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Physical Education 3.

Childhood Obesity & Inactivity


Is there an Issue?
By Annelise Wright Introduction The scientific knowledge and focus on overweight people and obesity is now huge. The term Obesity epidemic is a common phrase used in society, particularly by health professionals and doctors, who emphasise their concern for our society and future generations health. Undoubtedly, there are New Zealanders, both adults and children who are obese, but can we consider this an epidemic? The word epidemic is rather emotive as it has medical connotations giving the implication that mass amounts of people are suffering from some kind of condition or disease. Epidemic means to be spreading rapidly and extensively by infection and affecting many individuals in an area or a population at the same time. While we may consider some people obese, it may be an over-statement to categorise obesity among plagues such as influenza and smallpox. However, there are those who would argue against this analysis of the epidemic to be an exaggeration since some statistics do confirm that obesity and childhood obesity has in fact increased. Epidemic or no epidemic there is indeed a need to change something - even multiple things in order to improve the well-being of New Zealand children. To determine possible solutions to this problem it is important to understand what obesity and inactivity is, and why it may exist. Is it something that always has, and always will due to pre-determinants or have we created childhood obesity through our own choices? Throughout this essay, I am going to attempt to answer and evaluate many of the questions and opinions I have outlined above. I will also critically analyse the following: Possible causes of childhood obesity and inactivity, the relationship between childhood obesity and inactivity, and reasons as to why they are issues of concern for New Zealand. From this information, I will discuss possible solutions to these issues and implications of the possible outcomes. Additionally, whether current influences surrounding New Zealand are likely to enable and allow these solutions or act as barriers to prevent them. What is Obesity? Obesity is associated with heart disease, diabetes, stroke, high blood pressure and some cancers, however it is not surprising that this one English noun causes much confusion, worry and concern amongst society; our definition for the word is unable to be determined by our means of identifying it. The New Zealand Ministry of Health

defines obesity as an excessively high amount of body fat (adipose tissue) in relation to lean body mass. To contradict slightly, however, we identify this health problem by the use of a Body mass index (BMI) which does not calculate an excessively high amount of body fat in relation to lean body mass, but measures weight adjusted for height and is calculated by dividing weight in kilograms by height in metres squared (kg/m). For children and teens, BMI is age and sex-specific and is often referred to as BMI-for-age. The BMI number is plotted on the CDC BMI-for-age growth charts (for either girls or boys) to attain a percentile ranking. Below are the BMI-for-age weight status categories and the matching percentiles: Weight Status Category Underweight Healthy weight Overweight Obese Percentile Range Less than the 5th percentile 5th percentile to less than the 85th percentile 85th to less than the 95th percentile Equal to or greater than the 95th percentile

There are limitations to the BMI which will be discussed more soundly in the latter parts of the essay. However to date, this is likely to be the best measure of childhood obesity when considering both accuracy and practicality. Why does childhood obesity exist? There are many factors that contribute to childhood obesity coming from a variety of sources. Primarily, society itself plays a large part in fueling this problem; an article on Med India writes that eating fast food is no longer a fashion. It is now a necessity. It is the most attractive solution in the fast-paced life as it is inexpensive, tastes good and is made and served fast. Societys emphasis on instant gratification and our consumer driven lifestyles means we often look for easy, convenient options when it comes to consuming food. Generally, children do not have the authority to make their own decisions when it comes to food preferences and quantities, but unfortunately, what parents and caregivers are feeding their children is often what is easiest and what does not demand much effort or time. Food that fits this description is often highly processed, low nutrition and high in energy. According to the 2006 /07 New Zealand Health Survey, Seven out of ten (70.9%) children had eaten fast food in the past seven days. One in seven (13.6%) had eaten fast food twice in the past seven days and one in 14 (7.2%) had eaten fast food three or more times in the past seven days. Limitedly, this survey merely looks at Fast food; it is probable that these children are consuming other processed foods that are high in fat and low in nutrition, obtained by the means

of a supermarket. It is much easier to heat up a box of pies with frozen chips than to venture into preparing a healthier alternative such as a salad, which can involve washing, peeling, chopping and time. Time is of course in an economic sense, a limited resource and societys priorities in relation to how we use this resource often comprises of passive leisure activities (mentioned later) and as stated earlier, is about instant gratification. A scenario that demonstrates this well is becoming increasingly familiar amongst New Zealand families- a scenario where both parents work, who come home exhausted and run down, who then do not feel they have the time to prepare a meal and instead order some form of fast-food. This is not to imply that parents are becoming lazier and do not care for themselves or their family but to discern that we simply do not value our health perhaps as well as we should. The fatter we get, the fatter our children will get. A recent study, carried out at the University of California, showed that obesity spreads within social networks and that people with fat friends are 50 per cent more likely to be overweight than those who hang out with skinny people. Moreover, our children are subconsciously taking in the habits and lifestyle choices we make. By indulging in the wrong types of food, we are not only increasing passing on societys instant way of life but also increasing chances of obesity in New Zealand children. Dr. Hamish Meldrum, head of the British Medical Association claimed in an interview that fat people are simply greedy and obesity is caused by over eating, and that "We are in danger of over-medicalising the problem." This remark caused much controversy and The Independent (British online newspaper) writes that: Obesity experts were immediately outraged, and said that Dr. Meldrum's remarks were unhelpful and anachronistic, as well as politically incorrect. The 88,000 people who were prescribed with anti-obesity prescriptions for drugs like Xenical and Reductil last year, and the one in four Brits who, according to the World Health Organisation, are obese, no doubt felt similarly affronted. How, they probably wondered, could Dr. Meldrum, a medical man, not understand that their problem is genetic, an illness, a cruel compulsion. How could he fail to understand that what fat people need is medical intervention and drugs, and that if this was a simple matter of eating less then they wouldn't be in this position in the first place? And many would also say, what is wrong with being fat anyway? If you are not one of these people, then let me ask you this. How many of you have watched an obese person chowing down on a double hamburger with double fries and a triple cola and thought "Why don't you get it?" How many of you have stood in a newsagent watching an overweight person forcing their overweight hands into a family-sized bag of Doritos and thought "You shouldn't be eating that."

