Speech by Micheál Martin TD, Minister for Health and Children at the launch of the National Taskforce on Obesity
Ladies and Gentlemen
Obesity is becoming one of the fastest growing health problems in Ireland. One in eight Irish people are obese and every second person is overweight.
The trends from the second SLÁN survey on people´s lifestyles show that as a nation we are becoming progressively heavier – witnessed by the 30% increase in reported obesity levels over the last four years.
Obesity is a complex condition that affects and threatens to overwhelm virtually all age and socio-economic groups. Its health consequences range from increased risk of premature death to serious chronic conditions that reduce the overall quality of life.
While we know that the key causes of obesity are linked to food and physical activity habits – what we need to identify is a solution to halt the rise and reverse the prevalence of obesity in society.
This requires a societal approach and cross sectoral working. In response to this need I am, today, formally launching Ireland’s National Taskforce on Obesity, which will be ably chaired by the Chief Executive of the Irish Sports Council, Mr. John Treacy.
A key role for the Taskforce is to set out a strategic framework, that:
- encompasses the determinants of overweight and obesity,
- identifies best practice for prevention, detection and treatment, and
- creates the social and physical environments that makes it easier for children and adults to eat more healthily and be more active on a regular basis.
Scale of Problem
Obesity in Europe is five times more common now, than it was after the Second World War. Recent trends highlight that the number of obese people is doubling every 10 years and the problem is becoming increasingly prevalent in younger people.
Increases in obesity over the past 30 years have been paralleled by a dramatic rise in the prevalence of diabetes. Globally, around 85% of people with diabetes have been classified with type 2 diabetes and of these, 90% are obese or overweight.
Clearly obesity is a global problem that knows no boundaries. It is common throughout the island of Ireland and I am delighted that the Health Promotion Agency of Northern Ireland, the Institute of Public Health and Safe Food, the Food Safety Promotion Board are represented on the Taskforce. Our shared experiences will add value to effectively addressing and preventing obesity levels for the entire population of Ireland in the future.
While I have already referred to the overall levels of obesity -in Ireland the prevalence of obesity is greater in men than in women. 14% of men and 12% of women are obese and in certain regions this figure rises to 18% and 15% respectively. This places Ireland in a unique position compared to other developed countries and requires an added dimension to our work.
There are many physical problems related to obesity, including back ailments and breathing difficulties. Although obesity should be considered a condition in its own right, it is also one of the key risk factors for chronic diseases such as cardiovascular disease; together with smoking, high blood pressure and high blood cholesterol.
Life expectancy of people who are obese at the age of 40 years can be reduced by up to seven years, compared with people of a healthy weight.
The situation is worse for smokers. Obese smokers, on average, lose 13 years off their life, compared with people of a healthy weight and who do not smoke.
In addition to individual’s health, it is estimated that obesity accounts for up to 6% of Ireland’s total health care costs. These costs do not include a decrease in productivity due to illness and workdays lost; premature mortality or the intangible costs, such as impaired quality of life.
Obesity in Children
Obesity in children has been identified as an emerging public health problem, particularly in the Western World.
Data from recent surveys indicate that one in five Irish boys and girls are overweight and one in twenty are obese. Worryingly, the age of onset of obesity in children across the world is falling and a child is twice as likely to be an obese adult, if obese in childhood.
We need therefore, as a priority, to address the trend and scale of overweight and obesity in Irish children.
To do that we need to look at the eating and activity habits of children and what influences these. In a sentence, we need to make it easier for children to eat healthy foods and be more active.
We know that:
- less than half of teenagers aged 15-17 years take part in regular physical activity, and
- school children’s diet has a higher than desirable fat content – a significant proportion of which comes from high fat, energy dense snacks.
While many of the most active children in society spend time watching television, excessive television viewing is a contributor to obesity in children. This may be related to the high levels of food advertising to which they are exposed as well as reduced physical activity levels. Foods and drinks from the top shelf of the Food Pyramid – that is those of which we should eat less – are among the most heavily marketed products on television.
The evidence that the heavy marketing of these foods and beverages to young children causes obesity is not unequivocal, but it clearly does have an influence and deserves special attention in addressing obesity prevention. In that regard I welcome the Broadcasting Commission of Ireland´s review of the marketing of food to children.
Parents, guardians and home environments play an important role in children’s eating and physical activity behaviours. For example, it appears that access and exposure to a range of fruits and vegetables in the home is important for the development of preferences for these foods and that parental knowledge, attitudes and behaviours related to healthy diet and physical activity are important in creating role models.
Preventing and addressing obesity in children and adolescents, requires that we work together to:
- promote an active lifestyle;
- promote the intake of fruits and vegetables;
- restrict the intake of energy-dense, micronutrient-poor foods such as packaged snacks;
- restrict the intake of sugars-sweetened soft drinks; and
- detect and respond appropriately to children at risk at an early age.
