Sara Kirk, PhD, Canada Research Chair in Health Services Research, Research Associate with the Atlantic Health Promotion Research Centre and Full professor in the School of Health and Human Performance at Dal.
A new study on rising rates of obesity was published on March 3rd and has generated a lot of media interest. The trend analysis, by Laurie Twells and colleagues in Newfoundland, makes depressing reading – since 1981, the prevalence of obesity has increased by 200%, and rates in the Atlantic provinces are among the highest in the country. The health budget in Nova Scotia currently consumes more than 50% of the total budget, with much of this needed to address the burden of chronic disease in this province. Nova Scotians are among the least healthy in the country – with the highest rates of heart and lung diseases and the second-highest rates of diabetes and hypertension. We also have the highest proportion of individuals with multiple chronic conditions. Obese children have 21% higher physician and hospital costs than their normal weight peers (Kuhle et al, 2010), a cost differential that will only increase as these children age, threatening to overwhelm our health system unless we do something about these disturbing trends.
The reasons for the increasing rates of obesity and associated chronic diseases is complex. One key factor is that we live in an “obesogenic environment” – an environment that promotes the unhealthy choice as the default choice and in which healthy behaviour is the abnormal behaviour. Schools are one place where we can help our children to learn about healthy eating and active living, where we should be modelling the behaviours we want our children to adopt, yet these healthy messages are undermined by the constant barrage of unhealthy foods promoted by the food industry and a culture that equates junk food with “having fun”. Junk food is everywhere and cheap to buy, but it is costing us dear in increasing rates of poor health. Time pressures mean that we have less time to prepare healthier, home-cooked meals or to sit down as a family to eat. Ironically, time pressures to engage in physical activity can limit our ability to eat family meals at home – a case of one healthy behavior threatening to displace another in our crazy world (Chircop et al, 2013).
There is a glimmer of hope and that rests with all of us. As a society, we need to look at the bigger picture and recognize the multitude of factors that influence our ability to eat a healthy diet and be physically active, such as income, availability, education and culture, to name a few. It will take time to reorient our physical and social environments to promote health rather than hinder it. But there are some quick wins – things that we can all do to improve our health. Evidence suggests that children who are involved in meal preparation and enjoy meals with their families also have healthier diets. With March being nutrition month, there is no better time to make plans to eat more healthily – “simply cook and enjoy”.
For information on Nutrition Month, visit http://www.dietitians.ca/Your-Health/Nutrition-Month/Nutrition-Month-2014.aspx
Chircop A, Shearer CL, Pitter R, Sim M, Rehman L, Flannery M, Kirk, SF. (2013). Privileging physical activity over healthy eating: “Time” to choose? Health Promotion International 2013; doi: 10.1093/heapro/dat056.
Kuhle S, Kirk S, Ohinmaa A, Yasui Y, Allen A, Veugelers P (2011). Use and cost of health services among overweight and obese Canadian children. International Journal of Pediatric Obesity April 2011, Vol. 6, No. 2: 142–148.
Twells LK, Gregory DM, Reddigan J, Midodzi WK (2014) Current and predicted prevalence of obesity in Canada. CMAJ opne, DOI: 10.9778/cmajo.20130016.