Thursday 18 April 2013

My final thoughts...

Finally, this last blog post brings me to the end of my treacherous journey in exploring, discovering, examining, analysing, and critiquing, what I have found to be, the colossal social issue of obesity.

I have come to learn many new things about obesity, however the most astonishing fact of all is how fast obesity rates have increased over just the past decades. Which is why I have decided to take this information to the early childhood centre that I work at, in order to share some of the information I have discovered. I feel that this will encourage my colleagues to see the social issue of obesity from a different angle, as well as adding information to their forever increasing basket of knowledge.

In summary, I am so very pleased that I was able to research and analyse this topic, as it is an interest of mine, and as I am so passionate about creating healthy lifestyles for children. I have learnt so much about obesity, and have uncovered some astounding statistics that have opened my eyes to this epidemic that continues to grow before me. And so I am hoping that all the information in this blog, has also informed the readers of this blog, especially early childhood teachers who are also passionate about this subject.

So, may the following quote be an inspiration to all:



5 Years Old and Morbidly Obese


Are all children going to look like this in the future if we don't get our act together?

Pedagogical implications for early childhood teachers in Aotearoa, New Zealand

Early childhood is the most critical time for obesity prevention. Children are learning to walk and play, developing taste preferences, and eagerly mimicking both healthy
and unhealthy behaviours of their parents, teachers, and caregivers (Laughlin, 2010). In 2009, Statistics New Zealand conducted the New Zealand Childcare Survey (CCS) which aimed to find many things, one of which was the ‘Use of early childhood education and care for pre-school children’. Results illustrate that 53.9%, of the 308,800 pre-school children interviewed, “...attended at least one type of formal early childhood education (ECE) and care setting in the week prior to the interview, while 44.1% attended at least one type of informal care setting” (2009, p. 2). These figures suggest that on average, 88% of pre-school children attend some type of childcare. It is therefore vital for early childhood teachers to be aware of fundamental pedagogical implications in regards to the social issue of obesity. Thus the first and foremost pedagogical implication for early childhood teachers is therefore to remember the importance of keeping all children fit
and healthy. The Early Childhood Curriculum Te Whāriki (Ministry of Education, 1996) states that “...children develop knowledge about how to keep themselves healthy...[children also] develop positive attitudes towards [healthy] eating…” (p. 48). This is a responsibility for all early childhood teacher to carry out.
 
With this in mind, it is important to note that some ECE services provide all the meals, while some only provide morning and afternoon tea meals, and some do not provide any meals at all. In the services that do provide meals, there is often an employed chef who caters for the children. It is therefore imperative that the chef employed has current knowledge about food nutrition and balanced diets; thus ensuring that the health and wellbeing of all children is maintained to a healthy standard (Hayman, 2006). After searching for food and nutrition guidelines for ECE services, I was able to find many guidelines supplied by the Ministry of Health. The first guideline I found was the ‘Food and Nutrition
Guidelines for Healthy Children and Young People (Aged 2-18 years): A Background Paper’ which highlights that these guidelines “...aim to provide up-to-date, evidence-informed advice...for practitioners working with children” (2012, p. iii). This is therefore a document provided by the Ministry of Health to support early childhood teachers in their quest to prevent obesity in early childhood. Another document that I came across was the ‘Clinical Guidelines for Weight Management in New Zealand Children and Young People’ which was collated and provided by the Ministry of Health and Clinical Trials Research Unit, in 2009. These guidelines also “...aimed to provide evidence-based guidance for the management of overweight and obesity in children...” (p. 1). These two guidelines in particular suggest that the Ministry of Health and the Ministry of Education are working together to support and guide early childhood teachers as they deal with the pedagogical implications of obesity.
 
