References

Berk, L. E. (2010). Development through the lifespan (5th ed.). Boston, MA: Pearson        Education.

Clark, H. (2006). Mission on: Healthy lifestyles for young kiwis. Wellington, New Zealand. Retrieved from http://www.beehive.govt.nz/?q=node/27181

Dehghan, M., Akhtar-Danesh, N., & Merchant, A.T. (2005). Childhood obesity, prevalence and prevention. Hamilton, Canada: Nutrition Journal. Retrieved from www.nutritionj.com/content/4/1/24

Doheny, K. (2008). Stigma of obesity not easy to shed. Web MD Health News. Retrieved from http://www.webmd.com/balance/news/20080619/stigma-of-obesity-not-easy-to-shed

.

Harrison, P., Chalmers, K., D'Souza, S. Coveney, J., Ward, P., Mehta, K., & Handesley, E. (2010). Targeting children with integrated marketing communications. Adelaide, Australia. Flinders University. Retrieved from http://www.sahealth.sa.gov.au/wps/wcm/connect/0d3a6000490e3444b22ef67675638bd8/FU+Target+child+integrated+marketing-PHCS-HPB-201004.pdf?MOD=AJPERES&CACHEID=0d3a6000490e3444b22ef67675638bd8

Hancox, R.J., & Poulton, R. (2006). Watching television is associated with childhood obesity: but is it clinically important? Dunedin, New Zealand: Nature Publishing Group.

Harvard school of public Health. (n.d.). Sugary drinks and obesity fact sheet. Retrieved from www.hsph.harvard.edu/nutritionsource/sugary-drinks-facts-sheet

Mal, Y., Bertone, E.R., Stanek, E.J., Reed, G.W., Hebert, J. R., Cohen, N.L., Merriam, P.A., & Ockene, I.S. (2013). Association between eating patterns and obesity in a free-living US adult population. Oxford, England. Retrieved from. http://aje.oxfordjournals.org/content/158/1/85.long

Indonesia, P. (2011). Inspirational quotes and quotations on early childhood education for teachers. Retrieved from.. http://www.pestalozzi-indonesia.com/content/view/133/2/

Ministry of Education. (1996). Te Whaariki: He Whaariki maatauranga moo ngaa mokopuna a Aotearoa/Early Childhood Curriculum. Wellington, New Zealand: Learning Media.

Ministry of Health. (2004). Healthy Eating- Healthy Action: Organa kai-Oranga Pumau implementation plan. Wellington, New Zealand: Ministry of Health.

Ministry of Health. (2004). Tracking the obesity epidemic. Wellington, New Zealand. Retrieved from http://www.health.govt.nz/publication/tracking-obesity-epidemic

Ministry of Health. (2013). Obesity key facts and statistics. Retrieved from www.health.govt.nz/our-work/diseases-and-conditions/obesity/obesity-key-facts

Ministry of Business, innovation and employment. (2009). Identifying the resilience of the New Zealand work force in a recession. Wellington, New Zealand. Retrieved from.. http://www.dol.govt.nz/services/LMI/workforce2020/resilience-to-recession/resilience-to-recession_02.asp

Payne, D., & James, L. (2008). Make or break. Mothers' experiences of returning to paid employment and breastfeeding: a New Zealand study. 16 (2), 21-27. Auckland, New Zealand. Faculty of Health & Environmental Science AUT University.

TVNZ. (2010). One News: Recession causes kiwis to loosen their belts. Retrieved from.. http://tvnz.co.nz/business-news/recession-causes-kiwis-loosen-belts-3436552/video

Five Plus a Day. (n.d.). Retrieved from... http://www.5aday.co.nz/

Sport New Zealand. (2013). Push play campaign. Retrieved from. http://www.sportnz.org.nz/en-nz/communities-and-clubs/Push-Play/

McGraw-Hill (2005). American heritage dictionary. Retrieved from http://www.answers.com/topic/epidemic

World Health Organisation. (2000). Obesity: Preventing and managing the global epidemic. Retrieved from http://www.who.int/nutrition/publications/obesity/WHO_TRS_894/en/

