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/  

Family life. (2011). Retrieved from http://www.healthychildren.org/English/family-life/Media/Pages/Food-Ads-on-TV.aspx?nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token&nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token

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

Obesity is history - How the nation and children of Aotearoa, New Zealand are becoming obese!

Do we know what the definition of 'obesity' really is? I was surprised when I discovered the many definitions of obesity. Firstly, Berk (2012) defines obesity as an increase of weight higher than 20 percent of one’s own body mass index (BMI) “...a ratio of weight to height associated with body fat...” (p. 292). However, Wikipedia states that “Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems” (2013, para. 1). These two definitions define obesity as it is, and as it always will be.

Is this what our world is coming to?

Obesity has become the 'killer' epidemic that everybody is aware of. The World Health Organization (WHO) agrees, declaring the "...prevalence of obesity as an epidemic" (as cited in Ministry of Health, 2012, para. 1). The Ministry of Health (2012) clearly defines this social issue of obesity by stating that "If you're obese, it means: you're excessively overweight, [and that] your weight is above what it should be, for you to be healthy" (para. 1). WHO (2013) describes obesity in more of a rounded way, by suggesting that "Overweight and obesity are defined as abnormal or excessive fat accumulation that may impair health" (para. 2). These definitions, although worded differently, concur with each other as they both suggest that being overweight or obese means that you are carrying excessive fat or 'weight'.

Beginning in the late 1970s, there was an increase in the obesity levels in the United Kingdom for men and women. Percentage increases went from 2-3% in the 1970s to well over 25% today (more on these statistics later). This killer epidemic that has grown gruesomely out of control in the past 40 years is one that we do not talk about today, and political correctness is partly to blame. Tragically, obesity is so common around the world that most people either know someone who has a serious weight issue, or they themselves have the issue. However due to political correctness in this modern day and age, all over the world we are restricted in what we say and do, and for that reason, we dare not  mention the word ‘overweight’ or ‘obese’.

The future of our world.

A newspaper article published in 2010 in the United Kingdom is a clear example of how PC this world has become, as it headlines “Council to ban the word ‘obesity’ – so fat children don’t get offended”. Instead of ‘obese’ this council in Liverpool, England, will be using the phrase ‘unhealthy weight’ – which they hope will ‘encourage’ obese children of the United Kingdom to lose weight – or will it? The article goes a step further saying that they also want to “...drop the word from all local authority schemes aimed at improving children's health”. The article goes on to state that “...the word obese has negative connotations...” and they feel that the phrase “...unhealthy weight is more positive and a better way to promote it. The term ‘obese’ would turn people off, particularly young people” (Narain, 2010). I feel that this is quite ironic as the word ‘obese’ came into the regular language to replace the word ‘fat’ because that offended people. Now they need to take up two words to describe ‘fat’ because the word ‘obese’ is offending people. Soon the phrase ‘unhealthy weight’ will be seen as offensive. What other term or expression will be used? Perhaps ‘fat’ will have to do – who knows.

What's your fat percentage?

Looking back on the history of obesity in the United States, the number of Americans who are overweight or obese is growing each year. According to McTigue, Garrett, and Popkin (2002), research showed that in the years 1960-1999, a sample of the adult population (people aged 20-74) who were carrying excess weight (based on a body mass index (BMI) of 30 kg/m²), showed an increase in their weight of “...44% to 61%...”. Furthermore, the amount of people classed as obese (in the same age group) “...doubled from 13% to 27%” (p. 857). During that period, the amount of people becoming overweight and obese sent alarm bells, and obesity was soon to be acknowledged as an important medical and health problem (Allison & Saunders, 2008).

A fatal epidemic.

In New Zealand’s history of obesity there are trends relating to the occurrence of extreme obesity (based on a BMI of 40 kg/m²). Results are seen in the Ministry of Health’s study using graphical methods to visualise the trends in the BMI distribution of the New Zealand adult population from 1977 to 2003. The population of New Zealand was approximately 3,000,000 in 1977 growing to almost 4,000,000 in 2003. Trends show that cases of extreme obesity have increased sharply over the years (Ministry of Health, 2004). In 1977, of the adults aged 25-64, “0.32% of males and 1.28% of females” were classed as being extremely obese. These conclusions are consistent with the suggestion that the obesity epidemic began in the late 1970’s, and earlier among females, as the percentage of obese woman was 4 times greater than that of males. Levels of extreme obesity from 1977 to 1989 did not increase significantly. From 1989 to 1997 rapid growth began when extreme obesity levels showed that “1.2 % of males and 3.0%” of females were extremely obese. However from 1997 to 2003, male’s extreme obesity levels went from “1.2% to 2.2% and female levels continued at 3.0%” (Ministry of Health, 2004). In conclusion, in the year of 2004 an estimated “58,000 (± 8,000)” extremely obese people lived in New Zealand, of whom almost “60% were female” (Ministry of Health, 2004, p. 85; WHO, 2013).