Early childhood teachers are in a unique position as it is part of their ‘job’ to educate parents and children about healthy eating and active habits. ECE services must also ensure that they provide a healthy environment for children to eat, play, and grow (Ministry of Health, 2009). Teachers are influenced by government guidelines like the two mentioned above; they can serve children age-appropriate healthy foods, limiting high fatty, salty, and sugary food and drink, like juices and biscuits
(Ministry of Health, 2012). EEC services must offer children lots of opportunities for active play, in fun, short bursts throughout their day, keeping televisions and other influential media turned off and away from areas where children sleep (Te Whāriki, Ministry of Education, 1996). Whilst early childhood teachers offer these practices, parents too can adopt the same practices at home; thus ensuring children the best chance of growing into a healthy weight and lifestyle.
 
The Child Nutrition Survey conducted in 2002 found that “...the prevalence of overweight was about one in five children ... the prevalence of obesity was about one in 10 children” (Ministry of Health, 2009, p. 1). Teachers in ECE services therefore have many pedagogical implications that they must be aware of when working with these young children. According to Costley and Leggett (2010) another implication is that “It is important to teach children proper nutrition, and [about] how to stay physically fit” (p. 2). Consequently, as teachers, we are advocates for all children and it is essential that through our practices, we have extensive knowledge on healthy eating; providing information, and working in partnership with parents and whānau to begin their journey to growing fit and healthy children.

Finally, as children learn through observation, and as teachers are a child's main role model whilst in child education, I think that it is essential to role model healthy eating and drinking habits, and to be actively involved with the children in their physical activity. A teacher's own enthusiasm can have a
powerful effect on children’s behaviours and attitudes towards nutrition and physical activity (Curry, 2000).

So, it is time to start reconsidering the dietary intakes and physical outputs of children on a daily basis, as Te Whāriki does state that “Children experience an environment where their health is promoted” (Ministry of Education, 1996, p. 48). What teachers model to children matters, as they are future adults, who will in turn be role models to future children. 

An obese society is not an option; so it is time to be proactive, and to encourage healthy options so that children can learn to live a healthy and balanced life, without obesity hanging over their shoulders. What we do now, as teachers and parents, is going to count in the future, so let’s do it together.

References: 
Curry, L. (2000). Fit kids: Keeping our kids healthy, fit, & motivated. Sydney, Australia: Harper Collins Publishers.
Hayman, L. (2006). Nutrition in infancy and childhood. New York, United States, New York: Encyclopedia of Nursing Research.
Statistics New Zealand. (2009). New Zealand Childcare Survey 2009. Wellington, New Zealand: Statistics New Zealand.
Ministry of Education. (1996). Te Whāriki: He Whāriki Mātauranga mō ngā Mokopuna o Aotearoa/Early Childhood Curriculum. Wellington, New Zealand: Learning Media.
Ministry of Health. (2009). Clinical guidelines for weight management in New Zealand children and young people. Wellington, New Zealand: Ministry of Health.
Ministry of Health. (2012). Food and nutrition guidelines for healthy children and young people (aged 2-18 years): A background paper. Wellington, New Zealand: Ministry of Health.


Over 400 Pounds at 7 Years Old



An Unbelievably Morbidly Obese Child

Tuesday 16 April 2013

Television, school canteens, food advertising...are we aware?


Following on from my previous post, I will examine the roles that television, food advertising, and junk food play in childhood obesity. 

The obesity epidemic has attracted attention at all levels, from general media to policy and practice from health and other professionals, including urban designers and planners, wanting to shape the New Zealand environment, in order to support healthful benefits. However, recent research has identified that New Zealand has in fact got characteristics of an ‘obesogenic’ environment; obesogenic being defined as “...the sum of influences that the surroundings, opportunities, or conditions of life have on promoting obesity in individuals or populations” (Swinburn & Egger, 2002, p. 5). Carter and Swinburn (2004) have discovered, through their studies that the obesogenic food environment in New Zealand continues to grow, particularly in schools, where children learn about many things, including life skills like healthy eating; so, is the healthy eating education happening? 

