Kelsey, Age 10, Delta
2nd Session, 38th Parliament – November 29, 2006
< Tracking Childhood Obesity in British Columbia – Table of Contents – Food Security >
Kelsey, Age 10, Delta
At the most basic level, the likelihood that a child or adult will be overweight or obese occurs when caloric intake through the meals, drinks and snacks consumed exceeds the level of energy expended. Overweight and obesity in the general child population emerges as a result of the individual consumption and physical activity decisions made by parents and children. However, obesity is also an environmental disease formed by the interaction of a multitude of factors. Such factors range from the media and marketing messages that bombard children daily, to whether a child has access to safe areas to participate in physical activities, to a parent’s ability to provide healthy food.
Community and neighbourhood design can either promote or hinder physical activity. In recent years, the movement of traffic smoothly from the suburbs into the city centre and back again in the evening has come to dominate many aspects of community design. No longer is there simply a car for every family, instead families now own at least two vehicles, if not a car for every driving member of the household. As such, automobile demands take up much of the attention of city planners and engineers.
What is compromised in this design are attributes that promote fitness within communities: sidewalks, bike paths, green spaces, and central community areas. As a result, residents are guided away from daily activity in their communities. Children are driven to school and other locations within their neighbourhoods, rather than walking or riding a bike. Activities occur less outside within the community, and more inside individual homes or in designated recreation centres. Correspondingly, studies find that residents of neighbourhoods with abundant green space tend, on average, to enjoy better general health. 3
The majority of suburban commuters rely on their cars for most of their trip to work, while an increasing availability of “drive-through” services such as fast-food, coffee, banking, and video drop-off means people have less of a need to get out of their cars. This convenience and habitual reliance on personal vehicles results in most errands being done by car, even if it is only a few blocks to the grocery store.
Suburban sprawl is associated with higher body mass index scores and an increased occurrence of chronic diseases. In contrast to the lifestyles of their counterparts in the suburbs, those who live in dense urban centres are more likely to walk, and are therefore less likely to suffer from the same illnesses. 4
The variety of screen time pursuits has increased exponentially over the past decade. Children now have access to an abundance of electronic devices from television, videos and DVDs, to computer and video games, to the Internet. It is widely believed that excessive screen time in children causes obesity. In many Western countries, children now spend one quarter of their waking lives in front of screens of some sort.5 This sedentary behaviour competes with the time that children are physically active and creates a caloric imbalance. In addition to encouraging inactivity, television viewing also exposes youth to countless commercials for high-calorie, low-nutrition foods.6
The Provincial Health Officer’s Annual Report 2005 cited increased screen time as one of seven changes in the pattern of physical activity that contributes to obesity. The report asserted that the amount of time spent in front of a television or computer screen is directly related to increased body mass index rates in both children and adults. This is supported by research from the 2002 McCreary Centre Society Adolescent Health Survey, which found that overweight and obese adolescents in British Columbia watch an additional six hours or more of TV per week than those of a normal weight. Similar findings were noted by Statistics Canada in its 2005 report Overweight Canadian Children and Adolescents. Of children aged six to 11, those who had more than two hours of screen time a day were twice as likely to be obese.7
The previously mentioned changes in community design have further curbed children’s activity through the safety concerns of their parents. With unknown neighbours, no sidewalks, and fewer green spaces, parents are less likely to send their children outdoors for unstructured play. Because more parents are working and commuting, a greater number of children are enrolled in after-school programs and more structured, organized play. In addition, the lack of community infrastructure in many of the suburbs often means that these programs and activities are only offered outside the community.
Despite the vigorous activity levels that some of these organized activities provide, the fitness value of unorganized play is actually higher than that of organized sport. In the latter type of play, a child benefits from a limited, scheduled session of exercise as opposed to an extended, reoccurring session.8 As a result, unorganized play is more strongly related to decreased obesity.
Hailey, Age 9, Nelson
To what extent youth are active is influenced, in part, by the opportunities they have to engage in regular physical activity. Schools provide an environment where all youth can have the opportunity to be physically active. Province-wide initiatives, such as ActionSchools! BC, have been undertaken to encourage schools to integrate more physical activity into the daily lives of students.
