Why did the fat kiwi cross the road?

First, let me bore you all with some stats, facts, and figures,

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This page provides introductory facts and statistics about obesity in New Zealand. For more information, refer to A Portrait of Health: Key Results from the 2006/2007 New Zealand Health Survey.

Obesity statistics for New Zealand adults

The 2006/07 New Zealand Health Survey found that:

• One in four adults were obese (26.5%)
• 41.7% of Māori adults were obese
• 63.7% of Pacific adults were obese
• 11% of Asian adults were obese
• Pacific men and women were two and a half times more likely to be obese than men and women in the total population.
• Māori men and women were one and a half times more likely to be obese than men and women in the total population.
• There has been an increase in the prevalence of obesity for men and women from 1997 to 2006/07, adjusted for age, but the rate of increase appears to be slowing.

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Obesity statistics for New Zealand children

The 2006/07 New Zealand Health Survey found that:

• One in twelve children (aged 2 to 14 years) were obese (8.3%).
• One in five children were overweight (20.9%).
• There has been no change in the average (mean) BMI for children aged 5-14 years since 2002.
• There has been a decrease in average BMI for Māori children.
• Adjusted for age, Pacific boys and girls were at least 2.5 times more likely to be obese than boys and girls in the total population.
• Māori boys and girls were 1.5 times more likely to be obese than boys and girls in the total population.

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Other statistics

• Nine out of ten (87.8%) children aged from birth to 14 years have ever been breastfed.
• Nine out of ten (87.8%) children aged 2-14 years ate breakfast at home every day in the past 7 days.
• Two out of three (63.6%) children had fizzy drink in the past 7 days. One in five (19.6%) children had three or more fizzy drinks in the past seven days.
• Seven out of ten (70.9%) children ate fast food in past seven days. One in seven (13.6%) ate fast food twice in past seven days and one in 14 (7.2%) had eaten fast food three or more times in past seven days.
• Two out of three (64.1%) children aged 5-14 years usually watched two or more hours of television a day. This equates to 368,700 children.
• Two out of every three adults (64.1%) ate the recommended three or more servings of vegetables each day, and two out of three adults (60.0%) ate the recommended two or more servings of fruit a day.
• One in seven adults (13.6%) reported that they were currently taking medication for high blood pressure. This equates to 425,500 adults.
• One in 12 adults (8.4%) were currently taking medication for high blood cholesterol.
• One in 20 adults (5.2%) had been diagnosed with ischaemic heart disease.
• The prevalence of diabetes in children was 0.2% which means that approximately 1700 children had been diagnosed with diabetes by a doctor (most probably type 1).
• One in 20 adults (5.0%) had doctor-diagnosed diabetes (excluding diabetes during pregnancy). This equates to 157,100 adults. Nine out of every ten adults with diabetes were diagnosed when they were 25 years or older, and almost all will have type 2 diabetes.
• After adjusting for age, Pacific men and women had three times the prevalence of diagnosed diabetes than men and women in the total population.
• Just under half of children (47.0%) aged 5-14 years usually use active transport to get to and from school (walking, biking, skating or using other forms of physical activity). Common reasons given by parents for what stops their children walking, biking or skating to school – live too far from school, busy traffic/main road, too dangerous for reasons other than traffic, takes too long.
• Half of all adults (50.5%) met the definition of being regularly physically active. Overall one in seven (15.0%) adults were sedentary, reporting less than 30 minutes of physical activity in the previous week.

Source

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Like nearly every other Western (and non-Western) society, New Zealanders are putting on the kilos. The problem of obesity starts young in our lives, as we consume sugary, fatty, highly-processed foods – and usually ends in heart disease, diabetes, and early death. The last bit – early death – is usually the worst.

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Source

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In fact, obesity has become an epidemic in the West. This is not helped by the fact that over-eating can be as addictive as alcohol, tobacco, gambling, drugs, etc. A ‘Time‘ article, last year stated,

“But what shocked the researchers was that extended-access rats also showed deficits in their “reward threshold.” That is, unrestricted exposure to large quantities of high-sugar, high-fat foods changed the functioning of the rats’ brain circuitry, making it harder and harder for them to register pleasure — in other words, they developed a type of tolerance often seen in addiction — an effect that got progressively worse as the rats gained more weight. “It was quite profound,” says study author Paul Kenny, an associate professor of neuroscience at the Scripps Research Institute. The reward-response effects seen in the fatty-food-eating mice were “very similar to what we see with animals that use cocaine and heroin,” he says.” Source

Science is confirming what many of us had already intuited; that obesity was not simply a matter of “will power” or exercise – any more than “self-discipline” is for alcoholics or gamblers. There is much more going on, in the depths of our brains, that is affected by what we are eating – and vice versa.