Additional measures include modifying the environment to enhance physical activity in schools and communities, creating more opportunities for family interaction, such as eating family meals and family activities, limiting the exposure of young children to heavy marketing practices of energy-dense, micronutrient-poor foods, and providing the necessary information and skills to make healthy food choices.
Determinants of Obesity
The key causes of obesity are linked to food habits and physical activity levels. There is convincing evidence that a high intake of energy-dense foods promotes weight gain. Conversely, a high dietary intake of dietary fibre helps promote weight maintenance and loss. A clear and user friendly food labelling system is required to assist people become more aware of the nutrient and energy density of their food choices.
Research suggests that passive over-consumption of foods can lead to obesity. For example 100 extra calories a day – can add an extra 10 pounds of weight per year. Linked to this is the issue of large portion sizes, another factor for unhealthy weight gain.
The recent removal of ´supersize´ portions, in certain fast food outlets in the UK, is to be welcomed and I hope will be emulated in the Irish market and will be taken on board by other sectors, such as the confectionary industry.
While it is true that physical activity is protective against unhealthy weight gain – it is ongoing and regular physical activity that is protective – and not previous physical activity or temporary bouts of activity such as enrolment in exercise programmes.
The recommendation for individuals to accumulate at least 30 minutes of moderate-intensity physical activity on most days is largely aimed at cardiovascular health – the amount needed to prevent unhealthy weight gain is estimated to be higher and in the order 45-60 minutes.
What Can Be Done To Prevent Obesity
Obesity is caused by lifestyle choices. Habits need to be changed if an obese person is to stand a good chance of losing weight. There are no quick fixes.
Effective weight management for individuals and groups at risk of developing obesity involves a range of long-term strategies. These include prevention, detection, weight maintenance, management of co-morbidities and weight loss. They need to be part of an integrated, multi-sectoral, population-based approach, which includes environmental support for healthy diets and regular physical activity.
This is a major challenge for Ireland and the key elements must include:
- Creating supportive population-based environments through public policies that promote the availability and accessibility of a variety of low-fat, high-fibre foods, and that provide opportunities for physical activity; and
- Promoting healthy behaviour to encourage, motivate and enable overweight and obese individuals to lose weight by:
- eating more fruit and vegetables, as well as whole grain breads and cereals;
- engaging in moderate physical activity for at least 45 minutes most days of the week;
- cutting the amount of fatty, sugary foods in the diet;
- moving to lower fat choices, preferably from unsaturated fat sources; and
- mounting a clinical response to the existing burden of obesity and associated conditions through clinical programmes and staff training to ensure effective support for those affected to lose weight or avoid further weight gain.
In general, we know what causes obesity and how it affects the individual and society and we are cognisant of its economic and social costs.
As policymakers we have already considered the constituent elements which lead to overweight and obesity, namely poor nutrition and physical inactivity. We have been proactive and have responded in a variety of ways over a long time and through many successful programmes and initiatives – from the 12 year National Healthy Eating Campaign to the National Play Policy for Children announced earlier this week.
The investment by the Government in recent years, especially towards the implementation of the Cardiovascular Health Strategy, has put much of the infrastructure in place to address obesity prevention. This includes the appointment, for the first time of physical activity co-ordinators by each health board and twenty six additional community dieticians.
To halt and then reverse the rise in obesity levels, the infrastructure, programmes and initiatives need to operate in an environment that will influence, encourage and sustain a healthy lifestyle regime. This will require the direct involvement of a range of Departments and agencies. We need to work in partnership with the policy makers, the food industries, the town planners, the educators, the medical profession and many more.
We need to spend time clarifying what needs to happen and then develop a roadmap on how best we can make it happen. To provide the direction for this work and to develop the strategic focus to succeed I am establishing a Taskforce consisting of representatives of the key stakeholders. Their challenge will be to identify best practice for prevention, detection and treatment and how, in partnership, Ireland can create the social and physical environments to address and prevent obesity.
I am optimistic that the Taskforce can achieve this goal. There is a high level of support for this initiative. I received many letters from people who wished to represent their various organisations, and while regretfully this was not possible, the Taskforce will be seeking their support and input during the course of their work.
I am grateful for all the work that has been carried out to date by the Obesity Working Group, chaired by Dr. Donal O´Shea in advance of the establishment of this National Taskforce. I commend the commitment and interest of all those who will play an active role on the Taskforce, under the direction of Mr. John Treacy.
The establishment of this Taskforce will tackle an emerging health crisis, one which could afflict almost half the population. Their work that I hope will be completed by the end of this year will make a real difference to the future health of millions of people.