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King launches strategy to tackle obesity

King launches strategy to tackle obesity, improve nutrition and increase physical activity

Health Minister Annette King is today launching a national strategy to curb the rising numbers of New Zealanders dying prematurely and becoming sick from obesity-related illness, physical inactivity and poor nutrition.

Healthy Eating-Healthy Action: A strategic framework is designed to encourage healthier lifestyles.

"We're facing epidemics of obesity and diabetes. A third of New Zealand adults do not get enough physical activity to benefit their health, nearly four in 10 are overweight, and by 2011 it is predicted that three in 10 adults will be obese," says Ms King.

"The direct costs of obesity to the health sector were estimated several years ago at $135 million a year, and there's clear evidence that we need to act now or face increasing rates of poor health and spiraling health and disability costs."

Many of New Zealand's most serious diseases and conditions, such as heart disease, stroke, type 2 diabetes and some cancers, are closely associated with physical inactivity, poor nutrition and obesity, Ms King says.

“The strategy will establish a framework and encourage future funding decisions that achieve reductions in obesity, improve nutrition and increase physical activity. It provides high-level directions to help guide an advisory group, to be coordinated by the Ministry of Health, in developing an implementation plan.

"There are no quick answers to persuading people to change their lifestyles, but this strategy doesn't just focus on changing personal behaviour. It signals major changes that are needed to reduce social and physical environmental barriers to eating well, being physically active and achieving a healthy weight," she said.

"Turning these goals into reality requires innovative and shared solutions. It calls on a range of sectors, such as transport, local government, DHBs, education, and food, fitness and weight-loss industries to work together."

Launching the strategy at Wellington's Saint Anne's School, Ms King says children are a priority for Healthy Eating-Healthy Action.

Saint Anne’s School operates a Walking School Bus to encourage children to walk to school, has food and beverage policies to make it easier for them to eat nutritiously, and puts a priority on keeping students active.

Questions and Answers

Why launch Healthy Eating-Healthy Action at Saint Anne's School? St Anne's School, in Newtown, Wellington, is committed to encouraging the development of healthy eating and physical activity habits in their pupils. The primary school, which has a low decile rating and has a high Pacific population, is part of the ‘Health Promoting Schools’ initiative and has identified nutrition and physical activity as priorities for the students. Principal Doreen O'Sullivan encourages the children to walk to school each day wet or fine with one of the Walking School Buses the school community operates. The school also has a "water only" policy meaning that the children are encouraged to have a water bottle with them during class while sweetened drinks are actively discouraged. Many of the classrooms have fruit bowls for the children, and children can also participate in optional lunchtime aerobics sessions.

Why do we need the Healthy Eating-Healthy Action strategy? Too many New Zealanders are dying or becoming ill from diseases and health conditions that could be prevented by good nutrition and being physically active. Projections suggest that obesity is rising rapidly and will result in thousands of New Zealanders suffering from serious diseases and health conditions in the near future. The strategy proposes new ways of tackling these problems and signals the need for urgent action across a range of sectors.

Is New Zealand alone in this issue? No. The burden of chronic diseases, including cardiovascular disease, cancers, diabetes and obesity, is rapidly increasing worldwide. This week the WHO/FAO released a major report on the relationship of nutrition and physical activity to chronic diseases and makes recommendations for governments on how to tackle this increasing problem. For more information see: http://www.who.int/mediacentre/releases/2003/pr20/en/

Why are three issues being rolled into one strategy? Nutrition, physical activity and obesity are all key health issues in their own right, but there is extensive overlap between them. The potential to form alliances between the different agencies working in nutrition, physical activity and obesity gives the strategy a broader base, a bigger workforce and a louder voice both politically and in the community.

How will the strategy be implemented? An implementation plan will be developed over the next six months to identify key priorities and actions (including who will do what by when) for the next three years. An external advisory group will be established by the Ministry of Health to advise on development of this plan.

