Katherine Rich: Measured discussion sign of positive change in obesity debate?

20 March 2014

Did I recently detect a change in the obesity debate? A change from the hysteria that usually surrounds the issue to something more rational? If I’m right, it will mark a change that won’t be before time.

The source of my optimism was an article circulated by Fairfax NZ under the heading “Link found between obesity and religion”, which reported on a study which found that Pacific Islanders have a greater risk of being obese if they attend church!

I’ve read stories over the years that try to link obesity with everything from car ownership and TV watching, to closeness to shops, but church-going was a new angle, and I thought it was worth a closer look. So I did some digging, and there it was in the ‘Journal of Primary Health Care’ on the website of the Royal New Zealand College of General Practitioners. Labelled an “Original Scientific Paper”, it was entitled “The association between church attendance and obesity-related lifestyle behaviours among New Zealand adolescents from different Pacific ethnic groups”. The authors were all PhD’s: Ofa Dewes, Robert Scragg, and C. Raina Elley.

The Journal of Primary Health Care is a significant academic publication that writes for GPs, practice nurses, community pharmacists, other primary health-care practitioners, and patients.

The study said: “Obesity is disproportionately prevalent among Pacific population groups in New Zealand. Lifestyle behaviours of excessive consumption of high energy, unhealthy foods, and inadequate physical activity are risk factors for obesity that can be modified.” The study said the Pacific Island population has the highest obesity rate in New Zealand, with 97% of its community having an affiliation with Christianity, and said its aim was “to identify and describe the risk factors for and protective factors against obesity among Pacific Is­land (PI) adolescents who attend church and compare them with PI adolescents who do not attend church”.

To achieve this, the researchers investigated the lifestyle of 2,495 Pacific Island adolescents, at six secondary schools in Auckland, 77% of whom attended a church or other place of worship. The survey was done in 2005, and individual interviews and body measurements were undertaken. Questions included where they had their breakfast and lunch, how many serves of fruit and how many soft drinks and pies they had, what exercise they did, and how many hours of TV they watched.

And what they found was “an association between PI populations affiliated with the church and higher levels of obesity”, and “that church attendance was positively associated with higher levels of body mass index compared with non-attendance”. Churchgoers were more likely to buy breakfast and lunch from a shop or school canteen than take it from home. The survey also found that those attending church were more likely to have a distorted understanding of healthy eating habits and a limited knowledge of the risk factors for obesity, were significantly more likely to agree (incorrectly) that missing breakfast or lunch is a good way to lose weight than non-attendees, and were less likely to walk or bike to and from school.

 

It said appropriate weight management interventions were “urgently” needed to reverse the rising burden of obesity and its consequences on Pacific Island communities.

Lead researcher Ofa Dewes, of Auckland University’s Faculty of Medical and Health Sciences, told Fairfax that churches had been used as a vehicle for promoting healthy lifestyles for many years, yet obesity had continued to rise. “What we are doing now is not enough. We need to move beyond this and it’s time the Pacific community stands up and does something about it.” She said she was working with churches to permanently embed healthy cultural expectations and weight-loss interventions into their programmes.

There’s no doubt obesity is a serious public health issue in New Zealand, and, as this study emphasises, there are specific concerns for Pacific Island New Zealanders.

But what was interesting was the difference in tone in the comments by the authors. There were none of the usual calls for bans, taxes, law changes or more regulation. There were no claims that food and beverage manufacturers are to blame for everything and that they don’t care what they put in their food as long as they make a quick buck.

Instead, the authors talked about people needing help to better understand good nutrition and healthier food choices and exercise, and about the community tackling the issue head-on, to act locally and to encourage people to change the way they were doing things. There were no fingers pointed. The solution talked about personal choices and how to change that.

Obesity is a complex issue and there are many factors the food industry cannot control. There are so many variables, such as what people decide to eat or drink in a given day, food availability in the home, how much they exercise or are active, their genetic makeup, and so on.    

Manufacturers and distributors recognise this and have done so for many years, and have an excellent record of responding to this issue. They are providing greater choice, smaller portion options, and products with fewer calories. Many FGC member companies have been reformulating products for years, resulting in many hundreds of tonnes of sugar, salt, and fat being removed from the food supply each year. Depending on the component and product, there are many examples of reformulation in food products ranging from soft drinks and bread to breakfast cereals, dairy foods, and confectionery. Many are also involved in the Heart Foundation’s ‘Tick’ scheme, as well as school and community programmes that promote healthy eating and encourage regular exercise, while beverage companies are part of the voluntary agreement to not sell full-sugar and energy drinks to schools or aim advertising at children.

There are many other options for regulators and communities to consider before looking at extreme policies such as special taxes on ingredients. A one-size-fits-all solution to the obesity epidemic is a distraction from having a discussion about the real changes in lifestyle that have led to the obesity epidemic, and perhaps that’s where we should be looking.

So does the measured discussion of a study of a link between obesity and religion signal a positive change? I certainly hope so, because the finger-pointing will continue to get us nowhere.