Utter, Schaaf, Ni Mhurchu, and Scragg (2007), through the conduction of their studies, have found an association between school canteen use and more frequent consumption of various high fat, salt, and sugary (HFSS) foods. These HFSS
foods include soft-drinks, fruit juices, hot chips, hamburgers, sausage sizzles, and more. Utter et al. (2007) also established that students using the canteen were less likely to consume some healthier foods supplied, such as the fruits and vegetables, compared to students who did not use the canteen. This research suggests and supports the fact that the obesogenic food environment is being strengthened by the increase of HFSS foods which appear to be in school canteens (Carter & Swinburn, 2004; Utter et al. 2007).

Although all HFSS foods consumed by children in schools are unhealthy, I think that the unhealthiest HFFS food would have to be the soft-drinks. Poulter (2013) from Mail Online states that “A single can of Coke equates to 35g of sugar, the same as three-and-a-half lollipops or one and-a-quarter packs of Wine Gums” (para. 1). Thus equating to 114 calories, a child consuming a can of Coke, would have to do 20 minutes of physical activity, that’s just for one can of Coke – never mind all the other HFSS foods they consume along with the Coke, like a packet of chips or a sausage. Furthermore,
schools are also supplying diet soft-drinks which not only contain sugar, but also copious amounts of caffeine, which Green Party health spokeswoman Sue Kedgley is disgusted by. Johnston (2006) carries Kedgley complaint “...of children continuing to be exposed to the caffeine, acids and artificial sweeteners like aspartame in diet drinks” (para. 5). These diet drinks also include “...phosphoric acid, citric acid, caffeine and the sweetener acesulphame potassium” (Johnston, 2006, para. 7). Health professionals agree with Kedgley’s concerns, however the soft-drink industry does not; this is a scary thought; do they not care for the health and well-being of children? Considering this, I strongly agree with Kedgley, as all the ingredients found in these soft-drinks have detrimental effects on the whole body, for instance, dental decay (Marshall et al. 2003), and of
course obesity and weight-related diseases (Ludwig, Peterson, & Gortmaker, 2001), which any child, in my opinion, should not be experiencing.

Looking now at the effects of food advertising and television on obesity in childhood, a Dunedin multidisciplinary study found that factors like television viewing and shorter sleep time in childhood were strongly associated with obesity in young adulthood (Hancox, Milne, & Poulton, 2004). In support of this, Carter and Swinburn (2004) conducted research on the television advertising of HFSS foods during children’s viewing hours (Maher, Wilson, & Signal, 2005). Their research suggested that television advertising during this time was predominantly for foods such as sweets, fizzy drinks, and unhealthy snacks (HFSS foods) (Carter & Swinburn, 2004; Hammond, Wyllie, & Casswell, 1999; Consumers International, 2008; McClean & Knowles, 1992). Additionally, these HFSS foods are consumed on a daily basis, therefore contributing to the overweight and obese
generation of children that are seen in our world today. Ministry of Health (2012) agrees, suggesting that “High intakes of many of [HFSS] foods are associated with overweight and obesity” (p. 18). This daily consumption of junk foods is one of the direct effects that television and food advertising is having on children (Halford & Boyland, 2012). Graham (2004) concurs, stating that “Eating too much junk food and watching too much television are two major causes for obesity. And when children sit in front of the TV, they are more likely to snack and also to see advertisements for food products...” encouraging them to want the foods they see, even though they may not be hungry (para. 7). Boyse (2011) supports Graham (2004), confirming that children who watch copious amounts of television (more than seven hours per week) have an increased risk of being overweight or obese during their childhood, and more likely to be overweight or obese as adults (Consumers International, 2008). Current research also proposes that the effects of food advertising, via media, can influence a child’s preferences, requests, and consumption of food, to the detriment of a healthy diet (Hastings, Stead, McDermott, Forsyth, & MacKintosh, 2003). I, therefore, agree, as I have seen this type of behaviour both within my own family, as well as in my friend’s families – food advertising is a manipulative tool that companies use to make money.