The most recent (2013) key statistics based on the obesity epidemic have been published by the World Health Organisation (WHO) stating that:

• "Worldwide obesity has more than doubled since 1980.
• In 2008, more than 1.4 billion adults (approximately 20% of the adult world population), aged 20 and older, were overweight. Of these over 200 million men and nearly 300 million women were obese.
• 65% of the world's population (approximately 6.7 billion) live in countries where overweight and obesity kills more people than underweight and malnutrition.
• More than 40 million children under the age of five were overweight in 2010.
• Obesity is preventable".

Although obesity in adults is a major concern for all parties, what is even more concerning and alarming is the increasing rate of obesity in children. Heinberg and Thompson (2009) confirm this stating that “Rates of obesity in youth have tripled in the past 20 years ... This emerging epidemic has stimulated a great deal of new research into the formative influences and the interpersonal, social, and psychological effects of obesity on children” (p. 1). I am shocked by these results as these statistics fall within my life time. It has occurred to me, that if it weren't for my healthy introduction to life, I would have been part of these statistics.

“Obesity has been linked to increased mortality and chronic morbidity from such diverse causes as hypertension, diabetes, sleep apnea, certain types of cancer, and depression” (McTigue, Garrett, & Popkin, 2002). The International Diabetes Federation (IDF) supports this saying that "Diabetes and obesity are the biggest public health challenge of the 21st century" (2006, para. 1). According to Healthy Living (2013) "Of the people diagnosed with type II diabetes, about 80 to 90 percent are also diagnosed as obese" (para. 4). Personally, I feel that this fact therefore provides evidence that diabetes is definitely linked to obesity.

I feel that the history, statistics, and studies have shown that the obesity is still making history not only in adults, but also in children which is a major concern. So what policies and legislation have been put into place in order to fight this epidemic that has become so well-known to us, not in New Zealand as a whole, but in early childhood services?

References: 

Allison, D. B., & Saunders, S. E. (2000). Obesity in North America: An overview. Medical Clinic of North America, 84, 305-332. doi:10.1016/S0025-7125(05)70223-6

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

Central Intelligence Agency. (2013). The world factbook. Retrieved from https://www.cia.gov/library/publications/the-world-factbook/geos/xx.html 

Healthy Living. (2013). A co-dependent relationship: Diabetes & obesity. Retrieved from http://www.diabeticcareservices.com/diabetes-education/diabetes-and-obesity 

Heinberg, L. J., & Thompson, J. K. (Eds.). (2009). Obesity in youth: Cause, consequences, and cures. Washington, DC: American Psychological Association.

International Diabetes Federation. (2006). 11th FEND ANNUAL CONFERENCE. Retrieved from http://www.idf.org/node/3030 

McTigue, K. M., Garrett, J. M., & Popkin, B. M. (2002). The natural history of the development of obesity in a cohort of young U.S. adults between 1981 and 1998. Annals of Internal Medicine. 136(12), 857-864. Retrieved from Scopus database.

Ministry of Health. (2004). Tracking the obesity epidemic: New Zealand 1977-2003. Wellington, New Zealand: Ministry of Health.

Ministry of Health. (2012). Obesity. Retrieved from http://www.health.govt.nz/your-health/healthy-living/food-and-physical-activity/obesity

Narain, J. (2010, April 12). Council to ban the word ‘obesity’ – so fat children don’t get offended. Mail Online. Retrieved from http://www.dailymail.co.uk/news/article-1265327/Council-ban-word-obesity--fat-children-dont-offended.html 

Obesity. (2013). In Wikipedia, The Free Encyclopedia. Retrieved April 17, 2013, from http://en.wikipedia.org/wiki/Obesity 

World Health Organisation. (2013).Obesity and overweight. Retrieved from http://www.who.int/mediacentre/factsheets/fs311/en/