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Disadvantaged kids more likely to be overweight by age four

Children from low socioeconomic backgrounds are already more likely to be overweight by age four than median income families…

Childhood has become the critical period when socioeconomic inequalities in overweight emerge and strengthen, the study found. MaST Charter

Children from low socioeconomic backgrounds are already more likely to be overweight by age four than median income families, but the differences become much more marked as childhood progresses, a new Australian study has found.

People who are overweight or obese in childhood are more likely to suffer health problems as adults and are then unlikely to return to healthy weight without significant intervention, experts have said.

The new study, conducted by the Murdoch Children’s Institute and published in the journal PLOS One, examined data on 4949 children from the Longitudinal Study of Australian Children. Body Mass Index (BMI) was measured at age four to five starting in 2004 and again every two years until 2010.

The researchers compared BMI with data on the study participants' family and neighbourhood socioeconomic status and found that disadvantaged kids were much more likely to be overweight.

“We showed that socioeconomic differences in high BMI already present at age 4-5 years not only persisted but had more than doubled by age 10-11 years,” the researchers said in their paper.

However, lead researcher Professor Melissa Wake, paediatrician and professor at the Murdoch Childrens Research Institute and Royal Children’s Hospital, said these differences were not just confined to the most disadvantaged.

“There was a stepwise gradient in risk, such that children in each quintile further from the most advantaged fifth were progressively more likely to be on a heavier growth pathway from early childhood,” she said.

The researchers said that childhood has become the critical period when socioeconomic inequalities in overweight emerge and strengthen.

“Although targeting disadvantaged children with early overweight must be a top priority, the presence of childhood overweight even among less-disadvantaged families suggests only whole-society approaches will eliminate overweight-associated morbidity,” the researchers wrote in their paper.

Wake up call

Melanie Nichols, a Public Health Research Fellow at Deakin University, said the study reiterated the fact that overweight and obesity are unevenly distributed in Australian society.

“It is a real wake up call, however, that inequalities in obesity prevalence are so stark among such young children. We must do more to support all families to make healthy choices,” said Dr Nichols, who was not involved in the study.

“Only a very small percentage of children who had been overweight returned to a healthier weight status, which really emphasises the importance of primary prevention to keep children healthy. We need to be thinking big picture about creating health promoting public policy and comprehensive, whole of community primary prevention approaches to address obesity in all age groups and all socioeconomic backgrounds.”

Louise Baur, a professor of paediatrics at the University of Sydney said the findings highlight how early the link between obesity and social disadvantage occurs.

“Disturbingly, the social gradient linked to obesity at age 4-5 years, where obesity was more prevalent in socially disadvantaged children, was even more pronounced at age 10-11 years,” said Professor Baur, who was not involved in the study.

“In clinical practice – clinicians working with patients and families living in socially disadvantaged areas, or who experience social disadvantage, should be particularly aware of their higher risk of obesity and obesity-related health problems and the extra support that may be required.”

Pathologising poor families?

However, Darren Powell, a doctoral candidate in Health and Physical Education at Charles Sturt University, said that “the problem with this sort of study is its reliance on BMI.”

“BMI is a highly contested measure, particularly so when measuring children’s fatness and comparing it a ‘normal’ or ‘healthy’ weight. Using BMI as a measure of health is even more problematic, given the research that questions the whole notion that being fat or obese or overweight is inherently unhealthy,” he said.

“My other concern is with the authors' recommendation to target overweight children with a low socioeconomic background. Again poor people and poor families are opened up to further interventions because they are assumed to be unable to make (or be responsible enough) to make the ‘right’ choices, live the ‘right’ lifestyle, or weigh the ‘right’ number of kilograms for their height.”

Mr Powell said that while it is critical to look at health inequalities that are associated with poverty, “I worry that this sort of research and interventions that spawn from it may further stigmatise fat people and effectively pathologise poor families, neither of which address the wider determinants of ill-health and poverty.”

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25 Comments sorted by

  1. Stephen Ralph

    carer

    Do overweight parents subconsciously feed their children too much to create them in their own image, or because they might feel insecure having thin(ish)
    children?

    It doesn't matter if you are rich or poor good food is cheaper or no dearer than bad food.

    Is it education , stupidity, neglect, ennui, bad choices????

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    1. deborah Whitmore

      artist

      In reply to Stephen Ralph

      I am sorry, but good food is more expensive than simple take away. I have seen both sides . I have an 11 yo daughter, and I can see the rise in food costs in the last 10 years. Buy a pizza, frozen, 6.50,,,, make it from scratch,at least 10 to 12, depending on toppings, I have done it. I personally think that we have lost the art of cooking. But even cooking costs money, buy the ingredients and see what I mean. I feel we should look to our Asian neighbours, who can cook delicious food simply. It is a skill we need to learn again. And more backyard gardens,, with kids involved, even if only a small part of the family diet.We need to make cooking at home part of the family experience again.

