After receiving such a fantastic and positive response, not just from Ireland but from around the world regarding my last blog Obesity in Children, I have been asked on several occasions in the past few days to discuss the problem of obesity in Ireland in general. I have to point out that I’m not a statistician, I’m not a medical officer and I do not know about what the obesity levels and government plans are for tackling obesity in different countries other than Ireland. All of my opinions are my own unless referenced to a third party. All of the below are correct as of 2014, unless updated and stated.
Obesity in Ireland
So where do you start when you want to talk about obesity in Ireland? So I suppose I’ll start with some facts about obesity:
- 61% of adults and 20% of children are overweight or obese.
- Men are more likely to be overweight than women, but obesity rates are about the same.
- Obesity tends to be higher in those aged over 35
- One in ten 5-12 year olds is overweight and a further one in ten is obese.
- One in five teenagers is overweight or obese
One of the more shocking facts is that these statistics are getting worse by the year!
What do I mean by overweight and obesity?
Perception in Ireland is that we tend to underestimate our weight. We think that being overweight is bigger than we actually think. Out of the 61% of adults who were overweight or obese 40% of these didn’t realise they were. This has also been shown in a recent survey of Lifestyle, Attitudes and Nutrition (SLÁN) and measured (by researchers) BMIs, finding that when self-reporting, people tend to underestimate their weight. To some extent I was one of these people who used to underestimate their weight too. I remember initially (before I gained an excessive amount of weight) not thinking I was overweight. I saw myself as having “big bones”, that I was actually quite slim but I was “broad”. I was not as slim as I’d like to be sure – but certainly not overweight, looking at others around me I wasn’t anywhere near overweight. I told myself that I could never be as slim as other people because it was my frame. But at a size 12-14 for my height, and 11 stone and what I have now discovered as quite a petite frame and not big boned at all – I was actually overweight! This of course became worse and gradually each year edged closer and closer to the obese range before I finally hit over 16 stone and got the kick I needed to get my life back on track.
Overweight and obesity are defined as ‘abnormal or excessive fat accumulation that may impair health’.
The health effects of being overweight or obese:
- Coronary heart disease
- Type 2 diabetes
- Cancers (endometrial, breast, and colon)
- Hypertension (high blood pressure)
- Dyslipidemia(for example, high total cholesterol or high levels of triglycerides)
- Stroke
- Liver and Gallbladder disease
- Sleep apnea and respiratory problems
- Osteoarthritis(a degeneration of cartilage and its underlying bone within joint)
- Gynecological problems (abnormal menses, infertility)
*Overweight is defined as a body mass index (BMI) of 25 or higher; obesity is defined as a BMI of 30 or higher. You can check your BMI on our 3D BMI Calculator
Measurement in Adults
To measure quickly and on a grand scale, the rate by measuring an adults weight in Ireland is the BMI chart, which is endorsed by The World Health Organisation (WHO). BMI is a calculation of weight in kilograms divided by height in metres, squared (m2). It would unrealistic to measure and complete a body composition on every person. It would just take too long and cost too much. ‘The World Health Organisation defends BMI as a measure, but cautions that it ought to be considered ‘a rough guide because it may not correspond to the same degree of fatness in different individuals’. The issue with the scale is that is does not allow for age, gender, or ethnicity differences or for a range of body types to be described as ‘normal’. Other challenges to this model are that the measure does not distinguish between fat and muscle weight and so it is not a reliable measure.
Measuring Children
‘It is difficult to develop one simple index for the measurement of over weight and obesity in children and adolescents because their bodies undergo a number of physiological changes as they grow.’ (WHO)
Due to height and growth variations, measuring over weight and obesity in children is complex. A child’s weight status is determined using an age and sex-specific percentile for BMI rather than the BMI categories used for adults because children’s body composition varies as they age and varies between boys and girls.
Children’s weight and obesity were strongly linked to that of their parents. Where both parents were overweight or obese, 33% of children were overweight or obese. This compares with 11% of children in households where neither parent was overweight or obese. As I mentioned in my previous blog, my son was over weight at the same time I was over weight. I know now what I was feeding him was way too much for what he actually needed and I know it was my fault but I also knew that it was my responsibility to make a change. Just as I changed my life around, his diet automatically changed too. As my weight came off, so did his!
