Why Are Obesity Rates Rising

The Committee ApproachOBESITY RATES:• - Has become an epidemic in Canada• - Canada has one of the highest rates of childhood obesity in developing world (5th

out of 34  OECD countries)• - 26% of Canadians aged 2-17 are overweight or obese• - 55% of First Nations on reserve and 41% of Aboriginals off reserve are overweight

or obese

CHILDREN:• - Obesity as a child increases risk of obesity as an adult• - Fears of children of our generation having a shorter life expectancy then their

parents

RISKS OF OBESITY AT YOUNG AGE INLUDE:• - Many chronic diseases and premature death• - Serious enough for adults, yet pose even grater threat for children• - Could develop Type 2 Diabetes, heart attack and stroke susceptibility, joint

problems, and  mental health issues

THE COMMITTEE APPROACH:• -Gain better understanding of obesity in children• -Particular focus on First Nations and Inuit children• - From September 2006 to February 2007, the Committee aimed to: gather

information on the dimensions of the overall situation; understand the  influence of a wide range of health determinants; examine the approaches  adopted in the provinces/territories and relevant countries; and define the role of the federal government in this area.

• - Committee went beyond the health community to hear about the roles in income, education,  social and physical groups, health pros, nutrition and sports groups, municipal and  provincial governments, food security initiatives

• - Invited wide comprehensive approach to this serious problem of childhood obesity. Finance Canada, Indian and Northern Affairs Canada, Sport Canada, Heritage Canada,  Infrastructure  Canada, the Canadian Food Inspection Agency, the Canadian Radio-Television and  Telecommunications Commission and Statistics Canada talked about their role in federal  action on healthy weights for kids.

Children aged 2 - 17 in 1978

Overweight (12%)Obese (3%)

Normal (85%)

How Serious is the Problem?

Children aged 2-17 in 2004

Overweight (18%)

Obese (8%)

Normal (74%)

• While increases in overweight and obesity are similar among boys and girls, trends do vary with age. For example, the proportion of children aged 2 to 5 years who were overweight or obese remained virtually the same from 1978 to 2004 (around 21%). In contrast, the overweight/obesity rate in the other age groups doubled in the same period, from 13% to 26% for children aged 6 to 11 years and from 14% to 29% for adolescents aged 12 to 17 years. The adolescent obesity rate alone tripled from 3% to 9%.

• The situation for Aboriginal children is the most alarming. Some 55% of First Nations children and 41% of Aboriginal children and adolescents living off-reserve are either overweight or obese. First Nations children aged 9 to 11 years are twice as likely to be overweight as their 3 to 5 year old counterparts (29% versus 13%). Younger First Nations children, however, are more likely to be obese than the older children (49% versus 26%). Unfortunately, no comparable data currently exist on the prevalence of overweight and obesity among Inuit children.

National Overweight and Obesity Rates (2004) Age 2-17

National Average 26%

Newfoundland and Labrador 36%

New Brunswick 34%

Nova Scotia 32%

Manitoba 31%

Quebec 23%

Alberta 22%

P.E.I 30%

Saskathcewan 29%

Ontario 27%

British Columbia 26%

• The Committee was surprised that, although childhood overweight/obesity is rising, there is a major gap between that reality and the perception of Canadian parents about the weight of their children. The Committee heard that one survey indicated that only 9% of parents of children under the age of 18 years identify their children as overweight or obese. This contrasts to the actual combined rate of 26%. This lack of recognition, or denial, raises a significant challenge in increasing parents’ awareness, and it poses an even greater risk to the health of Canadian children. The Committee heard that, as overweight children of today become tomorrow’s obese adults, the burden on the health care and social systems is expected to increase. One estimate suggests that obesity in the overall population currently costs Canada about $1.6 billion annually in direct health care costs, or 2.4% of total health care spending. In addition, there is another $2.7 billion in indirect costs associated with obesity, including lost productivity, disability insurance, reduced quality of life and mental health problems due to stigmatization and poor self-esteem.

Why Are Obesity Rates Rising?• Low levels of physical activity and unhealthy eating habits.• Calories consumed much higher than calories burned.• Caused by: Economic status Social & physical environments Genetics Education Culture • Affect both children and parents.