By June, 2008, the previous Clark-led government courageously attempted to halt the obesity epidemic. Despite being sensitive to criticisms of “nanny statism”, their policy was not to ban junk food throughout the country. Nor to force feed us with vegetables and fruit. And not to frog-march us up and down our streets with battalions of Exercise Police.

Their plan was simply to cut crappy food out of our school ‘tuck’ shops.

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Full story

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You would think that this modest proposal would have been welcomed by sensible people who understood the problem, and realised that what we fed our children early in their lives would have an impact on their later years? Sensible, right?

Oh hell no. That would require common sense; foresight; and a strong sense of community responsibility.

In the above article, Secondary Principals’ Association president, Peter Gall said “ secondary school principals would generally have preferred an educational approach to improving nutrition, rather than Government rules which “can seem a bit heavy-handed“. ”

I wonder if Mr Gall considers it “heavy handed” when we deny our children access to cigarettes and alcohol? After all, if it’s “heavy handed” to try to provide healthier food options for our children, then let’s go hell-for-leather and give 10 year olds a six-pack of  DB Bitter for breakfast. We can always try an “educational approach” later?

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Unfortunately for us – but more unfortunate for our children – this bizarre attitude of Individual Responsibility won out over Community Proactivity. The National Party was perhaps chief amongst culprits, as it began a smear campaign of “nanny statism” against the then-Labour Government.

Headlines such as “National slams ‘nanny-state’ health bill“; “National Party: Public health bill in ‘nanny state’ realm“; and ” ‘Nanny state’ fears on health bill” filled our media. Irrational comments like this, became the mainstream ‘narrative’ of the debate, “”National said the codes were regulations by stealth as they could be converted into law if the Health Ministry did not think the voluntary codes were working.  Codes could cover a range of things from what could be in a school lunchbox, to physical activity and food advertising.”” Source

Gosh,  and just think; if Labour has it’s wicked way,  our kids might not become obese!! Shock! Horror!

In November 2008, National was elected into power, and John Key became our Prime Minister.

Even as the world was facing a global banking crisis, and recession was impacting on nearly every nation on Earth, the new National government still found time to reverse Labour’s evil plan to reduce obesity amongst our children.  In March 2009, National scrapped the healthy foods in schools policy,

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Full Story

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You have to read that article in it’s entirety to grasp the full flavour of lunacy involved in the ‘rational’ behind National’s decision.

There was simply no coherent, logical reason offered except, as Education Minister Anne Tolley said, “It’s not teachers’ responsibility to act as food police. If we want to start changing behaviour, that’s got to start happening at home.”

Riiiight. The same goes to allowing our children to have access to a couple of shots of bacardi as well?

Never mind that Wellington nutritionist, Sarah Burkhart, said that,  “[A pie] isn’t a high carbohydrate food source. That’s actually one of the worst things you could [eat].” Source

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Oh no, because neo-liberal politicians know better than nutritionists. We are going to have Freedom of Choice Even If It Damn Well Kills Us (and our children). Essentially, that is precisely the message that National gave New Zealanders two years ago.

Thankfully, some school’s exhibited far more maturity on this issue than our brain-dead politicians and Wellington College deputy principal Dave Ashby said the college would probably keep its new healthy menu,

“Schools have got a responsibility to young people. I don’t think we’re going to chuck it all in now.” Source

Thank you, Dave “Common Sense” Ashby.

However, leaving these matters to the whims of individual schools is not a solution. It means that some schools  simply won’t bother; they will defer decision making further “down the food chain”,  to our children.

It certainly  sends conflicting messages to the community.

And National’s over-turning of Labour’s policy also shows a total lack of any measure of leadership on this problem (I refuse to call it an “issue” – it is a problem).

On 27 February, the New Zealand Medical Association released a statement, condemning the National Government’s Do Nothing approach. They described Anne Tolley’s actions as “incomprehensible”. Despite it’s length, I will re-print their statement in full. It is worthwhile spending ten minutes to read it,

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Our reasons for opposing removal of the clause follow.