World Health Orgainsation. (2013). Global strategy on diet, physical activity and health. Retrieved from. http://www.who.int/dietphysicalactivity/factsheet_young_people/en/index.html

The Heart Foundation. (n.d.). What can I do to reduce my BMI? Retrieved from www.heartfoundation.org.nz/healthy-living/losing-weight/bmi-calculator

The Heart Foundation. (2013). Healthy heart award for early childhood education. Retrieved from. http://www.heartfoundation.org.nz/programmes-resources/schools-and-eces/healthy-heart-award

Utter, J., Scragg, R., & Schaaf, D. (2005). Associations between television viewing and consumption of commonly advertising foods among New Zealand children and young adolescents 9 (5). Auckland, New Zealand: Public Health Nutrition.

Waikato District Health Board. (2011). Obesity, diabetes and fast food- the impact of marketing to children. Waikato, New Zealand: Health Waikato Caring For You.

In Conclusion

This blog has taken me on a journey exploring obesity, its causes and its implications for individuals, families and communities. I believe that with the right support and pressure the New Zealand government will be able to make positive steps towards fighting the obesity epidemic.

• Raising the tax on unhealthy foods (similar to that done with tobacco sales)

• Reducing advertising for takeaway foods in prime time television spots

• Creating healthy school environments, where canteens are no longer allowed to sell energy dense, nutrient poor foods (even reducing soft drinks sold in schools has the potential to make a significant difference)

• Increase promotion of physical activity in schools, currently it is only required to participate in physical education once a week until the age of fifteen, Ministry of Education, (2013).

These suggestions are ones that I have found myself supporting. I have been guilty of choosing the easy option when considering meal ideas for my young children, opting for McDonalds or cheerios instead of a well balanced meal.  Although I believe my children are aware takeaway foods are a treat, I am now going to reduce the frequency of which I buy it for them.

I am also endeavoring to adjust my own lifestyle for the benefit of not only myself but my own children, extended family and the children I teach.  Small changes such as only drinking water at work, walking when possible, eating breakfast, and being more involved in physical activity experiences with children, all have the potential to ensure I am being a positive role model throughout my work and home environments.

I leave you with the top five tips compiled through this research to making healthier life style choices

1. Choose water over soft drinks- one can of Coke contains approximately 10 teaspoons of sugar.
2. Push play for 30 minutes each day- this can be anything from taking the stairs at work, to vacuuming, walking to collect children from school, mowing the lawn, or simply going for a walk.
3. Do not skip meals in the hope of losing weight - research has shown that the chances of binge eating and weight gain are heavily increased when meals are skipped.
4. Aim to consume 5 different types of fruit and vegetables every day- these will provide varied vitamins and minerals essential to a healthy body and mind.
5. Think of the children in your whanau - our biggest hope in fighting the obesity epidemic is through our children, their lifestyle choices when they are older have a direct link to those when they are young. . . create a healthy environment for your whanau to learn in.  

Throughout my research on obesity there is one specific element that has been mentioned in the majority all of the readings and websites. . .  Fast Food.

Fast food has been mentioned in conjunction with over eating, energy dense poor nutrient meals, soft drinks, large portion sizes and meals high in saturated fat & sodium.  There is also a strong link between obesity and the marketing of fast food restaurants and soft drink companies, this is especially relevant when delving into the causes of childhood obesity (Utter, Scragg & Schaaf, 2005; Hancox & Poulton, 2006; Havard school of public health, n.d.).
  
Fast food has been imbedded in New Zealand 'Kiwi' culture for many years; fish and chip Friday has been a routine meal for the first nineteen years of my life.  However fish and chips are now only one of several takeaway options, these options in some cases are open twenty four hours a day, seven days a week, three hundred and sixty five days a year.  This degree of choice and availability adds and extra layer to why there is now a prevailing obesity epidemic in New Zealand.

An important tool fast food chains use to bring customers in is saturation marketing directed at children.  This form of marketing  has ensured that the majority of children recognise the McDonalds symbol before they even recognise their own name (Harrison, Chalmers, D'Souza, Coveney, Ward, Mehta & Handsley, 2010).  Advertisments like the one below incorporate symbols, colours and tunes which are catchy and memorable for children and families. I saw this advertisement and immediately remembered the song.

