Janas Harrington is a lecturer at University College Cork with an interest nutritional epidemiology and public health nutrition and Eimear Keane is a PhD student at the department of epidemiology and public health at University College Cork with a focus on trends and determinants of childhood obesity.
Both are co-authors on a research article published in BMC Public Health that has found that although childhood obesity rates remain high in Ireland, there is evidence that they have stabilised and may be beginning to fall. In this guest post, they tell us more about their findings.
Childhood obesity has reached epidemic proportions worldwide. Current estimates indicate that between 15 and 32% of European children either overweight or obese. Obesity can affect children in both developed and developing countries and from all social backgrounds. Obesity in childhood is a risk factor for the development of many chronic diseases including hypertension, diabetes and cardiovascular disease.
If obesity levels are not monitored, the current generation of children may develop some of these chronic diseases, traditionally only associated with adults, much sooner in their lifecourse than in previous generations. This will result in adding to our already over-burdened healthcare systems. Recently there has been some cause for optimism with research groups in some countries reporting aslowing down and possible decline in overweight and obesity prevalence. Given that childhood obesity levels in Ireland are on par with those in other developed countries, we decided to explore if this decline/slow down was also evident in Ireland over the past 10 years.
We encountered a number of challenges when carrying out this research. Until recently, there was no routine national child-weight measurement programme in place, thus the data included in the review was based on a number of different national and regional studies. One of the main challenges with using different studies as a source of data was the lack of standardisation of methods or lack of detail provided by the authors on the methods used in the various research studies identified. Additionally the ages of the children in the included studies varied. Different age and sex profiles for different studies can make comparability across studies more difficult to interpret.
We decided to use a comprehensive approach to ensure that we included all relevant data sources. Therefore we used many approaches to source the included data. We searched online journals, the internet and we also contacted some professionals who work in the area of childhood obesity in Ireland. We only examined trends in primary school aged children and our search for literature was restricted to Irish data and limited to the time period from 2002 onwards. We chose 2002 as some previous work had assessed trends prior to this date in Ireland.
When we were analysing the data from the collected studies, we decided to examine trends separately for data collected at a national and at a regional level. This is because we could not be sure if the data from all the regional studies gave an accurate representation of all children in Ireland.
We encountered a number of problems. Firstly, not all the included papers had all the necessary data we required. Some studies did not explain all the methods used in detail. Therefore, we had to contact some of the authors of the included studies to obtain this information. Secondly, we noted that most of the studies did not provide an indication of the accuracy of the estimates of overweight and obesity provided in their studies such as a confidence interval or standard error. This makes it difficult to gauge how accurate some of the prevalence estimates were.
The findings of this review provide some ground for cautious optimism that childhood overweight and obesity levels in the Republic of Ireland are stabilising. To combat childhood obesity we need to use an approach which targets many aspects of the problem and we need to utilise expertise from professionals who work in many areas including public health, education, agriculture and the food industry.
We need to increase our efforts and support to target regular monitoring of obesity prevalence over time, to aid food industry regulation and develop population-wide intervention strategies. This will help us describe, understand and prevent obesity in children. Monitoring obesity prevalence rates is an important public health measure and as highlighted in this piece of research published in BMC Public Health we need a standardised routine child measurement programme at national level to monitor childhood obesity trends overtime.
Since 2008, routine heights and weights of a cross section of boys and girls aged 7, 9 and 11 years have been measured in Ireland. This data is part of the WHO Childhood Obesity Surveillance Initiative. Additionally routine height and weight measurement in second year of primary school (approximately 5-7 years of age) is currently being piloted by the Irish Health Service Executive. This research highlights the importance of these initiatives.
The unhealthy choices of modern life and our obesogenic environments, coupled with the toxic and unsustainable food environment, leading to the increased availability and accessibility of ultra-processed foods requires attention from our policymakers. Further, given the evidence that unhealthy lifestyle habits are evident in young children and that early signs of metabolic illhealth and cardiovascular risk factors are evident from an early age, early childhood interventions should be considered