OBESITY:

A growing problem in Ireland Obesity

Slide 1: Thank you for coming to this important presentation. The fact that you are here indicates that you are interested in one of the most important issues facing our Nation todaygrowing problem of obesity in Ireland. The reality is, we and in particular our children are facing a health crisis. Schools, workplaces, communities all play an important role in addressing the crisis. But they cant do it alone. Our nations children need you.1

OverviewNature of the problem

Causes & Consequences

Are people aware?

What can Nutrition Education do?

Final thoughts!

Slide 2: Over the next 15 minutes, we will explore the multifaceted and complex subject of obesity and how Ireland will be one of the leaders on the obesity prevalence table. That is not a race we want to win. We have heard the statistics time and time again, but now it is time to get to grips with the extent of the problem and come together to discuss practical solutions. Specifically we will look at how Nutrition Education can help tackle this urgent issue and the reasons why it should be included in national policy.

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Nature of the problem

Ref: Health Survey NI, 2011/12 & National Adult Nutrition Survey, 2011

Slide 3: The issue of obesity is described by the World Health Organization as one of the most serious public health challenges and is at epidemic proportions among adults and children on the island of Ireland. With a growth rate of 1% every year, tackling the obesity issue among adults and children requires a sustained, long-term effort and a true partnership approach that empowers people to take little steps towards a healthier and happier future. On the island of Ireland (IOI), currently 2 out of every 3 adults are either overweight or obese.3

Alarming Statistics

Childhood Obesity: 1 in 4 children are classified as overweight/obese.

WHO Modelling Obesity Project predict that 89% of men and 85% of women will fall into the category of obese/overweight.

Slide 4: This trend is also seen in children; 1 in 4 children are either overweight or obese. In 2030, the proportion of obese and overweight men in Ireland is projected to rise to 89% with a corresponding 85% of women falling into this category (unpublished estimates are part of the WHO Modelling Obesity Project).

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Causes

(Ref: Obesity System Map, UK Government Foresight Programme, 2007)

Slide 5: This diagram, the obesity system map was developed to understand the wide range of different factors that influence obesity and and how they interact. But more than that, it illustrates how incredibly complex obesity is, which raises the question of how do we tackle this problem effectively, what do we prioritise and where should funding be directed? Some of the immediate causes relate to food consumption, diets are falling short of the mark with increased intake of energy dense food. Underlying reasons could relate to the access and utilisation of fresh, healthy food which may be more expensive and less convenient. What about cooking skills? Or if we take the activity environment it could relate to the cost of getting exercise (gyms) or lack of safe spaces in the city to exercise. Or it could relate to the market price of food. We have socio-cultural and political influences..the power of food advertising, poor nutrition labelling, poor dietary practice and behaviour learning in our curriculum. These are just to name a few! However the positive is that Nutrition Education can influence all these factors in a positive way, for example, making informed decisions around food choicegoing for the healthy option5

Health ConsequencesReduced quality of life.

Micronutrient deficiencies

Increased risk of diet-related non-communicable diseases, for example, Type II Diabetes.

Severely obese people on average die 8-10 years sooner than people of normal weight. (Ref. Policy Group on Obesity, 2014)

The health consequences can be life-changing. There is a major psychological impact and a reduced quality of life. People who are classified as obese may also be victims of hidden hunger in that they could be deficient in essential nutrients such as iron. 42% of Irish women have iron levels below the AR which indicates that a large proportion are at risk of developing iron deficient anaemia. There is also the increased risk of developing diet related diseases such as Type II Diabetes, Heart Disease, some types of Cancer. It is reported that severely obese people have a premature mortality similar to smokers and on average die eight to ten years sooner than people of normal weight. Although not listed here, maternal obesity in Ireland is associated with an increase in medical complications.6

Economic Consequences

Increased cost of health and medical care and increased pressure on the health services

Costs the Irish state an estimated 1.13 billion in 2009

If overweight/obesity reaches the 90% predicted by 2030, direct healthcare costs alone will reach 5.4 billion. (Policy Group on Obesity, 2014)

Ireland is facing a costly future in terms of health and economic effects of obesity. The cost of obesity to the state in 2009 was estimated at 1.13 billion in direct and indirect costs. If prevalence of overweight and obesity reaches the 90 per cent predicted by 2030, direct healthcare costs alone will reach 5.4 billion. However, if action is taken to reduce BMI levels, the potential savings are significant; a 5 per cent reduction in overweight and obesity levels will result in savings of 495 million in direct healthcare costs over the next 20 years.7

Are people aware?Overweight/obese is seen as the norm: 74% of parents of overweight/obese children think that they are about the right weight for their height.