Level of Physical Activity• Only 49% active during leisure time.• Consistent in rural, urban, and aboriginal communities alike.• Girls report less physical activity than boys.• Most Canadian children do not get 90 minutes a day.• Only 21% meet international guidelines for daily activity.• 6-11 year olds who have more than 2 hours of screen time were

twice as likely to be overweight or obese.• Children with inactive parents are likely to follow that lifestyle.• Lower socio-economic status neighbourhoods = Higher obesity

rates.

Food Intake• Too many calories consumed because of increased portions,

increased intake of fatty and processed foods and greater consumption of sugary drinks.

• Sugary drinks = 1 pound of weight gained per month• 60% of 2-17 year olds eat fruits and veggies less than 5 times a

day.• Children who eat fruits & veggies less than 4 times a day were 9-

10% more likely to become obese.• Sweden, Norway, and Quebec have banned advertising of high-

calorie and low-nutrient foods and beverages to children.• United Kingdom banned all advertising of food and beverages

high in fat, salt, and sugar in programs that many children watch.

What Determines Healthy Weights? Eating habits

Convenience has become one of the main criteria’s for childhood obesity.

It has become of more convenience to consume low cost, low nutrition, easy to prepare foods, away from home or ready-to-eat meals brought home.

Parents are more inclined to give their children low cost sugary breakfast meals instead of preparing a healthy balanced

breakfast due to their work schedules.

Children develop a lack of understanding towards nutrition due to their parents’ own inadequate understanding.

This leading to….

ParentsParental influences shape the eating habits of youth including;  the

choice of an infant feeding method,  the foods they make available and accessible, the amount of time children are left unsupervised and their eating interactions with others in the social context. 

Children’s understanding of nutrition is then left for media, and mirroring their peers.

Studies reported that parents who ate diets high in saturated fats also had children that ate diets high in saturated fats.  

 -This observation is not merely due to the foods parents feed their children, but rather due to the preferences children develop through exposure to foods that their parents prefer early in their lives.

Studies have determined that parents who attempt to encourage the consumption of food(s) may inadvertently cause children to dislike the food.

Parents & CultureWitnesses noted the need to be specific and sensitive

todiverse communities, recognizing cultural food habits

and physical activity patterns

One witness presented evidence suggesting that, for South Asian children, cultural food preferences could contribute to childhood overweight and obesity.

Awareness and understanding of healthy eating habits and food preparation in urban settings is actually a learned skill.

 -Traditional knowledge passed down from grandparents to the young is not useful in urban settings and families who move actually have to re-learn what is nutritious and how to feed families.

CostIt is much more expensive to purchase nutritious food items such

as: leaner cuts of meats, fresher and organic vegetables etc.

-Studies and observers have shown that households with lower incomes purchase cheap meats such as fatty pork cuts instead of lean beef and often stay away from fresh vegetables because of high costs.

Food-basket studies indicate that northerners pay far more than southerners for the same basket of food. For a family of four, the northern food basket in Kugaaruk, Nunavut, costs $327 weekly,

an amount double that of Edmonton

Low household incomes cannot afford to get their children involved in organized sports: trends and studies have shown to prove that children are most sedentary after school, which is most of the time when organized sports take place.

Trends have shown that low household income have parents working fulltime and overtime.

This can lead to....

 -Children left unsupervised after school may make poor nutritional choices and engage in more sedentary activities.

 -Child care providers may not offer as many opportunities for

physical activity and may offer less nutritious food alternatives.

-Unsupervised children may spend a great deal of time indoors, perhaps due to safety concerns, watching TV or playing video games rather than engaging in more activities outdoor.

SafetyIn urban and suburban areas, the developed environment can create

obstacles to being physically active.

In urban areas, space for outdoor recreation can be scarce, preventing kids from having a protected place to play

- neighbourhood crime, inadequate lighting, isolated areas.

Even lack of street lighting may also inhibit children from being able to feel they can walk safely outdoor

- This also affects the parents’ encouragement towards their children to be active outdoors as they feel it is unsafe to do so. Which repeats the trend.

Urban areas have busy traffic which can impede commuters from walking or biking to work as a means of daily exercise.        **A child is more likely to find another means of transportation to school other than engaging in physical activity such as walking to or biking because it is unsafe and their parents are apprehensive towards the neighbourhood environment.    -about 27% of those living in low socio-economicneighbourhoods report that there is a lack of safe parks and playgrounds in theirneighbourhoods, compared to 9% in the high socio-economic neighbourhoods.

