared food on a daily basis, saving them the time of cooking it, the expense of buying it and the energy wasted on low quality convenience food.
6. Facilities managers can reconsider the food choices they offer in canteens by discussing fat content, calories, ingredient choices, etc. with their suppliers, so as to make it easier for staff to eat healthily at work.
7. Any individual can sign up for a local mini marathon or sporting charity event and encourage other members of their family, circle of friends, FaceBook friends, colleagues, etc. to take part and get moving!
8. An entire region can decide to get together and make a concerted effort to achieve something. For example, on 8th January Ireland made a “New Year’s resolution” to lose a million pounds.
9. Anybody with charisma, initiative and a sense of fun can get a group of people together to break a world record. For example, a smoothie with the most amount of fruit, the largest number of people simultaneously doing jumping jacks or the most children making vegetable shapes!
10. Schools could work with local supermarkets to organize food tastings. In many houses, children may never have tasted certain fruits, vegetables, lentils or other dishes. If kids go home and tell their parents that they like something, this can be a practical step towards healthier food choices. Very likely the parents will thank their good fortune that the child themselves came up with dinner ideas that will not start dinnertime arguments!
Are you on the list?