What are the key health messages in Healthy Eating-Healthy Action? To improve nutrition, increase physical activity and maintain a healthy body weight: Eat a variety of nutritious foods; Eat less fatty, salty and sugary foods; Eat more vegetables and fruits; Fully breastfeed infants for at least six months; Be active everyday for at least 30 minutes in as many ways as possible Add some vigorous exercise for extra benefit and fitness. Aim to maintain a healthy weight throughout life Promote the development of environments that support healthy lifestyles.

Are we going to see solutions immediately? Some actions are already underway, for example a Memorandum of Understanding between Sport and Recreation New Zealand and the Ministry of Health. It recognises the responsibilities of both parties to improve the health of New Zealanders through research, monitoring, policy and programme development, and promotion of physical activity.

What type of actions may come out of the strategy? There are many innovative programmes already underway and many potential initiatives. Some that may be supported or expanded are: the Walking School Bus concept (where a "driver", usually a parent, walks children to/from school) hikoi (popular walking programmes in Mäori communities) expanding the Green Prescription Scheme, possibly addressing nutrition the promotion of fruit and vegetables to prevent obesity and some cancers delivery of the Baby Friendly Hospital Initiative (supporting breastfeeding).

Other potential developments could include: community programmes to encourage physical activity and nutrition partnership approaches, for example, local government and transport sector initiatives to encourage walking, cycling and alternatives to cars school policies to ensure healthy food and drinks are available promoting the importance of folate for women of childbearing age programmes for poorly nourished children, such as breakfasts in schools in areas of need

What are some key facts and figures on inactivity, nutrition and obesity?

Physical Activity One third of New Zealand adults are not physically active enough to benefit their health. As many as 2600 people a year are estimated to have died prematurely in New Zealand because of physical inactivity, equivalent to 8 percent of all deaths. 30 minutes of moderate intensity physical activity on most if not all days of the week can benefit health. Only 40 percent of the adult population are regularly active (on five or more days a week). Overall men and women appear equally physically active. New Zealand European (69%) and Mäori (67%) adults are almost equally likely to be physically active, while activity levels are slightly lower (63%) for Pacific adults. Adults from other ethnic groups are the least active (54%). The highest levels of physical activity are among 15-24 year olds and 65-74 year olds. Among school-aged children and young people, physical activity levels decline significantly after age 16-17, particularly among young women. Physical inactivity has not been associated with socio-economic status in New Zealand. However people with no qualifications are more likely to be sedentary than those with school and post-school qualifications.

Nutrition If everyone ate five servings of vegetables and fruit a day there would be an estimated 800 fewer deaths a year. If everyone in New Zealand ate a healthy diet the health effect would be similar to the total elimination of smoking. Two-thirds of all New Zealanders eat the recommended three servings of vegetables and half the recommended two servings of fruit. Mäori and Pacific peoples are least likely to eat the recommended servings. Less than one-sixth of all New Zealanders eat the recommended servings of breads and cereals. Consumption is higher among Mäori and Pacific peoples in more deprived areas. 35 percent of total energy comes from fat (30 percent recommended). Mäori have higher fat intakes than non-Mäori. Other studies have suggested some children may consume too much fat and sugar and that iron deficiency may be prevalent among some children.

Obesity The direct cost of obesity for the health sector was estimated several years ago at $135 million per year. Thirty-five percent of New Zealand adults are overweight and 17 percent are obese. New Zealand data indicates the prevalence of obesity is increasing. Between 1989 and 1997 adult obesity increased by 55 percent. Obesity is projected to increase by a further 70 percent by 2011. It has also been estimated that by 2011 approximately 29 percent of the adult population may be obese (Ministry of Health 2002). There are no nationally representative data on rates of obesity in New Zealand children. However, a study of 2273 Auckland school children, aged 5-10.9 years, found that, in all, 14.3 percent of children were obese using the recommended definition of obesity (Tyrrell et al 2001).

Why focus on prevention? Treatment costs of diseases like diabetes and cardiovascular disease are unsustainable. Preventative measures are required urgently to reduce spiralling treatment costs. The number of people diagnosed with type 2 diabetes, currently 160,000, is also rising sharply, particularly among Mäori and Pacific peoples.

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