The Bigger Picture: Obesity is one of today's most blatantly visible - yet most neglected - public health problems. One in five Irish adults are obese, compared to one in three in the US, and obesity is increasing here at a rate of 1 per cent a year.
Recent data reveals 10 per cent of Irish children aged between 4 and 16 years are obese. Diabetes, heart disease, strokes and arthritis are but some of the adverse health effects associated with obesity so we are sitting on a health time bomb. It is a simple equation: if we take in more calories than we burn off through daily living and exercise we put on weight.
The onslaught of advertising directed at children encouraging them to eat all kinds of products of dubious nutritional value is never ending. Foods classified as "indulgence foods" by industry should be eaten as a treat but are marketed to be eaten several times per day. Endorsement of products by celebrities such as those well-known experts on nutrition Gary Lineker and Victoria Beckham who most likely eat few, if any, of the products they are promoting, are subtly changing consumption patterns. It is increasingly more difficult for children to distinguish between image and reality.
The Broadcasting Commission of Ireland's recent voluntary code on advertising to children is well intended but doesn't govern channels received from outside Ireland. It remains to be seen whether advertisers just switch their business to these channels or whether the code promotes more aggressive price competition to encourage demand and the onslaught on our children's senses will continue unabated.
One wouldn't leave your children alone in the front room with strangers yet parents are happy to leave them in front of a television with Rupert Murdoch beaming 90 channels at them. Some 78 per cent of 7 to 9-year-old Irish children spend at least three hours per day in front of a screen either a TV, computer or play station. Recent research by Sustain in the UK revealed that in 40 hours of children's viewing times, they were exposed to 272 food ads, 95 per cent of which were for foods high in saturated fats, salts and sugars and no ads for fruit and vegetables. The products were mostly what adults would describe as "junk food" but it is interesting that the term means different things to different age groups. High quality gourmet food may be regarded by children as junk. In many restaurants and hotels adults may be consuming quality food but the children's menu consists of sausages or chicken nuggets and chips.
Eating junk food is not the sole cause of the obesity problem but it is one of several contributing factors. Alcohol consumption patterns can also lead to a degree of excess calorie intake. Alcohol, like food, is there to be enjoyed. Relaxation and pleasure are desirable objectives. But when young people feel the need to go and "write themselves off" on a night out, this is a symptom of something wrong in society - a small subset of our youth is directly damaging their own health and indirectly that of others through violent behaviour.
A multitude of factors is contributing to the increasingly sedentary lifestyle of our children. Concerns about road safety and personal safety means most children are now delivered and collected from schools. Fear of litigation has resulted in banning skipping ropes, hoola hoops, skateboards, roller blades and even running from many school playgrounds. Availability of teachers to train teams is an issue, less male primary school teachers means less football trainers for boys. Teachers with longer commuting times to work, busier teaching schedules and home lives, have less time for extracurricular school sporting activities. Parents' involvement in school sport involves a degree of responsibility and risk many are reluctant to take.
Play stations and virtual sport are replacing exercise. If children do not engage in a sport before they are 11 they are unlikely to adopt one later in life. Increased participation in sport and exercise by ordinary mortals requires a different approach to that of fostering elite young athletes. In a country where outdoor activity is often curtailed by weather, availability of facilities and opportunities for affordable exercise are essential to make it easy and fun for both children and adults to participate.
We must use the strategies of the marketeers who influence purchasing and consumption patterns if we are to achieve change. Public awareness campaigns and education alone are not enough, as people might be aware some foods are not good for them and they may know about the adverse health effects of excess sugars, saturated fats and salt but they might not care either way. Therefore inducing an attitude change with sustained efforts and reinforcement from parents at home are necessary if the desired behavioural change is to be achieved. Fyffe's and Bord Glas have each piloted a promising intervention programme in schools to change peer pressure and make it trendy for children to eat fruit and vegetables.
But the Celtic Tiger has left some behind, and poorer people experience poorer health. If healthy food and opportunities for exercise become the prerogative of the rich, will only the wealthy be healthy? For many children, it is Christmas everyday and children are often in the driving seat with "pester power" ruling supreme. Patterns of behaviour adopted as children carry on into adult life. Time spent in educating children and encouraging healthy consumption and exercise patterns is the best investment we can make in their future.
Dr Patrick Wall is adjunct professor at UCD Centre for Food Safety, a board member of the European Food Safety Authority and former chief executive of the Food Safety Authority of Ireland.