And how many of you listened to Dr. Meldrum and thought "He's absolutely bloody spot on." This article does not regard New Zealanders, nor is it about children; however, it does give insight into westernized societies views on obesity. Dr. Meldrums statement comes across as harsh and offensive even; so why is it outrageous to suggest that energy in exceeding energy out is the cause of obesity? It is simple math yet deeply rooted in our society and human nature that is the desire to place blame on everyone and everything except ourselves. Our society is constantly creating more illnesses and diagnosing more people with disorders that we deem responsible for our obesity. There are however, those of us like Dr. Meldrum who think suck it up, stop over eating and stop blaming everyone else for your problems. There is a noticeable weight debate amongst New Zealand society, thus perhaps obesity is becoming more prominent within children amongst those of us who disregard obesity to be a health issue and take a more PC approach, seeing it as a bit of extra puppy fat or blaming genetics. In addition, economic factors determine many of the choices we make involving our children and the food they eat. Numerous studies indicate that places with fewer economic and social resources have higher rates of obesity. The 2006 /07 New Zealand Health Survey investigated the impact of socioeconomic status on levels of obesity amongst children and found the following: 13.9% of children living in areas of deprivation had had fast food three or more times in the past seven days, contrasting to only 3.4% of children in areas of low deprivation.
Obesity of children by Degree of Deprivation
18 16 14 Percentage 12 10 8 6 4 2 0 least deprived 2 3 4 most deprived
Boys Girls

Level of deprivation

This data supports the assumption that The fattest of us are also the poorest- an observation made by an article in the Listener, November 2003. This is most likely due to takeaway and highly processed foods often being cheaper than fruit and vegetables, meat and dairy foods. Undoubtedly, prices of food dictate to an extent what we choose to eat and food prices in New Zealand have been rising rapidly. The Consumers Price Index for the food group showed an annual rise of 5.1 percent in the year to the March 2008 quarter. Price increases for grocery food have been particularly noticeable. In the year to the March 2008 quarter, grocery food in the Consumers Price Index rose by 8.7 percent. Statistics New Zealand. This increase is largely driven by rapid rises in dairy and grain products- products that are part of the two lower tiers of the three-tier food pyramid; products that we are told to eat X amounts of per day to remain healthy. However, when money is scarce, prices become the crucial factor in buying food not what is going to keep us healthy. Currently, in some of the developing countries such as Mexico and Brazil the prices of corn and soya have increased due to their usage as biofuels thus limiting the healthy choices of the individuals in those countries even more than is already the case. Staple foods which are creating healthy habits in habitual ways, are becoming much more expensive and will be replaced by packaged foods, which are typically full of added sugar, fats and salt. The problem is that processed packaged food is often much cheaper and more economical for producers to produce than healthier food such as fruit and vegetables. Producing fresh food often relies on natural endowments such as soil and climate, and large associated costs of transportation and preservation; packaged food has a much longer shelf life than fresh food. Therefore, healthier foods are often more expensive for the consumer. For example, wholegrain bread is usually $3-4 per loaf, compared to budget bread, which is less than $2. Sausages, beef patties all processed meats, are cheaper that fresh meat. A box of small Soho rice crackers costs more than a large bag of potato chips. How is it that today the people with the least amount of money to spend on food are the ones most likely to be overweight? -An article from the New York Times proves partially why exactly the above statement is so. Drewnowski went on a mission- to purchase as many calories as he could. He discovered that he could buy the most calories per dollar in the middle aisles of the supermarket, among the towering canyons of processed food and soft drink. Drewnowski found that a dollar could buy 1,200 calories of cookies or potato chips but only 250 calories of carrots. Looking for something to wash down those chips, he discovered that his dollar bought 875 calories of soda but only 170 calories of orange juice.

Conclusion: If you are eating on a small budget, the most rational economic approach is to eat poorly and get fat. The environment in which we live unquestionably affects our behaviours and habits, what we value in life and our attitudes. To an extent, the family environment children grow up in influences the likelihood of childhood obesity. The risk of becoming obese is greatest among children who have two obese parents (Dietz, 1983). This may be due to powerful genetic factors or to parental modeling of both eating and exercise behaviours, indirectly affecting the child's energy balance through an obese-o-genic environment. Expectations and family values can determine obesity amongst children because children build their own viewpoints and values based on what they see and are taught directly and indirectly by those they look up to more than often parents or other persons close to them. A study of 120 young children, who were allowed to "buy" food from a pretend grocery store, proves that even 2-year-old children tend to mirror their parents' usual food choices. During the shopping game, it was noted that children who stocked up on sweets, sugary drinks and salty snacks generally had parents whose typical grocery list featured these items. Similarly, children with the healthiest shopping habits seemed to be copying their parents' lead as well. The findings, reported in the Archives of Pediatrics & Adolescent Medicine, suggest that it is not by chance that young children reach for sweets and unhealthy snacks when given the chance. Rather, they seem to form food preferences and decisions potentially lasting ones, based on their parents' shopping carts. "The data suggest that children begin to assimilate and mimic their parents' food choices at a very young age, even before they are able to fully appreciate the implications of these choices," writes the researchers, led by Dr. Lisa A. Sutherland of Dartmouth Medical School in Lebanon, New Hampshire. Thus, parents may be creating an obese-o-genic environment without realizing, purely based on their own lifestyles and preferences. Although the chances of obesity developing among children who are exposed to the likes of poor decisions and an obese-o-genic environment is relatively high, individuals do respond differently to food and exercise once genetics comes into play. Some people store more energy as fat in an environment of surplus food whilst others lose less fat in an environment of a lack of food. The different responses are mainly due to genetic variations between individuals. Although it is rare for people to have mutations in single genes, which result in severe obesity at infancy, it is possible for genetics to predispose people to being larger. Fat stores are regulated over long periods of time by complex systems that involve input and feedback from fatty tissues, the brain and endocrine glands like the pancreas and the thyroid. Thus, obesity can result from only a small energy surplus over a long period of time. Possibly, children who have always been slightly larger than their peers and considered to merely be carrying some puppy fat are just children who habitually carry surplus energy due to their genes.

Additionally, children with a family history of obesity may also be predisposed to gain weight. Historically, the predisposition to store energy in the form of fat is thought to result from thousands of years of evolution in an environment amid tenuous food supplies. Those who could store energy in times of plenty were more likely to survive periods of famine and to pass this tendency to their offspring. Therefore, in todays society where food is plentiful we may actually be instinctively storing more energy than is necessary. The marketing and large amounts of advertising for poor quality food products psychologically affect consumer choice. These products are promoted partly because many of the packaged, added salt and fatty foods are heavily subsidised by the EU agricultural ministries and others, as well as by the companies which all make money out of processed food. It is much easier to make money out of these foods than fresh foods due to the associated costs of transport and preservation. A few decades ago food and beverage companies realized that they could better reach their goal to increase sales by targeting a nearly untapped market children and adolescents. Children are particularly vulnerable to advertising because before the age of twelve, a childs cognitive development is limited and as a result they cannot differentiate between the truth and advertising. They trust and believe the persuasive statements made in commercials. As one Heinz brand manager stated, "You want that nag factor so that 7-year-old Sarah is nagging Mum in the grocery stores to buy Funky Purple. We're not sure Mum would reach out for it on her own without Sarahs persistent nagging." These tactics along with joint promotions where children's entertainment characters and role models are associated to fast food meals or other low-nutrition foods is certainly responsible to some extent for childrens dietary preferences of fatty, salty and sugary foods. Childhood Inactivity Put simply, inactivity is the state or quality of being inactive. It is habitual indisposition to action or exertion; want of energy and sluggishness. An inactive lifestyle is one that is sedentary or passive with little or no physical activity. Determining physical activity is difficult because people have different views on what they consider exercise, depending on their own personal philosophies. However, in general, childhood inactivity occurs when multiple childrens lifestyles are filled with passive leisure activities, which require a small amount of energy output, and does not raise the childs heart rate. Why does childhood inactivity exist? Similar to childhood obesity, many factors contribute to childhood inactivity. Technology is constantly evolving and todays society is very much technology-