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    2. Stephen Ralph

      carer

      In reply to deborah Whitmore

      Hear you..................

      stir fry, pasta, vegie burgers (home made).........

      plenty of books on eating cheaply but well.

      And as you say grow your own - garden, pots, rubbish bins.

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    3. Jonathan Marshall

      Founder

      In reply to deborah Whitmore

      Good food is not more expensive than bad food (or nutritionally poor quality food).

      According to ABS 90%+ of Australian's live a short distance from a Cole/Woolworths/IGA or other major supermarket. Every supermarket has a fresh food section as well as low cost high quality protein sources.

      I have just returned from my weekly shopping at Coles and purchased a whole weeks worth of very nutritious food for under $40 for one person.

      1 Kg Coles Brand whole grain oats - $2
      7 Kiwi Fruit - $3.50…

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    4. Judith Olney

      Ms

      In reply to Jonathan Marshall

      My local woolies:

      Potatoes $6 a kilo on average.

      Kiwi fruit $1.20 each.

      Apples, pears, oranges $6-10 per kilo depending on availability.

      Bananas anywhere from $8 per kilo up to $16 per kilo.

      Broccoli the cheapest I have seen is $6 per kilo

      Oats are cheap, as is rice and pasta, but living on these cheap carbs is not at all healthy.

      Meat, don't even ask unless you want to buy pet food.

      Frozen fat laden oven chips, $3 per kilo, sometime cheaper on special. Mc D's family meal, $19 including the obligatory soft drink.

      I have no doubt that if you live in a city you can find cheap nutritious food, but not everyone lives in a city.

      If you are poor you will choose the cheapest option, and if that cheapest option is junk food, that is what will be bought. Even food that is sold as healthy, is mostly not, and the noise from advertisers far exceeds the pleas of nutritionists, and this is what people hear.

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    5. Judith Olney

      Ms

      In reply to Sunanda Creagh

      Exactly Sunanda, and there is also the issue of availability of fresh healthy food, which was also brought up in the article you linked to.

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  2. Jan Burgess

    Retired

    The old chestnut of good food being more expensive that cheap takeaways is just that, an old chestnut.

    A beef casserole (cheap cut of beef, carrots, onions, celery, tin of tomatoes, potato and a good serve of whatever greens are in season) can easily be made for less than $2.50 per serve. Stir-fries, pasta, eggs, baked beans - many other simple meals. It takes time and effort, not money. Probably less time than driving to the nearest takeaway, but certainly more effort.

    I would also second the ideas of more backyard gardens and more family-oriented cooking.

    I don't know if cooking is taught in schools these days, but if not it should be. And mandatory for all children male and female. Basic, simple, nutritious cooking - not master-chef stuff. If their parents won't or can't teach them, then perhaps the schools can.

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  3. Jim KABLE

    teacher

    It was in the GREINER era in NSW when Home Economics - Home Science was effectively gutted from the curriculum - most girls and increasing number of boys lost to any proper understanding of the science of food and its preparation. Bits and pieces of the former subject hived off to others in sport - new subjects created PDHPE (a version one might think of ADHD - and probably not too far from the truth if one follows the analogies) - and a free-for-all kind of opportunity for cheap eats fast food and…

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  4. Judith Olney

    Ms

    I agree with Darren Powell, quoted in the above article, there is a trend towards pathologising the poor. Stereotyping the poor as ignorant, lazy and now fat, and blaming them for their situation has become a national pass time with those more fortunate. This has led to patronising interventions, and the desire to punish people rather than offer genuine solutions to the problems that the poor face. We see this in the way that single parent payments were cut, even for those already working as much…

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    1. Jonathan Marshall

      Founder

      In reply to Judith Olney

      Judith - Big Food has a great deal to answer for and they certainly contribute significantly to the problem.

      But that does not detract from the fact that some in society are making poor choices - how many times does one need to say it that Junk Food is Bad Food, Junk Food will lead to obesity and poor health. We are told this from about the age of two and it is drummed for ever more - but still people make poor choices.

      So on TV the image is of middle class families going to fast food restaurants…

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    2. James Jenkin

      EFL Teacher Trainer

      In reply to Jonathan Marshall

      Hi Jonathan, do you think working class people are less likely to be successful parents than the more affluent?

      You seem to be suggesting they're more easily sucked in by 'big food' and appear to make worse choices.

      I may have totally misread you!

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    3. Jonathan Marshall

      Founder

      In reply to James Jenkin

      Hi James,

      Cannot comment of the question regarding "successful" parenting - that is a complex issue and there is a lot of research showing the intensive helicopter parenting of middle class parents can be reducing the emotional resilience of children.

      Again a very complex area though what research is out there tends to indicate "tough love" is the best parenting approach. The Demos Think Tank in the UK did some terrific research on this a few years back.