You can check your child’s BMI here on our Children’s BMI Chart
Do you think the weight of children is the responsibility of the parent? I think this is a really tough question……sometimes as parents we think we are doing our best, and of course we never intentionally go out to make our children overweight. We love our children and want to make sure they are happy, and of course sometimes as parents we also have our rose tinted spectacles on and if our children are a little overweight we might not even see it. But what I do know, is that since I’ve made changes to my diet, my little boy is now in a healthy (and proportionate) weight for his height. Sure, he still has his treats, but now i’m more educated about the nutritional content of certain foods – I’ve swapped out most of the kids foods and replaced with better choices. The kids eat what we eat, and because I’m eating healthier – so are they.
They are also more active – because I’m out running, or doing different activities – they want to be too. Over the weekend they were itching to go “running” and we hit to the estate with paper and pen and a stop watch, created different “courses” and then with a ready-set-go they both ran as fast as they could around the course while I timed them. Then they did it all again trying to beat their own time – I honestly can’t say they would’ve wanted to do that if they didn’t see me out running. Being active is the best way to help upkeep a healthier body shape and lifestyle, so in effect me being more active is showing them a new and different normal to what it would have been before. I suppose what I’m saying, for me – is that I think as parents it is our responsibility to lead by example, making it normal to eat good food and keep active.
Do you think that it is the role of food industry that is making us overweight?
- Recipes high in sugar, salt & fat
- Large portion sizes
- Poor nutritional labeling
- Aggressive marketing of unhealthy foods
For me, looking in the supermarket – it hardly makes it easy for us to make healthy choices. Even the healthy choices are often filled with hidden sugars and salts and other bad stuff. It seems sometimes that it’s unavoidable! It certainly doesn’t help matters, but at the same time – we can make more sensible choices by learning how to understand the food labels a little better. Choosing the lower calorie, lower fat options when comparing products and also taking charge of our portion sizes at home. Eating out is difficult as portion sizes really are often double what we actually need – but at home, we can take more control.
Do you think it is because of the new environment that we now live in, food commercialism, technology, inactive lifestyles etc.? It’s easy to start laying blame everywhere, but today’s technologies do and have changed the way with live our lives. We don’t walk a few doors down to knock on the door to talk to our neighbour, instead we send a text or pick up the phone. Instead of running around in the fresh air because there is nothing else to do, we watch T.V, play on computer games or are spending a lot of time travelling to and from work where we sit at a desk all day and then feel too tired to fit any kind of activity in. Generally we are using up less energy and moving less, but still eating the same (or more), this coupled with the food industry and food choices on offer in the shops don’t make it easy to grab something healthy!
The International Association for the Study of Obesity states that: ‘Excess weight gain was found to be the 6th largest contributor to the world’s disabilities and premature deaths, and by 2006 excess weight had become the 3rd largest cause of ill health in the affluent world.’
Two RAND researchers examined the comparative effects of obesity, smoking, heavy drinking, and poverty on chronic health conditions and health expenditures. Their finding: Obesity is the most serious problem. It is linked to a big increase in chronic health conditions and significantly higher health expenditures. And it affects more people than smoking, heavy drinking, or poverty.
Although obesity is a recognised health risk, there have been relatively few public policies designed to reduce its prevalence. Governments haven’t given obesity the same attention as other risks, like smoking, but it is clearly a top health problem and one that is on the rise in all segments of the population. More effective clinical and public health approaches are urgently needed.
So what is Ireland doing about it?
The HSE Framework for Action on Obesity has set up strategic priorities
- Enhance the effectiveness in surveillance, research, monitoring and evaluation of obesity.
- Develop a quality, uniform approach to the detection and management of obesity.
- Improve the capacity of the HSE in preventing overweight and obesity and to promote health.
- Communicate the HSE’s messages on obesity effectively
- Engage and support sectors in addressing the causes of obesity and the obesogenic environment
I mentioned in my last blog that the HSE were about to bring in weight monitoring in schools for young children. Other projects arising out of the framework include:
- Provision of growth monitoring equipment and training
- Conduct several baseline research studies
- Implementation of several prevention programme such as the HSE Dublin North East’s ‘Be Active After School Activity Programme’
- Sponsorship of the Community Games.