Moreover Roberts and Foehr (2004) state that “Children aged over six years old today spend an average of five-and-a-half hours a day using media [this is] more time than they spend doing anything else besides sleeping” (as cited in Kaiser Foundation, 2005, p. 1). Studies have also proven that even children under the age
of six spend a similar amount of time interacting with media, more than they do playing outside (Rideout, Vandewater, Wartella & Kaiser Family Foundation, 2003). Putting this into perspective, on average, one child will see approximately 20,000 advertisements on television each year; that’s approximately 55 per day. This figure does not even include the millions of adverts they see on billboards and posters in their communities each year. Interestingly, Dr. Amanda S Bruce and her colleagues conducted a study assessing 10 healthy weight children and 10 obese children, aged 10-14 years. Children were shown 60 food logos and 60 non-food logos; functional magnetic resonance imaging scans indicated which sections of the brain reacted to certain familiar logos being shown. Results discovered that the 10 obese children displayed more brain activity in the reward regions, than the 10 healthy weight children. However, according to Nauert (2012) the “Healthy weight children showed greater brain activation in regions of the brain associated with self-control, when shown food versus non-food logos” (para. 11). This adds to the body of research showing that in certain situations healthy weight individuals experience greater activation of self-control regions of the brain than obese individuals. Nauert (2012) also confirms that this study, that used “...brain imaging, discovered that brain activity in [overweight and] obese
children is accelerated when shown food logos” (para. 1).  Results therefore suggest that overweight and obese children may be more vulnerable to the effects of food advertising.

Hammond, Wyllie, and Casswell (1999) propose that “There has been international concern over the balance of television advertising for healthy and less-healthy foods to which children and adolescents are exposed” (p. 49).  A recent longitudinal study supports this, suggesting that television viewing as a child is significantly associated with higher body-mass indices and raised serum cholesterol (Hancox, Milne, & Poulton, 2004; Boyse, 2011). In other words, the advertising of junk food on television contributes highly to obesity in children, leading to obesity in their lives as adults (Consumers International, 2008). 

Furthermore, as obesity in childhood is highly visible in New Zealand, early childhood settings are also in danger of being labelled as contributing to the obesity epidemic which is now seen in more and more children. Early childhood settings therefore have policies set in place in order to monitor and control obesity in their own early childhood settings. These policies are thereby influenced by the government and other government funded organisations (Ministry of Health, 2003). Coverage of this was seen in my previous blog post: ‘Legislation in place to curb obesity in early childhood settings in Aotearoa, New Zealand’. 

Moreover, as childhood obesity is so prevalent in New Zealand, early childhood teachers therefore need to be aware of the pedagogical implications that may arise when dealing with, not only overweight and obese children, but also with healthy weight children. This will be the topic of my next blog post entry: Pedagogical Implications for early childhood teachers.