As a result of this type of marketing and the exposure children have to advertisements through television watching one of the suggested first steps to begin to alleviate obesity in children is to limit the time allocated to watch television (Utter, Scragg & Schaaf, 2005).  
   

Overweight or obese?

How do I know if I'm obese or overweight and what consequences might this have?

Obesity is often diagnosed through Body Mass Index (BMI).  BMI is calculated by dividing weight in kilograms by height in meters squared. Although this method is most often accurate in determining whether an individual is obese, there has been some debate into its accurateness in all circumstances as a BMI reading does not account for muscle mass; if doctors were to go off BMI alone a majority of professional athletes would be classified as obese.

International cut-off points for adults aged 18 years and over

Classification	BMI score (kg/m2)	Risk of co-morbidity (multiple diseases)
Underweight	< 18.50	Low risk (but risk of other clinical problems increased)
Normal range	18.50–24.99	Average risk
Overweight	25.00–29.99	Increased risk
Obese: Obese (class I) Obese (class II) Obese (class III)	≥ 30.00 30.00–34.99 35.00–39.99 ≥ 40.00	High risk Moderate risk Severe risk Very severe risk

(Ministry of Health, 2013)

What is your BMI? Click here to find out

Obesity is a serious modifiable issue that can not only effect the health and well being of individuals, but can also place pressure on communities and health systems. People who are obese are at increased risk of type 2 diabetes mellitus, ischaemic heart disease, ischaemic stroke in addition to some common cancers (Ministry of Health, 2004). Public health systems are being stretched to cover the growing number of medical interventions required in managing the disease (Ministry of Health, 2013).

Importantly obesity is also noted to be detrimental to an individuals psychological well being; bullying, poor self esteem, lack of positive reciprocal relationships along with being stereotyped as lazy are all issues obese individuals often struggle with on a regular basis (Komesaroff as cited in Doheny, 2008).  The Ministry of Education is acknowledging the seriousness of this issue and have a page dedicated to the help and support of obese and overweight New Zealanders who wish to make a change.

Is the obesity epidemic really stuck with us or does New Zealand hold the power to change?

  

Where to from here?

With the cause of obesity being predominantly linked to an excess consumption of poorly nutritious foods accompanied by an inactive lifestyle, the Ministry of Education (2004) has recognised the importance of education in the fight against the obesity epidemic.  

 “Beginning nutrition education in early childhood is an important part of helping to ensure that children will achieve healthful lifestyles”    Robert Earl

 

Obesity in adulthood is often a result of childhood obesity (Ministry of Health, 2004). This is because it is through childhood experiences and environments that individuals establish habits and beliefs which in turn have a profound effect on their adult lifestyle choices (Berk, 2010; Leaity, 2008). 

Through the Healthy Eating – Healthy Action Strategic Plan, young children are being specifically targeted as a priority group for the education on the importance of healthy food and activity choices (Ministry of Health 2004).  This targeting is in the hope that education as children will lead to a healthier lifestyle choices throughout their lifespan and will result in a substantial decrease in obesity.  
 

Other initiatives designed to enhance healthy choices and lifestyles for the New Zealand are the 5 + a day campaign, push play, and the Mission On initiative which although was implemented in 2006 is still being carried on today.  

Early childhood education is also a profession who are going to great lengths to promote the healthy choices and lifestyles throughout their programs.  It is common practice within early childhood centers to create a policy surrounding healthy eating and active movement (Ministry of Education 2013).  The Ministry of education (1996) acknowledges the importance of promoting children's health through the well being strand. The promotion of the heart foundations healthy heart award is also bringing placing a heavy emphasis on healthy food choices and physical activity within early childhood centers not only for the children but also whanau and wider community.

 

 

Why has obesity become an epidemic in New Zealand

Why has obesity become an epidemic in New Zealand?

