Tackling the heart of childhood obesity

Tackling the heart of childhood obesity

Louise Baur

Childhood obesity is largely a by-product of socio-economic status, and diet and exercise programs alone won’t reduce rates of the disease among children, a new study has found.

For the very first time, a study published in BMC Medicine has mapped the complex pathways leading to childhood obesity, to get to the heart of the issue.

Childhood obesity is a complex health issue which requires complex solutions.

Unfortunately, one in four school-aged children and adolescents in Australia are affected by overweight or obesity, with one in 12 affected by obesity. Obesity can lead to a higher risk of cardiovascular disease, insulin resistance, psychological effects and even premature death.

Coordinated by the University of Sydney’s Charles Perkins Centre, the study brought together leading clinicians and scientists from the University of Sydney, University of Technology Sydney and CSIRO to analyse the long-term data of 10,000 Australian children, drawing on ‘Growing up in Australia: The Longitudinal Study of Australian Children’.

Examining factors at an individual, family and broader population level, the study found “upstream” factors – those relating to macro level social inequities – in particular, lower socio-economic status and low high school level for parents (which is a strong indicator of socio-economic status), as the primary cause leading to childhood obesity.

Professor Louise Baur, Paediatrician in Weight Management Services at The Children’s Hospital at Westmead (CHW), Chair of Child and Adolescent Health at the University of Sydney and co-author of the study said until the upstream factors are resolved, it is unsurprising that interventions focused on immediate causes such as poor diet and limited exercise have had limited success.

“We tend to ignore the root causes of childhood obesity which include social disadvantage, and of course, this is not something parents or children choose for themselves,” Prof. Baur said.

“Childhood obesity is largely a function of socio-economic status, and it is at this level that we need to focus on interventions.”

Upstream factors flow down to influence the body mass index (BMI) of parents, in turn having immediate lifestyle impacts (diet, sedentary time) on a child’s risk of developing obesity.

For children aged two to four, the study found parental high school level was a driver of parent BMI which then impacted the child’s BMI. For children aged eight to 10, parental high school level influenced how much a child played electronic games, particularly for boys, which impacted the amount of time they spent doing ‘free time’ activities like playing sports, in turn impacting their BMI.

Prof. Baur said bringing together diverse skill-sets, the authors were able to identify causal pathways and highlight the complex interplay between factors leading to childhood obesity.

“Through complex statistical modelling along with informed analysis, the collaboration between multidisciplinary teams was invaluable to this study, and key to informing future policy making to develop more effective interventions.

“We need to work together to make structural changes to reduce social inequality, which is at the heart of the childhood obesity issue.”

The work is a collaboration between scientists and clinicians, including lead author and statistician Wanchuang Zhu along with Roman Marchant, Richard W. Morris, Louise A. Baur, Stephen J. Simpson & Sally Cripps,  brought together by the Charles Perkins Centre, a research initiative committed to collaborative and multidisciplinary research to tackle obesity, diabetes, cardiovascular disease and related conditions.