enhanced often leading to sedentary, couch-potato lifestyles, too much TV, video games, computers, and a reliance on the car. Ultimately, we are not moving enough. Because we value entertainment to keep us content, many of us, (children included) seek passive leisure activities such as watching television for some entertainment. "TV remains the dominant free-time activity in America." The 2006/07 New Zealand Ministry of Health survey found that Two out of three (64.1%) children aged 5-14 years usually watched two or more hours of television a day, which equates to 368,700 children. It is not only the television promoting inactivity among children. Simple inventions such as escalators and elevators that we take for granted, designed to suit our increasingly fast lifestyles are second nature to todays children, embedding attitudes condemning active lifestyles - who wants to climb the stairs when an escalator can do the climbing for us? A study at the University of Geneva has shown how something as small as taking the stairs instead of the elevator can have a big impact on your health. The study started with 69 participants who had a relatively sedentary lifestyle, (they did less than two hours of exercise each week and climbed fewer than 10 flights of stairs each day). Over the 12 weeks of the study, participants were asked to take the stairs instead of the elevator, increasing their average number of flights from five to 23. After three months, tests showed they had better lung capacity, cholesterol and blood pressure levels, their fitness level improved and they lost weight. Researchers say that these results reduced their risk of dying young by 15 percent. Although larger scale studies would need to validate these results, they are very promising and prove that small factors that promote inactivity can have a big impact in the long run. Our reliance on technology for transportation can increase levels of childhood inactivity also. The attitude of why walk or bike anywhere when I can use some form of motorized transportation which will get me there much faster? is one entrenched amongst many of us and consequently being indirectly passed on to our children. Research reveals that one in five parents very rarely walk anywhere. In addition to our reliance on motorized vehicles to get us from A to B, parents' perceptions of the risks outside the home have severely controlled children's ability to carry out active ways of transportation such as walking, biking, and skateboarding. Despite 77% of todays parents walking to school when they were children, the percentage of primary school children walking to school has dropped to just over half. The majority of primary school children live less than or around a mile from their school, but at peak times of the day, one in five cars on the roads are doing the school run. These statistics from a walk to school organization in the United Kingdom demonstrates how times have changed and it is now more socially acceptable and common for school children to be dropped off at school in a vehicle. A survey carried out by a New Zealand organization Safe routes to school (SRTS) found the following:

As children, 77% of parents either walked or cycled to school, compared with 30% of their children who do so now. The modal shift has been from walking as the dominant mode of transport to school for parents (65%) to that of the car being so for children (66%). There has been a 4.5 fold increase in the numbers of children travelling to school by car compared to the numbers of parents who travelled to school by car as children.

These statistics confirm that New Zealand children today use considerably more inactive forms of transport than previous generations. Worrying parents limits childrens activities and the ability to be active. Just go play outside is often no longer a viable option. Some may even argue that friendly neighbourhood games of dodge ball and soccer are memories of an earlier era. Parents have raised their concerns about busy streets and child predators. We dont raise kids to lose them early we raise them to bury us, one man who drives his granddaughter to school each day declared. One woman, on the subject of her child walking to school said, I admit I was worried, I made him stop at my sister-in-laws house and call me halfway when he got there. It is possible that parents mollycoddling is limiting possible exercise and activity for their children. Besides, is there even a legitimate reason behind the over protecting of parents? The answer is likely to be No. In this age of Amber alerts and reports of child predators, a sort of mass hysteria has been created. There are no more incidents today than in the past of kids being abducted, one parent said, (based on statistics she has seen). Thus, protective parents may be doing more harm to their children than good. Most children spend at least six hours a day, 30 hours a week at school or some other similar institution, so it is vital that they receive some form of exercise during school hours. However, in many primary schools, there is often a lack of space, equipment

and specialist PE teachers, limiting the amount of physical activity children receive. The tighter school budgets become and the greater academic requirements get can force many schools to push physical education class to the bottom of the priority list. The 2003 National Child Nutrition Survey found that the amount of physical education being taught in New Zealand schools has declined. According to the survey, one out of five children between five and six and seven to ten years of age had no physical education class over the seven days of study (Ministry of Health 2003). Often in New Zealand schools, it is the individual teacher who decides on the content, duration and frequency of physical education because compulsory physical education is not required. Therefore, a teachers own enthusiasm, interests and knowledge on physical education solely determines the amount and type of physical activity that their students are receiving at school. The irony is that despite our knowledge of the importance of physical activity to children and strongly advocated campaigns aimed at children and schools such as Push play, not all children are getting some form of exercise during school hours and we are the ones preventing it. Additionally, there is evidence to suggest that the teaching of physical activities is often of poor quality, which is understandable; schoolteachers are primarily hired, based on their skills in academic teaching and are not usually trained in areas of physical education. If a child is experiencing physical education of poor quality, taken by a teacher who is rather unenthusiastic, then chances are the child will not enjoy the lesson and their views on physical activity may form negatively, increasing chances even further of inactivity in the individual. Undeniably, the lack of specialist physical education teachers and to some extent willingness amongst teachers does allow for childhood inactivity. The environment children grow up in, especially the family environment is a strong determinant of childhood inactivity. Children build many of their core values and morals as they grow based on what their parents say and do it is human nature. As discussed earlier, even very young children begin to form opinions and preferences based on their parents. If a child is familiar with an obese-o-genic environment, where parents speak negatively of exercise, see physical education in school as a waste of time and are a classic example of a couch potato, then chances are the child will follow suit. It is poignant, because for some children an inactive lifestyle is all they have ever been exposed to, hence subconsciously, that is all they know how to do. Differences in priorities manipulate the rate of childhood inactivity also. Factors such as cultures, personalities and interests mean different people will value the same things to different extents. Similarly, to the above, how much a parent prioritizes being active is likely to influence a childs view on physical activity also and no doubt there are some parents who do not rate activity particularly high on their list of priorities. Thus, they are unwilling to spend disposable income on activity- sporting equipment and sports fees and therefore the child misses out on exercise. Those in lower socioeconomic groups in particular are possibly unable to afford sporting equipment and pay sports fees, so unfortunately overlook activity and exercise when in reality lack of money does not largely hinder an active lifestyle. Playing around outside or kicking a

ball around are much cheaper leisure activities than watching television, however there are people who will happily pay for Sky TV each month yet state they are unable to pay for sports fees. This is a prime example of how physical activity rates poorly on peoples priorities, and ultimately leads to childhood inactivity. Relationships between childhood obesity and inactivity Childhood obesity and childhood inactivity often go hand in hand and to some extent share a cyclical relationship.
Difficulties with movement due to size Passive leisure alternatives Lack of motivation to exercise