References: 
Boyse, K. (2011). Obesity and overweight. Retrieved from http://www.med.umich.edu/yourchild/topics/obesity.html 
Broadcasting Standards Authority. (2008). Seen and heard: Children’s media use, exposure, and response. Wellington, New Zealand: Broadcasting Standards Authority.
Bruce, A. S., Lepping, R. J., Bruce, J. M., Cherry, J. B., C., Martin, L. E., Davis, A. M., ... Savage, C. R. (n.d). Brain responses to food logos in obese and healthy weight children. The Journal Of Pediatrics. doi:10.1016/j.jpeds.2012.10.003
Burns, J. (n.d.). 15 ways to get your kids to eat better. Retrieved from http://www.parents.com/kids/nutrition/healthy-eating/get-your-kids-to-eat-better/  
Carter, M. A., & Swinburn, B. (2004). Measuring the ‘obesogenic’ food environment in New Zealand primary schools. Health Promotion International, 19(1), 15-20. doi:10.1093/heapro/dah103.
Consumers International. (2008). The junk food trap. Retrieved from www.consumersinternational.org/media/540310/junk_food_trap.pdf  
Conflicting messages of a media monster. (n.d.). Retrieved from http://www.feministezine.com/feminist/anorexia/Anorexic005-MediaMonster.html
Controlling the global obesity epidemic. (2013). Retrieved from http://www.who.int/nutrition/topics/obesity/en/  
Graham, J. (2004). Children, television, and screen time. Retrieved from http://extension.umaine.edu/publications/4100e/
Hammond, K., Wyllie, A., & Casswell, S. (1999). The extent and nature of televised food advertising to New Zealand children and adolescents. Australian and New Zealand Journal of Public Health, 23(1), 49-55.
Hancox, R. J., Milne, B. J., & Poulton, R. R. (2004). Association between child and adolescent television viewing and adult health: A longitudinal birth cohort study. Lancet, 364(9430), 257-262. doi:10.1016/S0140-6736(04)16675-0.
Hastings, G., Stead, M., McDermott, L., Forsyth, A., & MacKintosh, A. M. (2003). Review of research on the effects of food promotion to children: Final report prepared for the Food Standards Agency. Glasgow, Scotland: Centre for Social Marketing.
Johnston, M. (2006). Row goes on over school soft drinks. The New Zealand Herald. Retrieved from http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10415658
Kaiser Foundation. (2005). Generation M: Media in the lives of eight to eighteen year olds. Washington, DC: Kaiser Foundation. 
Ludwig, D., Peterson, K., & Gortmaker, S. (2001). Relation between consumption of sugar-sweetened drinks and childhood obesity: a prospective, observational analysis. The Lancet 357(9255): 505–508. doi:10.1016/S0140-6736(00)04041-1
Maher, A., Wilson, N., & Signal, L. (2005). Advertising and availability of 'obesogenic' foods around New Zealand secondary schools: A pilot study. New Zealand Medical Journal, 118(1218), 11.
Marshall, T. A., Levy, S. M., Broffitt, B., Warren, J. J., Eichenberger-Gilmore, J. M., Burns, T. L., & Stumbo, P. J. (2003). Dental caries and beverage consumption in young children. Pediatrics, 112(3), e184-e191.
McClean, H., & Knowles, S. (1992). Television advertising of foods to children in New Zealand. New Zealand Journal and Diet Association, 46, 11-13.
Ministry of Health. (2003). New Zealand food New Zealand children: Key results of the 2002 national children’s nutrition survey. Wellington, New Zealand: Ministry of Health.
Ministry of Health. (2012). Food and nutrition guidelines for healthy children and young people (aged 2-18 years): A background paper. Wellington, New Zealand: Ministry of Health.
Nauert, R. (2012). Obese kids more susceptible to food ads. Psych Central. Retrieved from http://psychcentral.com/news/2012/12/03/obese-kids-more-susceptible-to-food-ads/48504.html
New Zealand Advertising Standards Authority. (2010). Children’s code for food advertising 2010. Retrieved from http://www.asa.co.nz/code_children_food.php
Poulter, S. (2013). Fizzy drinks loaded with sugar. Mail Online. Retrieved from http://www.dailymail.co.uk/health/article-207338/Fizzy-drinks-loaded-sugar.html
Proctor, M., Moore, L., Gao, D., Cupples, L., Bradlee, M., Hood, M., & Ellison, R. (2003). Television viewing and change in body fat from preschool to early adolescence: The Framingham children’s study. International Journal of Obesity, 27(7), 827-833. doi:10.1038/sj.ijo.0802294.
Roberts, D., & Foehr, U. (2004). Kids & media in America.  Cambridge, MA: University Press.
Rideout, V. J., Vandewater, E. A., Wartella, E. A., & Henry J. Kaiser Family Foundation, M. A. (2003). Zero to six: Electronic media in the lives of infants, toddlers and preschoolers. Retrieved from Discover database.
Swinburn, B. B., & Egger, G. G. (2002). Preventive strategies against weight gain and obesity. Obesity Reviews, 3(4), 289-301. doi:10.1046/j.1467-789X.2002.00082.x
Utter, J., Scragg, R., Schaaf, D., & Ni Mhurchu, C. (2007). Food choices among students using a school food service in New Zealand. New Zealand Medical Journal, 120(1248).
World Health Organization. (2006). Obesity and overweight. Retrieved from http://www.who.int/mediacentre/factsheets/fs311/en/index.html