Social Development Committee: Obesity

05 May 2004 archivespeech
This speech is in relation to obesity in Australia and the Social Development Committee.

The Hon. J.M.A. LENSINK: In commenting on this report I would like to acknowledge the work of the committee, in particular, our chair, Gail Gago and fellow parliamentary colleagues, the Hon. Terry Cameron, the Lion of Hartley, Mr Jack Snelling, and Ms Frances Bedford. This is a very comprehensive report encompassing close to 200 pages, which I think recognises the significance of the problem. I encourage all members to read it from cover to cover; it is very interesting. I do not say that facetiously. I have spoken to a number of community groups on this issue and they are always fascinated by some of the statistics which are particularly frightening. I have had an interest in this issue for some time, so I greatly enjoyed working on this committee. I commend our research officer, Suzie Dunlop, and our secretary, Robyn Schutte, for their work on this report.

As I said, the statistics are very frightening. As the Hon. Ms Gago pointed out, 60 per cent of men and 50 per cent of women are either overweight or obese. That is 2½ times the percentage in 1980. If we continue at the current rate—according to some of the evidence that we received—by the year 2025, 90 per cent of our population will be overweight or obese. This is a problem for many countries in the OECD. The United States Surgeon-General has declared war on obesity, and the 57th annual assembly of the World Health Organisation, which will meet in two weeks, will focus on this topic.

In Australia, we cannot blame our climate for not exercising. We also cannot claim a lack of availability of fresh, unprocessed foods, so there are obviously a number of other factors at play. As the Hon. Gail Gago said in her speech, 25 per cent of children are now overweight or obese. This is probably the most alarming statistic of all. Surveys conducted in South Australia show that children are now 3.4 kilos heavier than in 1985. That figure takes into account height and weight changes. If you say that perhaps they are taller, well they are only 2 per cent taller and 7 to 8 per cent heavier, and their waist girth measurement is 6 to 8 per cent larger. So, obviously, they are growing outwards out of all propor¬tion to their growth in height.

The risks of being overweight or obese are significant. They include: cardiovascular disease and type II diabetes, which was previously called adult onset diabetes. but which now occurs in children. Type II diabetes can cause other effects such as circulatory problems, cardiovascular disease again, and strokes, and it now affects 940 000 Australians. That figure has trebled in the last three years. Other risks include: high blood pressure, which also leads to kidney disease and strokes; some forms of cancer; and hormonal changes. Something that the chaps might like to note is that testosterone levels can drop, and arthritis and reduced musculoskeletal development are also possibilities, together with mental health problems, which can affect social status and sleep apnoea and so on.

In the United States the Surgeon-General stated in 2001 that the technology gains made in areas such as heart disease, diabetes and cancer may be completely wiped out by obesity. As has been stated, it costs Australia $1.03 billion per annum and I would hazard a guess that that would include some of the direct costs of treatment and the weight loss industry. Weight Watchers has something like 420 000 life members in Australia, Jenny Craig some 200 000 and there are indirect costs of secondary health problems, lost productivity and premature death.

To focus on children, there is a tendency in Australia and South Australia for children to become overweight and obese in their pre-school years. A study referred to several times was done on four-year olds, tracking their dietary habits and from 1983 85 and 1995 there was an increase in energy intake over that period in which childhood obesity and overweight rates doubled. The criminals here are the intakes of highly processed and high energy dense foods such as cakes, biscuits, chocolate, soft drinks, sugar and so on. Over that time milk take decreased by about 90 per cent. Children are replacing their milk intake with soft drinks, fruit juice and cordial, which is one of the messages we need to get out that parents need to be aware of.

We are all probably aware that we do not move enough. Only about 50 per cent of adults are sufficiently active and, while something like 80 per cent of children are sufficiently active, their level of sedentary activity has also vastly increased. For every hour a child spends in front of the television their risk of obesity increases by some 10 per cent and it is recommended that they should not be inactive for more than 120 minutes.
The factors that we are probably intuitively aware of are that we have had a number of changes in our society and environment, so the term `obeseogenic environments' has been created. We have an increasing proportion of energy dense and highly processed foods. We upsize and on average eat larger sizes. The average slice of bread 10 years ago was 28 grams and today it is 45 grams. Interestingly, over the past 30 years we received and adhered to strong messages about fats, as members would know from going to the supermarket and seeing low fat this, that and the other, but the role of carbohydrates in weight gain has been ignored. That is where some of our problems are coming from.