Large food portions

Unhealthy food choices

Obesity

Inactivity

A surplus of kilojoules

The diagram above shows in a simplistic form the way in which childhood obesity and inactivity are linked. Children who are considered obese are likely to find it difficult being active due to the excess weight they must now carry, leading to preferences for passive leisure alternatives. They may also be inactive due to the nature of physical activity and what it entails. Obese children can be incredibly vulnerable to bullying while taking part in physical activities, predominantly within schools. Consequently, the thought of ridicule and mockery is associated with physical education, putting children who often need the exercise the most, off physical activity. Children who are inactive, through habits and choices are at a greater risk of becoming obese due to the energy in, energy out equation. Inactive children are not dispensing many kilojoules of energy, therefore if they are consuming food at a greater rate than what they are burning off. As a result, they will hold surplus energy, which is likely to turn into fat. When our supply of energy is in surplus, the process of metabolism stores the excess

energy by converting it into body fat. It is also knowledge that people who are less active are likely to have a slower resting metabolic rate. This is because physical activity increases lean body mass and muscle; the addition of muscle mass on an individual will cause an increase in the number of kilojoules that are consumed at rest. Muscle burns calories, while fat does not. Hence, inactive children are often obese. However, this cyclical relationship between obesity and inactivity is not fool proof. It does not take into account the complex inter-relationship between energy balance and genes, behaviours, environment and other biological factors. The graph below demonstrates that although a positive relationship exists between fitness levels and healthy body weight, normal weight in terms of appearance does not automatically correlate to being fit, likewise being classified as obese does not necessarily mean unfit although this is generally the case.
Fitness and Fatness and risk of mortality

Normal weight and fit Normal weight and unfit Overweight and fit Overweight and unfit Obese and fit Obese and unfit 0 1 2 Risk factor 3 4

Wei, M.D, Kampert - Relationship Low Cardiorespiratory Fitness and Mortality in Normal-weight, Overweight, and Obese Men. An assumption often made by society is that slim and normal weighted children are healthy whereas bigger or obese children are less so. Often we overestimate the strength and reliability of the relationship between obesity and inactivity, overlooking the fact that physical fitness may be a more powerful measure of health. For example, a child who is extremely inactive, makes unhealthy food choices but does not eat excessively, and does not have a history of obesity in their family or the genes to trigger weight gain may remain in a weight range considered normal, but surely, this child cannot be considered healthy. This analysis shows just how complicated the issues of childhood obesity and inactivity really are.

Part of the reason that the relationship between childhood obesity and inactivity is not always consistent, (such as the above data) is due to the measure of obesity body mass index (BMI) calculation and its limitations in defining someone as obese. BMI does not distinguish between body fat and muscle mass. As lean body mass weighs more than fat, children who have lower body fat percentages and have larger muscles may be defined as obese according to the BMI calculation, when in reality they are relatively healthy. Ethnicity is also a factor providing limitations to the BMI. Studies used to develop the BMI classification system were derived from predominantly Caucasian populations in the USA and Europe. [1] Studies have shown that ethnic groups may vary in their level of total body fat at a given BMI, their fat distribution patterns, and their extent of health risk. As New Zealand comprises of various ethnic groups, this is a major limitation in defining who is fat and who isnt, and although it has been suggested to have different BMI cut-off points depending on race, this is much more difficult than it appears, as many children come from ethnic intermarriages and have various ethnic backgrounds. In addition, ethnicity is primarily based on self-identity and culture, and does not necessarily have a genetic link. These limitations mean that the relationship between childhood obesity and inactivity is not as inter-related as one might think [2]. Recent New Zealand research indicates that at the same BMI value, female children (aged 514 years) of Pacific Island and Maori decent have a lower percent fat mass compared to their New Zealand European peers. In another study using a larger sample size, however, no clinically significant difference in the relationship between BMI and body composition was found between young children (510.9 years) of Maori, Pacific Island, or European descent. [3] Thus, further research clarifying the relationship between BMI and percentage of body fat percentage according to ethnicity among the New Zealand youth population is necessary.
Behaviour Biology Fixed Ethnicity Gender Age Genetics Family Personality? Environment unfixed Food availability Determines Advertising Economics availability of money Surrounding Cultural views and morals Upbringing Habits Attitudes Self- perception Expectations Personal morals and views Priorities Emotions

Our pre-determined make up and the variable factors surrounding us determines our behaviours, which subsequently determines our decisions when it comes to food and fitness, influencing the strength of the relationship between obesity and inactivity to us personally. In general, there is no doubt a cyclical relationship between childhood

obesity and inactivity exists, however the strength of this relationship is hard to determine, as many other factors come into play. Factors determining obesity and inactivity are complicated; there is no one simple explanation. [1] World Health Organization. Obesity: Preventing and Managing the Global Epidemic. Report of a WHO Consultation on Obesity. 2000. [2] Rush EC, Plank LD, Davies PS, et al. Body composition and physical activity in New Zealand of Maori, Pacific and European children aged 5-14 years. 2003. [3] Tyrrell VJ, Richards GE, Hofman P, et al. Obesity in Auckland school children: a comparison of the body mass index and percentage body fat as the diagnostic criterion. 2001. Are child obesity and inactivity issues for New Zealand? Childhood obesity and inactivity are issues for New Zealand. Whether you see it as an epidemic, a fat and lazy crisis if you wish, or if you feel it is something that has been exaggerated and hyped up, it still remains an issue. Aiming to attain higher standards of nutrition and physical activity among children in order to improve their well-being and protect their health should be a major priority for New Zealand. Statistics and mathematical measurements of obesity and inactivity are indicating it is an issue. Yes, they may have flaws and limitations but we still have our judgment; purely through observation, we can discern that there are children in New Zealand today, who carry too much excess fat and there are children who lead incredibly inactive lifestyles. The 2006/07 New Zealand Health Survey found that: Just under half (47.0%) of children aged 5-14 years usually use active transport to get to and from school (walking, biking, skating or using other forms of physical activity). Common reasons given by parents for what stops their children walking, biking or skating to school live too far from school, busy traffic/main road, too dangerous for reasons other than traffic, takes too long. Of children aged 2 to 14 years: One in twelve were obese (8.3%) One in five were overweight (20.9%). Adjusted for age, Pacific boys and girls were at least 2.5 times more likely to be obese than boys and girls in the total population. Maori boys and girls were 1.5 times more likely to be obese than boys and girls in the total population. There has been no change in the average (mean) BMI for children aged 5-14 years since 2002. There has been a decrease in average BMI for Maori children.