Physical education is a mandatory curriculum component from kindergarten through to the tenth grade. The province recommends that 10 percent of instructional time be allocated to physical education in these grades. However, facilities, equipment, and time allocation vary widely. This time must also compete with “the basics” of the curriculum.
In addition, the level of participation varies between students. While innovative physical education programs and intramurals may be offered to encourage students to become active, participation is voluntary. By grade 11, physical education is no longer a mandatory component and the majority of Canadian students no longer take those classes at school.
Today’s children and adolescents are more likely to eat foods that are available and easily accessible, and they tend to eat greater quantities when larger portions are provided. The former issue is evidenced by the long-term trend towards making food readily available in more places and more quickly. Whether it is pre-packaged microwaveable food, convenience store items like chips and candy, or the ubiquitous fast-food restaurant, unhealthy items are remarkably accessible. The option of packaged food is made more appealing by the fact that many families consist of two working parents, or single parents, who may turn to unhealthy convenience foods in order to put a meal on the table when they come home.9 The increasing trend toward convenience with food preparation is also reflected by the popularity of eating out and fast-food restaurants, as well as by the popularity of frozen/microwaveable foods and quick-cooking devices such as microwaves.10
Another contributing factor to unhealthy eating among youth is that the meal as a family event has become decentralized. Whereas eating dinner was once a primary activity that involved all members of the family, over the past 30 years the family meal has been in decline. Conversely, snacking and the secondary consumption of food, which often has fewer nutrients and more calories has increased. 11 This trend leads to overeating because snack food is not usually considered a full meal. Since chips, pretzels, and popcorn rarely satisfy one’s hunger, people may still consume regular meals on top of snacks, resulting in excess caloric consumption. In determining one’s meal, nutritional considerations are in an increasingly fierce battle with taste, cost and convenience; factors that unhealthy packaged foods offer in well-researched profusion.
Since the mid-1970s, soft drink consumption among North Americans has doubled.12 For example, a 355 millilitre serving of pop may contain between ten to 12 teaspoons of sugar and between 140 to 160 calories, numbers that are similar for other, non-carbonated, soft drinks. The rise of soft drink consumption is particularly acute among children. Sugary beverages like pop, iced tea, and calorie-laden “sport” drinks are replacing milk, fruit and vegetable juice and water in the minds and bellies of today’s children. The consequence of continually choosing soft drinks over more balanced alternatives is simple: more calories for children who are doing increasingly less to work off the excess energy.
Again, satiety is not achieved by drinking these sugary beverages, prompting a greater likelihood that one will drink a greater amount of them. Some public health officials have noted that the beginning of the obesity epidemic coincides with the beginning of the message to eat a lower fat diet. Although this is generally sound advice, it may have had the unintended consequence of encouraging people to eat proportionally more calories from carbohydrates. Since protein and fat are more satisfying, some speculate that avoiding fats make us hungrier, which then translated into more calories consumed from carbohydrates.13 While carbohydrates provide energy and are important to any diet, in high calorie beverages the carbohydrates are refined (i.e. sucrose-based) rather than complex (i.e. starch-based). This make soft drinks not only less satiating than nutrient-rich drinks, but also a prime contributor to unhealthy eating in youth.
Portion size is another major factor negatively effecting people’s eating behaviour. Since the 1970s, standard portions have increased in nearly every food group in both restaurants and homes.14 U.S. research shows that the size of many common foods including soft drinks, hamburgers, salty snacks, and desserts sold in fast-food establishments, convenience stores, and restaurants began to grow in the 1970s, rose sharply in the 1980s and have continued to rise since. For example, between 1977 and 1996, soft drink portions had risen from 387 to 588 millilitres and hamburgers from 162 to 198 grams.15 This trend parallels the obesity and overweight epidemic around the world. Some current sizes are more than twice that of the original, with fast-food outlets leading the way in large- portioned offerings.
Larger portions can effectively outweigh the benefit presented by otherwise healthy alternatives. People tend to eat more when portions are larger, which can negate any benefit of healthier food choices.16 However, the most dangerous combination remains the continued overeating of unhealthy foods that is prompted by increased portions. In these cases, cost incentives may outweigh health considerations in a child or adolescent’s choice of food, as some opt to increase the amount of food they eat because it is perceived as a better value.
< Tracking Childhood Obesity in British Columbia – Table of Contents – Food Security >
© 2006 Legislative Assembly of British Columbia