• The Minister, Hon Anne Tolley, states that the core business of schools is to provide students with a “quality…learning environment”.1 Students cannot be expected to benefit fully from such an environment if they are inadequately nourished or experiencing poor health because of poor nutrition. Research suggests that good nutrition is associated with better overall school and academic performance, intelligence, and psychosocial functioning.2–4 Thus, a healthy school food environment seems imperative for a quality learning environment.
• The Minister states that boards of trustees can “make their own decisions about appropriate food and drink options”.1 However, the reason the clause was introduced was that school food under boards of trustees was not sufficiently nutritious. A study in 2007 by Utter et al showed an association between use of school canteens in New Zealand and more frequent consumption of high fat and high sugar foods. 5 An earlier study by Carter et al found that the most commonly available foods in primary schools were pies (79%), juice (57%), and sausage rolls (55%).6 There were over five times more unhealthy meals on offer than healthy meals, and filled rolls (a healthy option) were the most expensive item.
• It is unrealistic to expect boards to have the detailed nutrition knowledge necessary to ensure an appropriate and healthy food service, especially with their already heavy workload. The Minister’s decision means that whilst schools are still required to promote healthy foods, they must determine what foods are healthy and, of greatest concern, can continue to sell unhealthy food. This is contradictory and suggests ‘do as I say, not as I do’ to children.
• Relying on education alone has not worked for other public health issues such as smoking, seat belts, cycle helmets, and drink driving, which ultimately required regulation to bring about positive changes in behaviour.7 There is no reason to think education will work any better for tackling our obesity problem. If we expect people to eat healthily, the environment must be changed to “make healthy choices the easy choices”.8
• Relying on nutrition education alone also assumes there is free choice in school canteens. However, food choices are constrained by the environment. If all that is available is food that is unhealthy and heavily promoted in the media, or if healthy foods are more expensive, then students don’t have a true choice. Furthermore, younger children can not be expected to make rational choices about food based on health.
• Development and implementation of the Ministry of Education’s guidelines on ‘Food and Nutrition for Healthy, Confident Kids’9 was the result of a prolonged and extensive amount of work on the part of government, schools, health sector, and the food industry. That expense and resource was well justified given the potential long-term gains, but has now been completely wasted, without even evaluating its potential success.
• The Minister has also stated that there is confusion about the guidelines amongst schools.1 However, this could be resolved given sufficient time to work with schools. ERO report that since the clause came into effect in June 2008, 95% of schools had already implemented the guidelines.10
• The fact that children bring unhealthy food into school or buy it out of school is not, as has been proposed, a reason to allow unhealthy food to be sold at school.1 The same rationale is not accepted in other circumstances. For example, it could never be acceptable to allow cigarettes to be sold at school because students could buy them at a local dairy.
• Whereas at one time New Zealand was seen as a global leader in our efforts to tackle obesity,11 this latest move by the National government puts New Zealand seriously out of step with other countries. The UK Government, for example, is making laudable efforts to tackle childhood obesity, including implementing regulations around school food, and embarking on plans to broaden the reach of such regulations to include other key environments such as restaurants and workplaces.

The future cost to the country of obesity and nutrition-related disease is immense.12–14 It is of the utmost importance that we support young people to develop healthy eating habits as they grow. This requires environments that support healthy food choices.

The current rates of childhood overweight (21%) and obesity (8%) show that existing environments are not conducive to healthier choices.15 Government intervention is justified to protect children and to prevent the high societal costs of nutrition-related disease. This does not make New Zealand a ‘nanny state’, but simply a caring state.

Delvina Gorton
Dietitian / Research Fellow
Clinical Trials Research Unit, University of Auckland

Helen Eyles
Nutritionist / Research Fellow
Clinical Trials Research Unit, University of Auckland

Cliona Ni Mhurchu
Public Health Nutritionist / Programme Leader (Nutrition & Physical Activity)
Clinical Trials Research Unit, University of Auckland

Chris Bullen
Public Health Medicine Specialist / Acting Director
Clinical Trials Research Unit, University of Auckland

Source & References

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Now, you’re probably wondering; why should I accept the statement of the people above, rather than my democratically elected representatives?

It’s very simple. The people above are trained in matters relating to health. Their #1 concern is mine and your well-being. That is why they went to University; spent years and thousands of dollars being educated; and why they took time to make their views known to you. In short, they care.

The people who over-turned Labour’s National Administration Guidelines for healthy foods are politicians. They care only to be re-elected.

Or put another way, who would you trust to look after your health; your GP? Or the Minister of Health, Tony Ryall? Your call.

In March 2010, more Health professionals joined the nutritionists above, calling on the Government to reinstate legislation for all schools to provide healthy canteen food,

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Full Story

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Christchurch public health nutritionist Bronwen King, said,  “What we need is strong leadership and tough measures, not the soft options they are dishing out now. Unless we get this, we will all pay the price.”  Source

The response of the Minister of Health, Tony Ryall, was thus,

“The new Government has a more balanced approach than the finger-pointing, nanny state attitude of the previous administration,” he said.

“We trust school boards of trustees and parents to decide what they sell in their own tuck shops.”  Ibid

“Nanny state attitude”, remarked Mr Ryall. More politicking.  What was it I said about who to trust; health professionals or politicians?