When I have been speaking to community groups I usually do a quick survey of the required daily intake of how many serves of fruit and vegetable are required and there are not too many people who get that right. Obviously we live on smaller blocks and that has had a significant impact. People watch more TV, spend more time in front of screens and there are safety issues as well with parents being busier and having less time to accompany their children. Parents are tending to drive their children to school and do not let them go to the park by themselves.

 If you compare generations and surveys, of today's parents 83 per cent played unsupervised in their neighbourhood compared with 25 per cent of today's children. From 1985 to 1997 the percentage of children walking to school dropped from 45 per cent to 33 per cent and the percentage riding to school dropped from 16 per cent to 9 per cent. There are fewer opportunities for participation in community sport because there are fewer coaches, referees and sports adminis¬tration people and some sports are quite costly for participants.

 People cook less at home. If they eat out the foods tend to be high in calories. We get to some of the solutions. This is a very complex area, as the chairperson, the Hon. Gail Gago, pointed out. I will reflect on some of the comments of Dr Allison Smith who works for the Centre for Health Promotion at the Women's and Children's Hospital, namely, that if we are to tackle this seriously there needs to be a long-term investment. The solutions will be complex because the causes are complex and the solutions will need to be based on evidence and involve communities and all of the settings in which children are located.

We also heard, unfortunately, that there is not much empirical evidence about what works. David Engelhardt and Victor Nossar from Child and Youth Health, in their written and oral evidence, stated:

 There is scant evidence that any interventions over the past 30 years have brought about the desired reductions in childhood obesity at the population level.

We do need to focus on prevention rather than treatment and need to focus on a multi-strategy approach, so we are looking at homes, communities, schools, out-of-school hours care and so on. Comparisons have been made with smoking and the reduction in smoking levels. As everybody would be aware, that has been a sustained process. We have had legislative intervention as well as education, which, as the previous speaker pointed out, by itself does not necessarily work. We need good nutrition education about what people should and should not be eating and simple clear messages and need to provide people with much better opportunities to make healthy choices. One of the big things this report has to say is that it is not that easy to make healthy choices because the bad ones are far and wide and easy to fall into.

Breastfeeding within the first six months has a protective role in preventing obesity. We heard quite a bit about things such as breakfast programs and school tuckshops and trying to get the message through to children and families about having junk food just on special occasions so that people do not think that when you are hungry you eat a bag of chips. The TV advertising was particularly interesting. Some of the evidence we heard was that something like 80 per cent of ads in kids' TV viewing times are for high fat/high sugar foods, which has the effect of normalising children's attitudes towards these foods. Five to 12-year olds watch on average some two and a half hours of television every day. Young children under 10 years are not able to discern the persuasive intent of adverts and, having being a resident aunt, I can say that that is certainly the case. TV is the primary medium used by food companies to market to children. The number of food commercials is something like 12 per hour and is one of the highest rates in the world and greater than the rate in the United States.

Some of the evidence internationally showed a favourable correlation between the regulation of junk food advertising and obesity. Australia is the only country with no regulations about the type or amount of TV ads kids can view, and that is something about which we have made a recommendation. We have also recommended that organised physical activities for primary school students be 30 minutes a day and 100 minutes a week for secondary students. We agree that some of the actions taken by the industry to improve the calorific and nutritional value of their foods is welcome. We also applaud things like virtual buses and walking school buses that collect kids on their way to school and provide a safe option to ensure they get some exercise daily. We also applaud the work of organisations such as the Women's and Children's Hospital, which produce simple information for schools to include in their newsletters. There were also other urban development issues to do with safe play zones, safe bike lanes and providing safe places to walk. Cul-de-sacs discourage people from walking—a bad innovation of the past few decades.

The good news is that small amounts of weight loss lead to significant health increases. If an individual loses three kilos their cholesterol decreases, four kilos lead to diabetes prevention and to lowering blood pressure. If across the population people on average lost five kilos, overweight and obesity rates would fall to 45 per cent.

 Brian Haddy, who used to run Gutbusters, had some very good news for the fellows; that is, they can lose weight quite easily, lose a kilo a week or a centimetre off their girth and manage to keep it off. The bad news for women, unfortunately, is that it is much harder work for us to lose weight, but we always knew that, anyway. I commend this report to the council and encourage everyone to take some interest in this because, clearly if we do not take some pro-active action, things will get worse and it will be quite costly for us in the future.