The HSE has also been involved in mass communications via RTE’s Operation Transformation television programme.
The Irish health Minister has indicated that priorities include
- Calorie posting on menus
- The introduction of a “sugar tax” – tax on sugar sweetened drinks
- Nutritional labeling
- Restrictions on the marketing of food and drinks to children
- Improved detection and treatment of obesity
- Revised healthy eating guidelines
- Promotion of physical activity
Facts if not stated reference Oireachtas library & research service Nov 2011
Do you think having the calorie amounts on all menus will make a difference?
It was only a couple of days ago I met with my parents-in-law for coffee in a nearby café. I was pretty impressed, all the bagels, sandwiches and rolls had their calorie amounts next to them on the menu. I have to say it was very handy. I have a fairly good idea of how many calories are in what but you’d never be 100% sure so it was really good knowing that the bagel that I was about to select was the highest in calories and fat! I knew I would be having a substantial meal for dinner that evening so by using the calories on the menu I was able to select something that was less in calories and fat but still something that I liked. I thought this was a fantastic idea and all food outlets should have the calories and fat shown for their food. It also highlighted that no matter how much I think I know about food, that it can still shock you – at a glance looking at the calories, there were some choices that on the surface seemed to be good choices but the calories showed otherwise and that there must’ve been hidden calories in the mayonnaise or dressings that you wouldn’t even have thought about had the calories not been up on the board. It would certainly make me think twice about having anything at all – especially if I was trying to lose weight, as half my daily allowance would be gone on one small meal! I think in effect – this will gradually help people to become more aware, and might be the little nudge/reminder some people need to deter them from a certain choice.
I can understand that this may not be possible for every restaurant. Restaurants that change their food menu on a daily basis would not feasibly be able to have the exact calorie amounts on their foods as they might only write up their menu on the day or few days before and would need to get all the calories checked by a nutritionist. What I did notice in another menu in a restaurant though was a general calorie guideline with a Minimum and maximum calorie amount next to the item on the menu. This means that restaurants can give a guideline without having to get exact figures which I thought was a good idea, and certainly made me change my mind about what I was choosing to eat too!
In June 2011, the European Parliament voted against proposals to introduce a new ‘traffic-light’ style food labeling regulations. The traffic light system displays a red, amber or green light on the front of food packaging to clearly show consumers how the contents rate in terms of healthy eating criteria. The colour is determined by the levels of calories, sugar, salt and fat the product contains.
The European Public Health Alliance (EPHA) backed the measure, citing evidence from British and Australian research that found that: ‘a traffic light label on the front of [the] package is the best way to facilitate accurate interpretation of key nutritional information and therefore enable consumers to make informed choices about the food they purchase.’
Studies showed that the traffic light system is understood equally by all consumers, regardless of socio-economic status, gender or ethnicity. This type of labeling is already used by some supermarkets in the UK. The food and drinks industry was opposed to the traffic light labeling system. It ran what has been described as ‘one of the most expensive lobbying campaigns ever mounted in the European Union – at a cost of a whopping €1 billion euro’.
Food and Drink Industry Ireland (FDII) welcomed the MEPs rejection of the traffic light system, saying it ‘failed to take into account the place of a particular food in the context of a balanced diet and healthy lifestyle.’
Instead, a rival system known as Guideline Daily Amounts (GDA) is to be introduced across the EU on a mandatory basis. This scheme expresses nutritional content as a proportion of the recommended daily intake of each nutrient.
This insert was added 23rd August 2012: Today Tesco, the UK’s biggest supermarket, will introduce a ‘traffic light’ food labelling system after finally bowing to pressure from shoppers. http://www.telegraph.co.uk/news/uknews/9492946/Tesco-finally-introduces-traffic-light-food-label-system.html
You will already have seen a lot of products advertising that the food is so many percent of your GDA. Personally I would have preferred the traffic light system as it would have made checking of nutritional labels that much easier.
The obesity level in Ireland is getting worse every year and we are on target to match the level of the United States.
What can you do about it?
- Eat smaller portions
- Eat healthier
- Check nutritional values of food
- Keep active
- Restrict foods that you are giving to children
- Understand that being overweight or obese is not healthy
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