However, the government has taken “action”. If you can call it that,

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By now you are probably wondering why on Earth our political representatives in Parliament would ‘can’ Labour’s healthy foods policy for schools – which costs very little for the taxpayer to impliment – whilst committing $8 million dollars for 300 bariatric procedures (weight loss surgery) in the next four years? What possible sense is there to such a bizarre situation?

In terms of health outcomes and sensible use of tax-dollars – very little sense.

In terms of political appearances to be Doing Something – it makes perfect sense.

By scrapping Labour’s healthy foods policy, National gives the appearance of rejecting “nanny statism” (though National has passed, or assisted, similar legislation in the past – such as the so-called “anti-smacking Bill), and reinforcing the Rights of Individuals to “make their own decisions”.

By funding 300 bariatric procedures, National is seen to be Doing Something to address this nation’s obesity problem. Above all, politicians understand that the public’s perception must be influenced: politicians need to be seen to be Doing Something to address a problem.

It is precisely the reason why “boy racer” legislation was passed by National – despite police already having considerable powers to seize cars and arrest drivers. The point was not that new laws were needed – but politicians had to be seen to be Doing Something.

The reason why National could not rely on Labour’s healthy foods in schools programme? It would not have offered the immediate results that politicians require. Such a programme takes years – decades! – to show results. Politicians face re-election every three years.

Unfortunately, as usual, it is the public and our children, who will suffer the results of this political expediency. We will also pay for it, in monetary terms,

“About 150,000 New Zealanders could potentially benefit from bariatric surgery. One in five New Zealanders are obese, leading to direct health costs of almost half a billion dollars each year. “ Source

And it’s getting worse,

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Note the statement in that article, under-lined in red,

“Christchurch obesity surgeon Richard Flint said patients selected for the pilot programme would be younger and with a body mass index (BMI) of 35 to 45. “

That’s right, folks. Not only are we  spending more money for weight-reducing operations – but the patients are becoming younger, as obesity increases in our society.

National is also supporting a policy of “outsourcing” these procedures to private clinics,

Christchurch obesity surgeon Richard Flint said… ” Christchurch Hospital did not have the resources to do the operations so they would be outsourced to private clinics.” Ibid

So now companies are making a profit out of the growing obesity epidemic. This, no doubt, fits in very well with National’s core ideology of  encouraging private “providers” for our health needs.  Someone will be making a lot of money out of  peoples’ misery.

But it’s going to cost us taxpayers even more,

“There were plans for the multimillion-dollar Christchurch Hospital redevelopment to include a bariatric surgery unit. “ Ibid

This is how obesity impacts on us, as a society, and as individuals. As obesity gets worse, we will end up paying more for hospitals, surgical procedures, medicines, post-surgical care, etc.

And to make it worse, the Government is actually proud of it’s “accomplishments” in this area,

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Source

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Remarkable. We have a government that is willing to spend half a billion tax-dollars on new hospital facilities and operations…

… but balks at removing unhealthy food from school cafetarias. Obviously, National has forgotten what their grandmothers and grandfathers knew instinctively; a gram of prevention, is worth a kilo of cure. I guess their imperative for re-election outweighs simple common sense? Little wonder that we distrust politicians.

There are those in society who are vocal in their  insistance that obesity is an “issue of personal responsibility”, and not something for the State to be concerned with. I reject that philosophy utterly.

We are a community, who rely on each other for everything that we have. None of us achieved or gained anything on our own – someone, at some point in time, helped us to get to where we are today.

When it comes to the obesity epidemic, this is a problem that affects us all; whether in the taxes we pay, or a family member directly affected. Or ourselves.

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We need to remember this, the next time a Minister tells us that it is a matter of “choice”. If it is “choice”, then we should be choosing to have sensible, proactive policies when it comes to food for our children – and not just leave it up to individuals. For children, that does not always work. And eventually, that “choice” will lead to a “choice” whether to have an expensive operation or not.

(Please note, I am not opposed to people requiring such operations. Such medical interventions are life-saving.  My call is for programmes that offer children better outcomes than what is currently “on the menu” for them.)

And yet, with a bit of common sense and prevention, we ultimately wouldn’t be needing those expensive new hospital wings, and surgical weight-loss procedures.

Q: Why did the fat kiwi cross the road?

A: To get to his appointment at the new bariatric-wing of his local hospital. (Yeah, I know, not funny. It wasn’t meant to be.)

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Previous blogpost

Hey, People! Leave our kids alone!

Additional

Tumeke blog:  Ronald McDonald becomes guest editor at the NZ Herald

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