Most Victorians will be familiar with health messages encouraging them to eat less, choose healthier foods and be more active. Yet despite the prevalence of such advice, Victorians and Australians generally continue to become heavier and sicker.
Treating and preventing the complex and worsening problem of overweight and obesity is an area of increasing urgency, with associated illnesses such as diabetes, heart disease and stroke affecting all sectors of society.
New research funded by VicHealth on the past trends and future projections of overweight and obesity has found that – by 2025 – around 83 per cent of males and 75 per cent of females aged 20 years and above will be overweight or obese, as well as one-third of 5–19-year-olds. The research, Past trends and future projections of overweight and obesity, combines epidemiological analysis with chronic disease modelling techniques to examine the trends in obesity and its related diseases.
The research was led by Head of Obesity and Population Health at the Baker IDI Heart and Diabetes Institute, Associate Professor Anna Peeters, and aims to improve understanding of obesity trends, the health risks associated with obesity, and the impact of specific obesity interventions on different social groups. Her paper also projects that for the most disadvantaged groups in society obesity could affect almost one in two.
It was this finding Associate Professor Peeters said most concerns her. "Obesity is high and increasing in prevalence, and is unequally distributed across society," she said. "It is important that we identify the most effective and equitable interventions to prevent and manage obesity in order to improve health and wellbeing for all Australia’s adults and children."
While body weight has increased across the entire Australian adult community, Associate Professor Peeters' research identified that the greatest increases have been at the higher end of the weight spectrum. In other words, the rate of increase in severe obesity is much greater than the rate of increase in mild obesity. This, combined with the social inequalities associated with obesity, means current, simplified monitoring of overall obesity trends may be masking the rapid increases in severe obesity, and associated large social inequalities.
To combat this, Associate Professor Peeters recommends improving the rigour of some of the strategies already being used to tackle and prevent obesity. For example, current school nutrition guidelines should be made mandatory; government measures that have long been discussed should be introduced, such as removing marketing of unhealthy food and beverages from settings where children and adolescents are exposed, including digital marketing and sports sponsorship; and workplaces should become healthier environments.
But strong leadership will be needed to achieve these changes, Associate Professor Peeters said, making a number of recommendations in her research. The Federal Government must facilitate discussions around food taxation and advertising restrictions in order to promote healthy eating. Occupational health and safety legislation needs updating to better address modern risks to the health of employees, for example sitting for long periods of time. And State and local governments should facilitate partnerships to ensure local environments are conduits for the promotion of physical activity and healthy eating.
A range of efforts are already underway such as the Healthy Together Victoria initiative, which incorporates policies and strategies to support good health across Victoria, as well as locally-led Healthy Together Communities. Another example is the forthcoming collaboration between VicHealth, Superfriend and WorkSafe Victoria to promote workplace health. With most working-age Australians spending about one-third of their waking lives at work, it is logical that workplaces nurture good health with a supportive environment, conditions and culture1.
Reducing sedentary behaviour in the workplace is also critical especially with physical inactivity responsible for an estimated 16,000 premature deaths each year in Australia and costing the health system at least $13.8 billion each year in direct health care cost2. Barriers to the implementation of such measures must be overcome. But Associate Professor Peeters said a lack of clarity of roles between local, State and Federal governments, the large industry opposition to a number of the potential obesity-tackling measures, and the difficulty in obtaining evidence of effectiveness for any specific intervention were hampering obesity prevention and treatment efforts.
Executive Director of the Centre of Excellence in Intervention and Prevention Science, Dr Alan Shiell, says focusing on children may be society’s best bet in addressing an escalating obesity battle. "We have a huge and powerful food and drink industry that wants to promote the wrong kinds of food, there is a belief that what we eat and drink is purely a personal choice that should have nothing to do with government, and there is a lack of political will behind intervening, getting into people’s kitchens and taking on the food industry."
However, those barriers are becoming increasingly hard to justify where children are involved, he said, which meant there might be more opportunities – and political will – to implement change in the environments children most interact with. Recent physical activity guidelines released by the Federal Government for the first time warn of the health dangers of sedentary behaviour in young Australians3. Updated guidelines state that children and teenagers should accumulate at least 60 minutes of moderate to vigorous exercise activity every day, including aerobic activities. The guidelines urge parents to encourage their children to do more traditional exercises such as skipping, hopping, running and jumping, playing games such as hopscotch; and to take up structured activities, including dance, gymnastics and martial arts.
Previous research has found that obesity in childhood is linked to a higher chance of obesity in adulthood4. Therefore, any increase in rates of childhood obesity will contribute to the already alarming rates of adult obesity and related chronic diseases in Australia.
Similarly, an inactive child is likely to continue on a path of inactivity throughout adolescence and into adulthood5. However, if people are active as young children, they’re more likely to stay active throughout childhood and develop good habits to support becoming healthier adolescents and adults6.
VicHealth CEO Jerril Rechter agrees that the early years of childhood is a vital period to shape healthier attitudes and behaviours. Unfortunately, Australian children are more inactive than ever before. "The unfortunate consequence of modern life being predominantly sedentary also impacts our younger generations, with many of our children spending too much time sitting each day and not enough time being physically active.
"This is affecting their health and wellbeing, their school performance, their self-confidence, their ability to mix with peers – all with lasting consequences," Ms Rechter said.
Getting children to move more in their daily lives requires understanding the barriers that are preventing this and how to overcome them.
"There are a range of influences shaping how active a child is in their day, from where they live, the school they attend, the opportunities for physical activity each day, the games they play and of course, their home environment," Ms Rechter said. "Considering how to better integrate movement and reduce the convenience of sitting for children in a variety of situations is important."
Ms Rechter hopes a new VicHealth resource, Active for Life, will help decision makers in a position to influence the environments where children live, learn and play. School teachers, community groups, art organisations, sporting associations and clubs, and state and local government officers in the areas of planning, health, education, parks, sport and the arts are encouraged to refer to the resource when considering how to get children to more active.
VicHealth's Active for Life brings together Australian and international research to challenge our current thinking and identify the changes we can all make to influence how much our children move each day.
Investing time, effort and resources into policies, programs and infrastructure that support and encourage physical activity among children can bring enormous rewards – including improved physical and mental wellbeing, more social interaction and improved academic performance. This will also result in stronger, more connected communities, higher performing schools, more vibrant sporting clubs, arts organisations and happier, healthier families and communities.