      But would probably agree (though…

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    4. Judith Olney

      Ms

      In reply to Jonathan Marshall

      I agree with you Jonathan Big Food does indeed have a lot to answer for, and I know adverts are not real, as do most people, but this is not the issue.

      I also agree that reading to kids is great, and most of the people I know already do this, but again this is not the issue.

      The issue is that we live in a consumer society, and to feel like you belong in society, (this is a basic human need), it is necessary to consume. Advertisers know this.

      It is complicated, far more complex than your post suggests.

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    5. Judith Olney

      Ms

      In reply to Jonathan Marshall

      Rather than just blaming people, and seeking to stigmatise the poor even more than they are, we should be looking at why this is happening, smug judgements about personal responsibility, and how ignorant you believe others to be, helps no-one, nor does patronising advice.

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  5. rory robertson
    rory robertson is a Friend of The Conversation.

    former fattie

    Sunanda, thanks for your timely update. Of course, an important part of Australia's obesity problem as you describe it is that reliable information on healthful nutrition is less prevalent amongst less-well-off parents. That is, too many parents have no idea that many of the things that they allow into their children's mouths actually are a serious health hazard, in part because professional nutritional advice often is as clueless on this matter as the population in general. (Try googling "Coco…

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  6. Brian Byrnes

    Retired

    Sunanda, are you aware of any research which actually tells us about the typical diet of the 27% of children who are overweight or obese ? Perhaps more importantly, what is the diet of the 73% of children who are not overweight or obese ?

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    1. rory robertson
      rory robertson is a Friend of The Conversation.

      former fattie

      In reply to Brian Byrnes

      Brian, Sunanda and other readers may come back and prove me wrong, but my strong sense is that there is not much in the way of hard, reliable data on what the healthy kids are consuming versus what the unhealthy kids are consuming, given myriad measurement issues including those associated with "free ranging" and "self reporting". We do, however, have quite good information on what groups of other disadvantaged Australians are eating and drinking on the way to getting fat and sick: bottom row of…

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    2. Brian Byrnes

      Retired

      In reply to rory robertson

      Rory, thanks for your link, which is very informative in respect of remote indigenous community diets.

      It is however very difficult to see a parallel between that and the dietary habits of western Sydney or Melbourne residents who have much more ready access to a much wider variety of foods, both fresh and processed.

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    3. rory robertson
      rory robertson is a Friend of The Conversation.

      former fattie

      In reply to Brian Byrnes

      Actually, Brian, in my opinion, it is not very difficult to see a strong parallel: the common thread (threat) is sugary drinks and sugary junkfoods, including breakfast cereals. Just as the people in Professor O'Dea et al's study are sucking down giant-sized servings of sugary drinks and sugary junkfoods - on average, over 20% of daily energy intake was refined sugar, more than twice the "recommended" dosage - so too are many other adults and kids elsewhere in Australia's poorer communities, in…

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  7. Gary Cassidy

    In my experience a good quality diet costs more than a low quality diet dominated by sugar and other refined carbohydrates. However, regardless of the outright value of food as fuel, food also carries other value. Food is a social thing, a fun thing, an exciting thing, a thing of occasion, of association, of comfort. Food processors know this and cleverly market their products to promote excitement, fun, comfort, etc. So when people buy this low quality cheap food we are subconsciously including…

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  8. Raine S Ferdinands

    Education

    Food is food; no such thing as good food and bad food. Choices are made by individuals. Parents who have an issue with food, create an environment that facilitates and enhances this poor decision making and choice of food to their offsprings and the cycle continues. Branding good food as expensive is a cop out and utterly irresponsible. Lazy people make excuses and are not willing to take responsibility for there eating habits. Come on, people, call a spade a spade. Take responsibility for you actions, or the lack of it. Food choices abound in a country like Australia; take the initiative to get valid information on food and get cooking at home.... simple nutritious meals in ten minutes or so and save money, too.

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  9. Simon hauser

    Medical Specialist

    Inadequate parental education is the issue. I work in a low socioeconomic area and most children are overweight if not obese. Many of the families I see have generational health (and general) illiteracy. These families give there childen unhealthy food as it is 'easier' to prepare and it's what they eat themselves. Most overweight children I see eat the same portion sizes as their parents.

    A public health education campaign is necessary with major input from schools... don't get me started on what is sold in school canteens in lower socioeconomic areas.

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    1. rory robertson
      rory robertson is a Friend of The Conversation.

      former fattie

      In reply to Simon hauser

      Simon, on your suggestion for a public-health education campaign in schools, perhaps you will join my push to give all kids a fairer and healthier start in life: http://www.australianparadox.com/pdf/Sugary-Drinks-Ban.pdf

      If after assessing the facts you think this proposal has merit, please forward it to parents, students, teachers, principals and heads of schools, nurses, doctors, dentists and others involved in public health and education.

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