Global leaders meet to address childhood obesity epidemic

WHO/Ana Rito

In his keynote address, Dr Gauden Galea stressed the parallels between public health policies on tobacco, alcohol and unhealthy diets.

Obesity is preventable. Eradicating obesity, however, is very complex. The prevalence of childhood obesity in nearly every country around the globe is increasing at an unprecedented rate, and yet few countries have pushed this public health issue to the top of the political agenda.

The International Conference on Childhood Obesity (CIOI) is one of the most important forums for policy-makers, experts and key stakeholders to learn about and discuss tactics for the prevention of childhood obesity. This year’s CIOI, led by the National Institute of Health of Portugal, took place in Lisbon on 5–8 July.

There, an internationally renowned group of experts covered diverse aspects of the issue, from the marketing of unhealthy food and the need for regulation to methods for increasing physical activity in schools and the mental health aspects of childhood obesity.

Dr Ana Isabel Rito, President of CIOI 2017, said, “During a time when many inequalities in obesity, physical activity and eating behaviours exist, and when young people from low-affluence groups are generally more likely to report lower physical activity levels and worse diets, tackling childhood obesity together is the key.”

One of the biggest health crises of our time

The problem with childhood obesity is clear: children who are obese are more likely to stay obese into adulthood, which puts them at increased risk for noncommunicable diseases (NCDs) such as heart disease, type 2 diabetes and some cancers. Even today, some of these so-called adult diseases are affecting children and adolescents.

It is estimated that 1 in 3 children in Europe suffers from overweight or obesity, and that 170 million children worldwide are overweight or obese. Low- and middle-income countries are experiencing a rate of increase in childhood obesity 30% higher than that of high-income countries. WHO reports that if current trends continue, 70 million infants and young children will be overweight or obese by 2025.

To address this crisis, health professionals, entrepreneurs, psychologists, educators and urban planners attended lectures and debates, and posed questions and ideas about changing the physical environment to promote healthier lifestyles for children, particularly the most socially disadvantaged.

“We need a revolution”

Childhood obesity is increasing, particularly in developing countries around the globe. These countries are facing a health crisis of epic proportions, and urgent action from key stakeholders is needed.

Keynote speaker Professor Philip James, Chair of the Presidential Council of Global Prevention Alliance in the United Kingdom, highlighted the fact that policies affecting the supply and cost of food should be considered, as availability and price affect what parents are able to feed their children. The high price of vegetables and low cost of foods high in fat, sugar and salt (HFSS) is a barrier to promoting healthy lifestyles in children. “In summary,” Professor James said, “we need a revolution.”

Keynote speaker Dr Tim Lobstein, Head of Policy at the World Obesity Federation, also called for more accountability from industry. He concluded with a call to action, stating that the public must hold companies accountable for the deleterious health effects they are having on our children.

A call for marketing restrictions

Currently, between the ages of 7 and 12 children are exposed to approximately 40 000 television advertisements promoting HFSS products. Reducing this marketing is one of the core recommendations from the WHO Commission on Ending Childhood Obesity.

Dr Gauden Galea, Director of the Division of Noncommunicable Diseases and Promoting Health through the Life-course at WHO/Europe, and Dr João Breda, Head of the WHO European Office for the Prevention and Control of Noncommunicable Diseases, were among the invited guest speakers. In his address, Dr Breda called on WHO European Member States to restrict the marketing of HFSS foods to children in all forms of media. He pointed out that self-regulation by the food industry has proven inadequate.

Regulation limiting or banning the marketing of HFSS foods to children has commenced in Portugal under the leadership of Professor Pedro Graça, Coordinator of Portugal’s National Program for the Promotion of Healthy Eating and a CIOI keynote speaker. Researchers are now waiting to see if this bold initiative will change children’s food consumption patterns and thus their nutritional status.

Schools as a focal point

Several interventions are using the school environment as the focal point for introducing children to nutritious foods and healthy eating behaviours. Providing free and nutritionally dense school meals, for example, has been shown to improve children’s cognitive abilities and health.

School food policies to create healthier food environments, such as removing sugar-sweetened beverages from vending machines, have also successfully played a role in developing good habits in childhood.

Physical education is implemented in most schools, but studies have shown that in some programmes, children are only physically active for approximately 6 minutes of this designated time. This reveals an opportunity for improving the efficiency and effectiveness of such programmes. Increasing local safety so parents feel comfortable letting their children walk or ride a bicycle to school is another opportunity for increasing physical activity in children.

Social norms and mental health

Shifting the public conversation from concern about underweight children to concern about overweight children is another challenge. Dr Sanja Milanovi from the Croatian National Institute of Public Health pointed this out during a panel discussion.

Psychologist Dr Andrew Hill from the University of Leeds, United Kingdom, focused on the importance of improving self-esteem in children. Professor Isabel Loureir from the National School of Public Health in Portugal affirmed this, stating, “Obesity isn’t just a problem of physical health – it’s also a problem of mental health.” Introducing the dimension of emotional wellness gave attendees another perspective on how to create interventions targeting childhood obesity.

Exploring new ways to combat childhood obesity

A food revolution is needed to change obesogenic environments and to ensure a better future for children in every country of the world. The critical importance of changing marketing practices, improving the school food environment, taking a health-in-all-policies approach to changing consumption behaviours, and promoting physical activity and emotional wellness are some of the key takeaway messages from CIOI.

Inspired and invigorated, leaders will carry these projects forward, continuing to explore new ways to combat one of the most profound problems of the 21st century.