Is there an Epidemic? The above statistics show that yes, obesity does exist amongst New Zealand children. However, the final two statistics are particularly intriguing as they indicate that childhood obesity in New Zealand is not the epidemic it has been made out to be obesity has not been spreading rapidly. Though to confound the situation even more, between 1989 and 1997 obesity levels rose from 3% to 12.6% in males, and from 2% to 5.3% in females who were aged between 15 and 18 years [1]. Therefore, over an 8-year period, obesity levels increased by 300% for males, and a 160% increase for females, thus an epidemic. It is even thought that this comparison may under represent the true increase in obesity because the 1989 Survey used a lower BMI cutoff value (30 kg/m) to define obesity among individuals of Maori and Pacific Island descent in comparison to 1997 (32 kg/m). [2] Although the latter information may be less reliable as it is untimely, a huge contrast between the two sets of data exists. This is possibly due to the differences in ages, and for that reason much older children are the likely cause for the label epidemic. Additionally, the statistic suggesting that just over 20% of children are overweight is particularly alarming because if current trends continue, in time these children are likely to progress to an obese stage later in life. All in all, epidemic is a matter of opinion; no specific guidelines or figures exist which can detect whether something has reached epidemic rates. However, the health of New Zealand children remains a concern, especially considering the dire consequences that can result, if not now then later in life. The NZ medical journal, originally from [1] Russell D, Parnell WR, Wilson NC, et al. NZ Food: NZ People. Key results of the 1997 National Nutrition Survey. Wellington: Ministry of Health; 1999. [2] Russell D, Wilson N. Life in New Zealand Survey: Executive Overview. Wellington: Hillary Commission; 1991. Impacts of childhood obesity and inactivity on New Zealand Society Obesity statistics show that obese children, particularly adolescents have a 70% chance of being obese as adults, and that percentage increases to 80% if either one or both of the childs parents are obese as well *1+. Thus, inactive and obese children do not only create detriments for themselves and society at present, but also stand to be a future burden for New Zealand society when they reach adulthood. Unhealthy children will cost New Zealand now and in the future a great deal on many levels: in monetary terms, socially and emotionally to individual persons and families. As a nation, we must forego spending a large amount each year on areas that should be of high priority such as economic growth and education due to the large costs associated with obesity health related issues. It is estimated that obesity health care expenditure in New Zealand is NZ$303 million per annum. [2] This is a large burden for the taxpayer, and an unnecessary one, mainly created through the likes of those living amid an obese-o-genic environment. Although many of the health costs associated

with obesity do not occur until late adulthood; if our children are becoming much larger physically and increasingly unhealthy then inevitably, they too will one day be large contributors to New Zealands health care expenditure costs. However, this may not even be a solely future issue; evidence is now suggesting that children are now developing diseases of old age such as type 2 diabetes, which is caused from a lack of exercise and poor diet. New estimates indicate 500 young people aged between 10 and 18 years have the disease that was, only a few years ago, virtually unknown in this age group. It used to be a disease that only affected adults over 45 years old, but not anymore, says Mike Smith, president of Diabetes New Zealand. Its our own inaction that is allowing Type 2 diabetes to become an epidemic. The fact that type two diabetes is often preventable makes the whole idea of a diabetes epidemic even more tragic. Type 2 diabetes and other diseases caused by obesity and inactive lifestyles such as coronary heart disease, hypertension, and some types of cancers impact New Zealand society in an economic sense but culturally and socially also. Physical inactivity in New Zealand ranks behind smoking as the second highest modifiable risk factor for poor health, and is associated with 8% of total deaths. [3] Furthermore, it has been predicted that todays generation of children may be the first generation not to out-live their parents. If todays children are becoming increasingly unhealthy and consequently sick, then this is likely to pose as a huge emotional burden for communities and families. A sickness culture concerns a phenomenal amount of people not just the individuals directly affected. It creates a large economic burden for families to afford health care and it can be emotionally draining caring for a sick family member advanced cases of type 2 diabetes can involve coming to terms with blindness, amputation and kidney failure, a horrendous ordeal for anyone to go through. Sickness and disease is saddening for society in general- having to deal with illnesses that were not necessary in the first place. In the future, when todays children enter the workforce, New Zealand may experience a greater loss in productivity than present if obesity and inactivity continues to rise. The loss of productivity that occurs when employees come to work, but are not fully performing to the standard expected due to an illness or injury is potentially a bigger problem than employees being absent (absenteeism). This may also stand to be a future problem. Loss of productivity and absenteeism has a direct impact on a businesss bottom line, depleting New Zealands rate of growth and potential competitiveness with the rest of the world. US research has found the cost of loss of productivity due to employees being present corresponds to approximately 3% of a companys gross payroll. [6] Another study, this time Australian, showed that workers with a high HWB (health and well-being) score worked approximately 143 effective hours compared to 49 effective hours worked per month for a worker with a low HWB score. [7] The table below shows how the unhealthier someone is the greater liability they are to a business.

Unhealthy worker

Healthy worker

Self-rated performance of 3.7 out of 10

Self-rated performance of 8.5 out of 10

49 effective hours worked (full time) per 143 effective hours worked (full-time) month per month High-fat diet Healthy diet Low energy levels and poor Fit, energetic and alert concentration Obese or overweight Normal body weight Irregular sleep patterns More attentive at work, better sleep patterns Poor stress management techniques Actively manages stress levels 18 days annual sick leave 2 days annual sick leave [6] Living with obesity at a young age can affect the well-being of a child, decreasing their quality of life not only through physical factors. Generally, obese children tend to have a poor body image, partially caused by the bullying culture often seen in schools and amid children. Bullying can be incredibly worrying for children and lead to psychological problems such as stress and anxiety, depression, and behavioural learning problems, social exclusion and an overall decrease in happiness. Studies have shown that physically fit students are more content and perform better academically. [4] Physical activity builds character, pride, self-esteem, teamwork, leadership, concentration, dedication, fair play, mutual respect, social skills, and healthier bodies; help keep children in school; help develop academic skills to do better in school and in life; and increase access to higher education. This long list of benefits is all things that New Zealand children will not be receiving to the extent that they should be, due to childhood obesity and inactivity. Additionally, increase in rates of childhood inactivity may contribute to the negative culture within New Zealand such as gangs, as children who do not experience the benefits highlighted above look for alternative ways to gain social interaction, acceptance or be appreciated in some way. Arguably, childhood obesity and inactivity may be partially responsible for many seemingly unrelated issues to New Zealand society today. Studies have shown that teenagers who participated in team sports are less likely to have unhealthy eating habits, smoke, have premarital sex, use drugs, or carry weapons. [5] It all comes down to the well-being of a person, particularly ones emotional and mental state. Exercise releases endorphins into your body that reduce stress, and is highly recommended as both a prevention strategy and cure for depression and emotional difficulties. Possibly,

obesity and inactivity are contributing causes to the growing rate of mental illnesses in New Zealand, which we are now told affects one in five New Zealanders, undoubtedly a large proportion of society. Additionally, depletion in physical activity may contribute to a culture of unhappiness amongst society, which may sound asinine and slightly ridiculous, but it is nevertheless, a negative impact.
Decrease in: Leads to a Overall wellCausing being Emotional state Happiness Value on life Value on yourself

