Posted by: ezzakazhall | September 15, 2012

We’re taking you down town, obesity!

This opinion piece appeared on The New Zealand Herald‘s website on 7 September. The author is Dr Paul Hutchison, a National MP and former obstetrician and gynaecologist.

I will admit I chuckled a bit upon reading the headline. Arrest obesity, you say? I was left with some strange mental images: sticking handcuffs on a lump of adipose fat tissue, bundling a scale showing triple figures into a police car with the sirens blaring. Things like that. Then, it hit me how problematic that headline actually is. The word “arrest” brings up associations with lawlessness and criminal behaviour. One could gauge that, according to Dr Hutchison, obesity is a crime that needs to be clamped in irons and hauled in for questioning. Not the smartest choice of words, I’d say.

As for the content of the piece, Dr Hutchison says he believes that an “optimal start in life” is the key for preventing obesity in New Zealand children, and also to prevent obesity stretching into adulthood. And that healthy habits need to be “hardwired” from birth. He says:

“As a former specialist in obstetrics and gynaecology for over a decade I have stressed to my parliamentary colleagues the profound importance of an optimal environment around conception, antenatally, and postnatally as to how the child will end up – whether it be from a health, education, justice, or social viewpoint.

Sir Peter Gluckman says there is now compelling biological and clinical evidence that those who have a poor start in life have greater risks of developing obesity and non-communicable diseases. He believes the most important political and scientific question is ‘Whose fault is it?’ – to what extent are these diseses a matter of voluntary behaviour and to what extent are they hardwired?

…Current methods for dealing with non-communicable diseases – optimal diet, exercise, and stopping smoking -are not enough… attention has to be paid to what Gluckman describes as developmental hardwiring of appetite control, developmental hardwiring of willingness to exercise, developmental set points for body weight and exercise.

On a surface level, I do believe that the health of New Zealand children is paramount. This report, commissioned by the Ministry of Health, shows that child health indicators are far below where they should be (particularly compared with other OECD nations) and that harmful experiences in the early years can result in poorer health outcomes later in life. So yes, the early years are critical for achievement across a range of fields, including education and employment.

However, Dr Hutchison is vague as to how “the best start in life” can prevent obesity, and on what exactly the best start looks like. When I think of the “best start in life”, I think of a baby with loving parents (this most definitely includes solo parents) who feed, clothe and shelter it appropriately, who protect it from any conceivable harm, who seek support where it’s needed (given it takes a village to raise a child) and who basically tend to its every need. But preventing obesity?

I wondered if breastfeeding was part of this plan, given it is promoted by Government as helping to reduce obesity later than life, as well as other health conditions. However, this is all very well if a mother is able to breastfeed, and there are myriad reasons why a woman cannot- such as difficulty expressing milk, the baby refusing it, medical conditions (for both mother and baby) and certain medications, such as antidepressants. This Psychology Today article tells us more.

Does obesity prevention rest with good dietary habits of activity of the mother while pregnant? Last year, the University of Auckland  conducted a study, mentioned in this article, which showed a link between childhood obesity and the mother’s diet during pregnancy. (My mother had a serious craving for custard squares while pregnant with me. Looks I’m screwed!) However, given pregnancy hormones can lead to all kinds of food cravings (everything from chocolate to curry, peanut butter to olives, from grass to burnt matchsticks), keeping “bad” foods at bay is easier said than done. And as for physical activity, pregnancy comes with many  physical complications, including nausea, back and rib pain, swollen ankles and dizziness- none of which are particularly conducive to exercise. 

The parents’ choice of baby food could be something to think about. This New Zealand website points out the benefits of feeding babies fresh, homemade food, as opposed to pre-packaged baby food.  This US article from a couple of years ago says that 65% of pre-packaged baby foods contain excessive levels of sugar and sodium, with 75% of calories coming from added sugar. This is something for parents to bear in mind, of course. However, for some families, such as those with single parents and working Mums (especially given New Zealand’s low paid parental leave rates and mothers feeling forced back into the workforce), preparing fresh food for their babies is just just one more juggling ball in the game of survival. Plus, in most cases, baby food is cheap- if these Countdown prices are anything to go by.

As for “hardwiring” healthy habits into our next generation- my guess is that he means getting our youngsters practising healthy behaviours from a very young age. The things I have already mentioned, that is breastfeeding, natural baby food and a “healthy” pregnancy, plus introducing infants to daily activity (my sister, aged two, for example, took swimming lessons at about six months old, and is now playing soccer), may be just the ticket. However, as I mentioned before, these solutions are not necessary applicable in all situations, or to all families. Plus, there is still the issue of hereditary obesity, as I mentioned in this post. In these cases, indoctrinating a child into a healthy lifestyle may not be a magic bullet. Also, as I noted here, there are other causes of obesity in adults, despite the practice of healthy behaviour earlier in life.

As is obvious from some of the comments on Dr Hutchison’s article, this gives rise to the classic Government intervention vs. individual choice argument. Libertarianism vs the “Nanny State”. Is it the Government’s role to police our individual food choices and what goes into our children’s mouths? Or, does it keep out of our kitchens, and only have the ambulance at the bottom of the cliff when it all goes “wrong”?

I don’t have the answer to that. But one thing I would like to ask is why are our politicians having this debate when 27,000 Kiwi children are living in poverty? Why are we concerned about indoctrinating our kids into the model of a healthy lifestyle when 27,000 children are coming to school every day without breakfast? What are we doing about the 27,000 children for whom being “healthy” is the least of their concerns…when it pales in comparison to simply staying alive.

Healthy habits are a great thing for families of all ages to practice and, yes, they should be encouraged. However…it was say our politicians have bigger fish to fry in batter and oil.

 

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Responses

  1. Hey Erin, you could look into “baby led weaning” for it’s impact on a child’s start in life. The idea is that when a baby starts solids at 6 myths, they are given soft finger foods and are given control of getting that food in their mouths. They can stop eating whenever they want, which means they learn how to listen to their body’s signals, without a caregiver encouraging them to eat just one more spoonful.
    We used this method with Natalie and intend to use it with Alison (she’s 5 mths already, if you can believe it) and it was very successful, she eats a wide variety of foods and is very good at telling us when she is full. However, like everything, it doesn’t work for everyone. Our nephew has a very sensitive gag reflex and still at age 2 tolerates very little texture in his food.
    Hope that helps give another thing to look into.
    Though I do agree with you, child poverty is a much more important issue to be dealing with. Let’s just concentrate on filling the hungry tummies, before we worry about how to make the food as healthy as possible. Though apparently my kids fit into the child poverty statistic based on our household income, so maybe they should refine that slightly.

  2. nice post, erin. very thoughtful. i especially like your point that this ‘healthy diets from birth’ idea is all very good, but how about the 27,000 NZ children living in poverty right now? maybe the 2 are more connected than we think.


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