The health Committee has seen that people who live in walkable neighbourhoods are 2.4 times more likely to get the recommended

amount of physical activity.

- Every additional hour spent in a car is associated with a 6% increase in the likelihood of being obese.

- -Each additional kilometre that people walk translates into about a 5% reduction in the odds of obesity.

GeneticsThere is an abundance of evidence that supports genetic susceptibility as an

important risk factor for obesity.

Family studies strongly suggests that biological relatives exhibit similarities in maintenance of body weight, and that heredity contributes between five and 40

percent of the risk for obesity-there is a 75 percent chance that a child will be overweight if both parents are obese, and a

25-50 percent chance if just one parent is obese.

Though this relationship is well established, the role of genetics in obesity is actually complex.

-The main reason why the percentages are so great is because of one of the main reasons, lack of knowledge and enforcing nutrition

-Genetic susceptibility to obesity in most cases is due to multiple genes that interact with environmental and behavioural factors.

What we can do?• Endeavours that recognize the influence of multiple sectors health,

education, environmental, social services, agricultural, transportation, community infrastructure

• Interventions must take place at all levels — individual, family, community, school, municipal, provincial/territorial and federal, as well as extending into the international sphere where globalization of markets and media advertising play a role.

• Against adopting measures that would stigmatize obesity or demonize food

• Witnesses were frank about the fact that, while some initiatives might yield unexpected results and might be limited in their scope, all had the potential to produce benefits and all provided a measure of learning for others involved in the promotion of healthy weights for children. They emphasized that it is rare for one intervention to demonstrate a direct link or change to weight.

• Have government funded programs that raise awareness through education (i.e problems of obesity, the weight it carries on the health system)

• Have government promote opportunities for lower income families to enjoy physical education (i.e tax breaks, sports opportunities, funding)

• Raise public awareness of key issues (i.e why the health system is a wreck, and what people can do about it)

• Include programs that include special needs as well as special populations to enjoy physical activity

• Include programs that include minorities and other populations

• Develop cultural relationships with sports and its benefits (i.e - teamwork leadership, excellence)

• Award sports excellence

• Tax breaks on people who participate in physical activity

• Nutritional education (i.e how to make healthy food easy, cheap healthy food, promotion of healthy gardens)

• Cooking in the kitchen instead of eating out

• Making healthy food cheaper

• Make healthy food visible and easy to grab/packaging and education on how to read food labels

• Adapt to cultural food needs 

• Have schools promote cultural food and healthy food

Issues Specific to First Nation’s People 

There is a need to provide a separate focus for First Nations and Inuitchildren:• Prevalence of childhood overweight and obesity among these

populations is twice that of the general Canadian population. About 55% of First Nations children on reserve and 41% of Aboriginal children living off reserve are obese. First Nations children aged 9 to 11 years are twice as likely to be overweight as their 3 to 5 year old counterparts (29% versus 13%). Younger First Nations children, however, are more likely to be obese than the older children (49% versus 26%).

• The increased rates of overweight and obesity in First Nations children translates into higher incidence of Type 2 diabetes (not a reportable disease) by the time they reach adolescence.

• 40% of caloric intake is from sugar, fat, high refined sugars and junk food

• Eating less high quality foods affects the rising obesity rate

• Low income is a large barrier to a healthy lifestyle

• Many first nations schools lack proper facilities to promote and ensure healthy lifestyles

• Not much awareness and publicity about health

• Change in the environment has made the availability of traditional foods and associated traditional physical activities go down

• Want to keep traditions without seeing the negative effect to their health

• Language is a barrier

What we have done so far...- Government plays a large role in guiding the nation towards a healthy lifestyle; each of the government 'groups' must come together to achieve optimal success

- The government needs to address obesity concerns and acknowledge the fact that it is a long-term battle

- The Canadian Government has taken the first step in promoting healthy eating and exercise through the Canada Food Guide and also DPA in all schools.

What else we can do..- Inuit and first nation children are primary risks of obesity; this could be due to numerous of reasons such as living on a reserve or lack of financial aid. We need to reach out to those whom are isolated.

- The government can create a budget to allow more kids who come from lower class families to have the opportunity to play sports.

- It is vital that knowledge is spread about WHY it is important to be healthy and the domino effect that it has on many areas of your life.

- Spread word about financial aids the government is providing for active kids such as the ParticipACTION and also the Children's Fitness Tax Credit.

FIN