Childhood Obesity and inactivity

Decrease in societys wellbeing as a whole Increase of negative culture. I.e. Gangs, passive leisure culture

[1] United States Department of Health and Human Services. [2] Ministry of Health. Health Eating Healthy Action Oranga kai Oranga Pumau: A Background. Wellington: Ministry of Health; 2003. [3] Ministry of Health. DHB Toolkit: Physical Activity. To Increase Physical Activity. Wellington: Ministry of Health; 2001. [4] Ca. Department of Education, Press Release, Dec. 10, 2002. *5+ Russell R. Pate et al., Sports Participation and Health-Related Behaviours amongst US Youth, Archives of Pediatrics and Adolescent Medicine. [6] Goetzel R.Z., Long S.R., Ozminkowski R.J., Hawkins K., Wang S. and W. Lunch (2004), Health, absence, disability and presenteeism. Journal of Occupational and Environment Medicine [7] Source: The Health of Australias Workforce, November 2005, Medibank Private Possible Solutions, Actions, and Implications to Reducing Childhood Obesity and Inactivity Educating people, children and especially parents, about healthy lifestyle choices and the negative implications associated with obesity and inactivity may be the most vital and effective way to cease obesity. Knowledge, in general provides people with insight so that they can discern what is best and make informed decisions. If parents were more knowledgeable about ideas and concepts relating to wellbeing and how to avoid obesity and the effects obesity and inactivity can have on a person, then it would create a personal solution to the problem as they would be more conscientious about providing a healthy environment for their children. It is much easier to prevent obesity than to treat it, and prevention largely relies on parent education. In infancy, parent

education should focus on promotion of breastfeeding, recognition of signals of satiety, and delayed introduction of solid foods. In early childhood, education should include proper nutrition, selection of low-fat snacks, good exercise/activity habits, and supervising television viewing. In cases where preventive measures cannot totally overcome the influence of hereditary factors, parent education should focus on building childrens self-esteem and addressing psychological issues. There are many means available to educate parents that will appeal to each individual differently. Generally, there are ways to communicate with all kinds of parents. One form of education is through community-based seminars and newsletters / periodic magazines, where those who are knowledgeable about parenting and health related issues can give practical advice to parents. Additionally, this could be subsidized by the Government, making these educational resources free or of an optional donation, giving parents an even greater incentive to show interest. Community gathering type events can also create a highly positive atmosphere where parents exchange advice and share their own personal experiences. Situations like these also create accountability among people and inter-personal strategies. Another alternative is more subtle, through means of television advertisements a great way to reach those who are more passive when it comes to finding out information. Well recognized organizations such as Plunket could put their name to advertisements, providing parents with facts and ways to eat healthily and encourage children to participate in less sedentary activities. Television advertisements may only be 30 seconds long but they have managed to assist selling burgers and fries in the past, so it is surely an effective way to influence a persons viewpoint. Educating children is also important. Even though a childs choices are limited; their ability to make decisions concerning themselves only increases as they grow, thus the more knowledge they hold the better. Schools should teach children about health and fitness, how to make good food choices and the importance of being physically active. A set curriculum would ensure sensitivity when covering these topics, preventing any psychological problems that may arise such as bad body image and eating disorders. Future implications of this may include healthier food choices amongst children and a greater desire to endeavour in some form of physical activity, leading to an increase in overall well-being. Many societal strategies can be put in place to solve the current levels of inactivity and obesity among children. The Government holds a great deal of power, thus impacting New Zealanders directly and indirectly when it comes to decisions they make which then influence levels of obesity and inactivity. Government policies often influence the level of individuals disposable incomes and as it has been established that low levels of income is a cause of childhood obesity and inactivity it is vital that Government policies ensure families have the monetary means to live relatively healthy lifestyles income and price must be in equilibrium.

It has been suggested that GST (Goods and services tax) is taken off the deemed healthy foods (fruit and vegetables) in order to promote these food groups and making it easier for lower socio-economic families to purchase healthy foods. This may well be an effective societal strategy to reducing childhood obesity provided that those who do eat poorly due to economic reasoning are capable of changing their habits and lifestyles, which although often easier said than done, with other solutions in place such as emphasis on parental education, it may be highly feasible. Removal of GST tax will particularly benefit those in lower socio-economic families more so than tampering with other taxes because GST is a regressive tax. Someone on a low income is forced to spend a larger proportion on goods (e.g. food), and thus ends up spending a higher proportion of their income on GST than someone on a higher income, who for example will have money left over to invest. It would be no easy task developing a graded GST system without grey areas. Determining what foods are healthy and what is not is difficult, however a grading system similar to the NZ Heart Foundations Heart Foundation Tick campaign with standards set that are specific to each food group may be ideal. In general, foods with GST removed should have low levels of bad fats (saturated and trans), salt and kilojoules, and contain positive nutrients such as fibre and calcium. The Government would have to employ nutritionists to analyse all foods and decide whether they qualify as GST removable or not. Although it may be tedious to firstly launch the idea, in the future when the policy has been established, it will only be new food products that need to be checked out which will be much less time consuming. Another way to decrease costs of healthy foods in proportion to the cost of unhealthy foods is for the Government to focus on giving subsidies to producers who produce fresh produce and getting the money to do this by taxing producers who produce unhealthy packaged foods. Although the same issue arises, where it is controversial and difficult to determine healthy and unhealthy, once this is overcome (e.g. from similar ideas to above) it is likely to have many benefits now and in the future. When subsidies and taxes are placed on producers, part of the benefit or burden is passed on to consumers. Since food is a necessity with no substitutes and therefore highly inelastic, consumers will bear more of the tax and receive more of the subsidy than the producers as the difference between what the price consumers pay and the initial market price is greater than the difference born by producers. With the big rise in the cost of food over the last few years (food prices increased by 8.2 percent from June 2007 to June 2008), the subsidizing of fresh food is likely to greatly benefit all families especially those who currently struggle to afford nutritious food. Possible implications of these two Government interventions are that children will be on a more nutritious diet and therefore have better levels of concentration and focus in school and less malnourishment. The current habitual lifestyles many low-income families lead indulging in low nutrition foods may be reversed, thus increasing the physical and emotional well-being of children, decreasing hyper-activity and increasing longevity. In the future, the children of today are likely to make these healthier