Some (67% of those surveyed) have tried to lose weight in the past, but have lapsed (Safefood)

Some may identify the problem, but nutrition and health are not the priorityYeah well Im not thinking longterm, Im just trying to get by, day byday, Rent, heat and electric come first

There seems to be various levels of knowledge, awareness, attitudes and perceptions in the Irish population. The following are some snapshots. For example, overweight and obesity is seen as the norm. In a recent Growing Up in Ireland study, 54% of parents of overweight children and 20% of parents of obese children report that they are about the right weight for their height. Safefoods (state body that promotes nutrition/food safety) own consumer research indicates that 67% of people surveyed have tried to lose weight to feel better about themselves, 62% wanted to improve their figure and 48% wanted to have more energy. For those who were unsuccessful in trying a sensible approach to successful weight loss to lose weight, the main reasons cited were a lapse in their diet over a holiday period such as Christmas or summer holidays (21%), becoming bored or not seeing any results (18%) and not having time to cook healthy food or to exercise (17%). Due to the increased cost of living, others may not consider nutrition and health as the main priority. 8

What can Nutrition Education do?

Well designed nutrition education interventions/programmes can contribute to preventing overweight/obesity, both on their own and in combination with other kinds of intervention. However, NE is needed at all levels, from the individual to improve or harness their knowledge, attitudes & perceptions and skills around eating for long term health; to public policy which can emphasise the importance of NE and nutrition in a national policy. If families want to eat healthy food, we need to ensure that our environment encourages that.9

How? Examples

Schools: Bring back Home Economics where students develop lifelong skills in cooking healthy meals. Improve the school nutrition environment where healthy lifestyles are easy to adopt and consistently reinforced, not just in the classroom.

Community, HealthCare & Workplace Settings: Support community food initiatives where people learn practical skills around growing, accessing and cooking healthy food; provide healthy options in hospitals and workplaces, emphasise the benefits of being a healthy weight. Make every contact count!

Some key examples are:Schools can make a difference in improving eating and physical activity patterns for long term health. The type of education is important, bring back Home Economics where students can develop practical skills as well as an understanding of nutrition and it applies to their health. If we are going to turn these negative trends around, we must take action to improve the school nutrition environment. A healthy school nutrition environment can help prevent health problems and help students have healthier, more productive lives. Schools are the perfect place to create an environment for children where healthy lifestyles are consistently reinforced, and easy to learn and adopt. We need your help to make our school a place where students can learn about, and participate in, healthy eating and physical activity.These Community Food Initiatives represent excellent examples of how local communities can work together to overcome some of the problems they face in accessing healthy, affordable food. Waterfords Ballybeg Family Growing Project which aims to engage local families in skills-based food education programmes and change food consumption habits from convenience foods towards more nutritious meals includes produce on the menu grown locally in the community garden. We could encourage a weight aware ethos in all clinical services, provide healthy options in hospitals, emphasise the benefits to mental wellbeing of being a healthy weight. Make every contact count!

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How? ExamplesPolicies & FrameworkProgress the new National Nutrition Policy and ensure that nutrition education is visible and concrete recommendations are made

Integrate NE in existing national framework, for example Healthy Ireland programme. Encourage dialogue with other sectors, agriculture, education, health and environment.

Education must be accompanied with changes in the food environment to effect positive long lasting change. Some public policy measures apply to food marketing, local area planning in terms of fast food outlets, places to be physically active etc.

As you may be aware a new national nutrition policy is currently being developed and from the last few slides I hope that you also consider that NE needs to be included. There are of course other avenues. Under the Healthy Ireland framework the government has expressed its commitment to increasing the number of adults with a healthy weight by 5% and the number of children by 6%, by the year 2019. Nutrition education can play a vital role in this. Some possible public policy measures include, prohibition of TV advertising of foodshigh in fat, salt and sugar (HFSS) up to 9pm and a ban on marketing of HFSS foods to children; monitoring by government of all approaches to food marketing, sponsorship, and brand management directly or indirectly aimed at children; introduction of a front-of-pack, traffic-light, food labelling system; consistent application and monitoring of local area planning guidelines on the location of fast food outlets throughout the country; built environment planning that facilitates and encourages people to be physically active including promotion of active travel through planning regulations and guidelines, and continued investment in necessary infrastructure. 11

Final thoughts

We have seen how complex the problem is, how it can negatively impact our economy but more importantly our health. Nutrition education is key in preventing obesity in the future and addressing it now. Its time to act. We need to take action now to create a healthier future, especially for our children. You can be a part of the solution. Thank you for your time and attention and I will now open up the floor to questions.12