Dehghan, Akhtar-Danesh & Merchant (2005) describe the cause of obesity as “energy intake exceeding energy expenditure”.  However factors such as genetics, environment, lifestyle, and culture also contribute to the growing prevalence of obesity (p.3).  The Waikato District Health Board (2011) has described the three main causes of obesity as:

• Human biology: an individuals own genetics and metabolic rate have an effect on their weight
• Eating behaviour: what an individual eats and how much
• Physical activity: how much activity an individual undertakes

The Waikato District Health Board (2011) does go on to admit however that due to the “growing prevalence of obesity it is unlikely that genetics is the main cause of the epidemic” (p.4) and that eating behaviours are the main contributing factors to the obesity epidemic (Ministry of health, 2004; Waikato District Health Board, 2011; Dehghan, Akhtar-Danash, Merchant, 2005; Berk, 2010). 

The term eating behaviours includes food choices, portion sizes, frequency of eating and fad dieting and breakfast skipping (Ma, Bertone, stanek, Reed, Herbert, Cohen, Merrriam & Ockene, 2003). There are a number of influences on individuals/families food choices, one of which is the increasing availability and affordability of convenience foods. These types of foods include takeaways, pre-packaged and heat and eat meals which are commonly high in sodium, sugar, and saturated fats; energy dense foods with little to no nutritional value (Ministry of Health, 2013). These foods however unhealthy are being consumed on a regular basis by many New Zealander's.  

One of the main causes for the growing consumption of convenience food is the expense of fresh foods (a head of brocoli at New World supermarket on the 29th of April is $2.49 while a large pizza at Domino's on the same day is $4.99). A lack of disposable income has become more and more common in New Zealand since the beginning of the recession in 2008 (Ministry of business, innovation and employment (2010) (see video)

As obesity occurs through high energy intake and low energy expenditure, food choices alone cannot be blamed for the increase of obesity in New Zealand.  The Ministry of Health (2013) shows through their 2006/2007 New Zealand health survey that one in ten adults are physically active for less than thirty minutes each week, and only eleven percent of adolescents surveyed met the recommended level of daily physical activity. To maintain a healthy weight, heart, to build muscular fitness and bone health the World Health Organisation (2013) recommends children between the ages of five to seventeen participate in sixty minutes of moderate to vigorous activity daily, while adults are recommended to participate in one hundred and fifty minutes of physical activity per week.  

When you consider this documented lack of activity by adults and children in combination with eating large quantities of energy dense, nutrient poor food both world wide (World Health Organisation, 2013) and throughout New Zealand (Ministry of Health, 2013) is it any wonder obesity is such a threat to the health of New Zealanders?  
         

  

      

  

Obesity - A global epidemic

What does this mean?

McGraw-Hill (2005) define a global epidemic as "problems that are geographically wide spread" (para 2) and fast spreading.  Obesity is defined by World Health Organisation (2000) being "a condition of abnormal or excessive fat accumulation in the adipose tissue (connective tissue consisting of mainly fat cells) to the extent that health maybe impaired" (para 1).

With these definitions in mind it is possible to explore the negative implications for both the obese individuals and collective society. 

I have found it easy to see the words 'global obesity epidemic' and not be concerned.  New Zealand has a small population of approximately 4.5 million people.  We are a country that prides itself on sporting ability and achievement, a country of farmers and a country with a beautiful outdoor environment with a wide range of action and adventure activities.  How could we really have an obesity problem?

Reading the statistics compiled by the Ministry of Health in 2006/07 and 2008/09 looking at adult and child obesity in New Zealand opens a completely different view into the life styles, genetics and health of some New Zealanders.  In the 2008/09 adult nutrition survey one in four adults or 27.8% were obese, 44.7% of Maori adults were obese and 57.9% of Pacific adults were obese.  Child obesity statistics are just as appalling with one in twelve children (8.3%) aged between 2 to 14 years recorded as being obese, in addition to this one in five children (20.9%) were overweight.  Pacific boys and girls were recorded as being 2.5 times more likely to be obese than boys and girls in the total population, along with Maori boys and girls were 1.5 times more likely to be obese (Ministry of Health, 2013).

Where to from here? These statistics bring to light a number of questions. What initiatives are the government putting into place to address this issue? How do these statistics influence and impact on the children's health, learning and development? What can we as a society, as families and as individuals do to recognise and change these staggering statistics?