lifestyles part of their own, setting an example for future generations to come. Additionally, because the subsidies and taxes make it relatively more profitable to produce fresh produce than packaged unhealthy food (which is likely to be taxed), producers may decide to switch resources in to producing healthier fresh food benefiting society by creating a healthier environment. Implementing new policies and guidelines will help counter rates of childhood obesity and inactivity only to an extent, because in the end it all stems back to a childs home life and their upbringing and choices themselves and their parents make you can lead a horse to water but you cannot make it drink. Children with greater health problems often come from families who are not as well off families often living off financial handouts. A possible solution to childhood obesity is to give these families, vouchers for fresh food instead of solely money. This would have to be done with great caution and sensitivity because otherwise society may get the impression that bureaucracies are taking over and limiting individuals own ability to make decisions. A way of doing that would be to not eliminate financial handouts drastically but decrease the quantity slightly, and bring in food vouchers to compensate. The quantitative amount of the vouchers should be in proportion to number of people living in a household, the household income and their expenses. Whether these families appreciate the change or not they are still, to some degree, highly likely to eat healthier foods because they simply do not have the monetary means to buy what they like. This may lead to healthier eating among beneficiaries, as over time they are habituated with healthy eating and learn to appreciate such foods to some extent. In the future, this could lead to lifestyle changes and priority changes, leading to happier healthier children. Although this analysis may be overly optimistic and wishful thinking, it is definitely an idea worth giving a go. If done properly with careful planning, positive implications are likely to follow. A way in which the Government can intervene to decrease levels of childhood inactivity is to promote sports clubs, especially in places that are of high deprivation. This can be done in many practical ways. Firstly, subsidizing sports clubs that are already established would make sports more affordable for families and therefore a more desirable activity alternative for their children. Secondly, money could be funneled directly through to sports equipment and space (e.g. fields, gyms; predominantly natural environments) in schools, clubs and communities. This would make physical activity a more viable option for schools and communities because of the ease of resource availability. If children begin to engage in more physical activity due to the ease of financial costs associated and greater resources available to them natural and manmade, then there are likely to be many positive implications. Estimates indicate that a 5% increase in physical activity levels could result in a saving of NZ$25 million per year. Additionally, $160 million each year could be saved if all New Zealanders were to become physically active to levels that afford health benefits. [6] This release of financial burden for New Zealanders is huge, and may lead to an increase of economic growth in the future. In addition, childrens overall well-being is

now likely to be a lot higher, hence less health problems and proportionately more health care professionals available to treat other patients, thus a decrease in the levels of waiting lists and neglected patients a great benefit for society overall. An increase in natural environment available for children to engage in physical activity may lead to children developing an enhanced mental and spiritual well-being as it has been verified that green spaces are linked to improved mental health. For example, symptoms of ADD are relieved after contact with nature. [6] Additionally, parks and schools can offer activity and socialization; it has been proven that the strength of social ties is important predictors of well-being and longevity. [6] [6] Bauman A. - Potential Health Benefits of Physical Activity in New Zealand. Wellington: Hillary Commission; 1997. What influences currently exist that will enable the solutions and what influences might act as preventions? The Online Dictionary states that an influence is the capacity or power of persons or things to be a compelling force on or produce effects on the actions, behaviour, opinions, etc., of others. From this, we can recognize that influences are often powerful; a force of some sort which manipulates and persuades. Everyone is constantly under the influence of something to what extent though will depend on their personality and viewpoints, how easily someone is persuaded and what persuades them. External influences are influences created from what is outside the self. External influences can include the media and advertising, legal restrictions e.g. Speed limit and drinking age, setting, culture, parents/family, friends and role models such as celebrities. Internal influences are ideas formed within ones self, based on thoughts and feelings and ones innate personality traits. Internal influences can include fears, desires, knowledge, curiosity and ones level of sensitivity and awareness. These dissimilar influences then form our own personal viewpoints, but to the extent that the way in which each one affects an individual is always unique as it is determined largely by our personalities. Personality is a solid core of traits, reflecting the unique essence of a particular human being. Some people are affected largely by intrinsic ideas whereas others focus more on what is around them and are influenced extrinsically, having a tendency to place emphasis on external matters instead of on more philosophical truths. Intrinsic thinking tends to focus on morals and ethics whereas extrinsic thinking is inclined to stress the external adherence of laws and principles. This complex mix of diverse views and ways of thinking ultimately penetrates through to society to create common ideas of mainstream society. These ideas then form the ideologies we base our lives on in various areas of society i.e. in parliament and schools, which in turn affect society. Influences form, grow and ultimately impact. I am going to use the idea of an influence to discuss current

enablers and barriers existing amongst society today that will impose on possible solutions and their effectiveness. Enablers Currently, there are projects, ideas and plans set in places that are likely to help the solutions suggested above to work. Many of these influences were originated from the Government. Recently the Government launched a $67 million four-year campaign aimed at raising physical activity and reducing New Zealand's growing obesity rates, targeting schools in particular. The campaign titled "Mission-On" was aimed at schools in particular and involves the Health Ministry working with the food industry and advertisers in order to reduce the advertising of unhealthy food to children. This initiative acts as a positive external influence toward obesity prevention as it has created an environment that condemns advertising of unhealthy foods. This atmosphere is influencing society indirectly and affecting individual ideas and beliefs, ultimately presenting people with a more concerned approach towards the prevention of obesity and inactivity. Additionally, because the advertising of unhealthy foods is in the process of being reduced, children in particular will be less susceptible to commercial brainwashing. Therefore, they are likely to desire less unhealthy foods, not because their tastes and preferences for fats and sugar have changed but because they are no longer surrounded and enticed by it. This would enable solutions to work, particularly solutions involving price changes. In situations where price changes may seem too small to influence a radical change in the way people spend their money (such as GST exclusions, advertising or lack of advertising) can aid this change. Society will not be faced with such pressures of unhealthy advertising to counter the efforts made by a reduction of prices. In the future, if this campaign runs successfully and advertising of unhealthy foods is significantly reduced, it would enable suggested solutions to work; a negative external influence would have been taken out of the current situation. The natural tendency to maintain general health embedded in human beings is likely to influence the effectiveness of possible solutions. Everyone holds some degree of self-worth and because it is common knowledge that obesity and inactivity can cause negative effects on ones overall well-being and even happiness, people are likely to respond positively to various solutions, because ultimately they are here to help, not to harm. Intuitively, we all want to feel good about ourselves; internal influences formed innately will differ but everyone cares to some degree what they are shoving in their mouth. Even people who live on poor diets have a conscience letting them know that too much food is not a good thing, but their diet is based on other influences: tastes and feelings, habits and costs. Solutions that reduce the impact of negative influences such as high costs and lack of resources (external influences), makes way for our innate desire to do well for ourselves to over power. For example someone who is currently living on a poor diet may decide to change their eating habits for the better if a subsidy of fresh foods came in to play, not merely because fresh food is now

cheaper, but because the one barrier preventing them from doing what they instinctively knew was best for them has now been removed. This is not to say that if healthy food had always been more accessible previously, our natural instincts would have led us to make healthy choices. In general, human beings have always expressed unlearned preferences for fat-associated textures and flavours. It is merely to say that embedded in everyone is the desire to be happy and feel good about themselves, hence maintaining good health. Barriers Lack of concern of individuals (children and adults), and society in general may act as a barrier to many of the solutions outlined previously. Undoubtedly, there are people who lack concern for the issues raised of obesity and inactivity, even apathy toward health in general. This indifference is likely to be due to both a lack of knowledge, and due to a general lack of interest and personal philosophies. Lack of concern will mainly affect the first solution suggested child and parental education, due to the nature of educating. If community seminars were organized and parental magazines put forward, it merely gives parents an opportunity to learn but they are under no obligation to do so. Consequently, if a general lack of interest toward obesity related issues is implied then few will make an effort to learn, hindering the potential effectiveness of the solution. This idea correlates to children also, possibly limiting the effectiveness of teaching within schools and practical physical education. As stated previously, you can lead a horse to water, but you cannot make it drink. The media and advertising is a significant part of the external influences component and with current trends in advertising, it is likely to act as a barrier, making it difficult for various solutions to be successful. The Food and Nutrition Monitoring Report in New Zealand shows that fast-food chains and cafes spent $67 million on advertising, whereas only $6.2 million is spent advertising fruit and vegetables. Along with increased intakes of foods high in fats and empty kilojoules in the last two decades, advertising of unhealthy foods has increased also. This is likely to act as a major hindrance if further action relating to advertising is not taken, simply because advertising works; and it definitely influences. It is even more of a concern for children because before the age of twelve a childs cognitive development is limited and as a result they cannot differentiate between the truth and advertising. Currently, the average household spent $6.50 a week on confectionary over the past year, compared with $5.90 on fresh fruit. Possible solutions such as price incentives has been suggested, aiming to counter the previous statement however, if current advertising trends continue then society may continue to make unhealthy choices; the media is a powerful manipulator. Financial means will largely determine the likelihood of solutions working and whether they can even be instigated to begin with. Because money is a scarce resource and unable to satisfy our unlimited wants and needs, a lack of funds is likely to act as a major hindrance to solutions. Many of the solutions suggested involve laws and policy

changes involving money. These changes may be costly to the taxpayer or other parties. For example, one possible solution is that the GST on healthy foods be removed. If this strategy was put into place the Governments overall revenue would decrease. Consequently, the Government may react to this loss of income by increasing other taxes, (e.g. Income tax). Therefore, the theoretical benefit of cheaper healthy food will now not be so because income tax has risen at a rate that is in proportion to the decrease in GST countering the benefits of the solution. Enablers or Barriers Initiating new ideas often means using money that was previously being used elsewhere. This can cause controversy, as people will prioritize the various possible uses for money differently. For example, if the Government were to subsidize sports clubs and funnel money directly through to providing sports equipment then this money would either have to come from one of two places. Firstly, taken out of another area of spending or secondly, taxes and forms of Government revenue would need to increase to accommodate for the increase in Government spending. There are people who would agree with the idea, as they either intrinsically or extrinsically feel that childrens sport needs to be given more attention and improvements should be made. This viewpoint depending on the strength, will act as an enabler, influencing the wider society that it is of importance. However, others who will be opposed to the idea will have viewpoints that disagree with the solution and they too will influence wider society shaping others views in a way that hinders the likelihood of the solution working. Whether viewpoints act as an enabler or barrier is often dependent on the status and power held in each group. Well-recognized influential individuals, such as celebrities and people who have political power hold a greater influence over controlling societys views than the average person. Therefore, the views of such individuals will ultimately determine whether opinions act as an enabler or barrier. Conclusion Obesity has reached epidemic proportions globally, with more than 1 billion adults overweight - at least 300 million of them clinically obese - and is a major contributor to the global burden of chronic disease and disability. (The World Health Organization) Unfortunately, we as New Zealanders are contributors to these statistics. Contributors sure, but are Kiwi kids becoming fat and lazy? Yes, I believe they are. We may not rank alongside the Americans or the English when it comes to our childrens weight, but that does not make us healthy. Being better than others, does not automatically mean good; we can compare ourselves all we like, but the fact remains that proportionally speaking, our children are getting fat. Throughout this essay, I have covered various angles and views on childhood obesity and inactivity. Many views and opinions may contradict one another, though it remains in mutual agreement that throughout New Zealand obese children do exist. While issues surrounding obesity and inactivity remain controversial, it undoubtedly

grants some concern. Now that it has been established that it is an issue, and awareness of the problem amongst society is relatively high, it is vital that suggested solutions to the problem are seriously considered. The Ministry of Health estimates that poor diet contributes to 30% of all deaths in New Zealand. If we want our children, and our childrens children to live long contented lives then changes must occur, because current trends suggest the contrary. Ultimately, it comes down to the value we place on our lives, and whether we are willing to change. Change will not come if we wait for some other person or some other time. We are the ones we've been waiting for. We are the change that we seek. - Barak Obama Bibliography The following, are resources I used in writing this essay; Books Year 13 Physical Education NCEA Level 3 Workbook Campos, P. (2004). The Obesity Epidemic: Why Americas Obsession with weight is Hazardous to your Health. Death By Supermarket: The Fattening, Dumbing Down, and Poisoning of America.

Websites www.sparc.org.nz/admin/ClientFiles/ http://herbalremedies.freeblog.co.nz/2008/12/12/child-obesity-effects-causesand-solutions/ www.walktoschool.org.uk/ www.csmonitor.com/2004/1014/p11s02-ussc.html www.nytimes.com/2007/04/22/magazine/22wwlnlede.t.html?fta=y www.moh.govt.nz/moh.nsf/indexmh/obesity www.nzma.org.nz/journal www.medindia.net/news/healthwatch/Fighting-Obesity-While-Sticking-to-FastFood-is-It-Possible-43078-1.htm www.independent.co.uk/news/uk/this-britain/size-matters-the-great-britishweight-debate-462748.html www.stats.govt.nz/ www.nzherald.co.nz/nz/news