1. Centre for Physical Activity and Nutrition Research Centre for Physical Activity and Nutrition Research Parental concerns about childhood obesity David Crawford* and Tony Worsley *NHMRC/NHF Career Development Fellow

2. Centre for Physical Activity and Nutrition Research Centre for Physical Activity and Nutrition Research Burden of disease in Australia

3. Trends in obesity-related media coverage Note: Figures represent IFIC tracking of U.S. and International (English-speaking) wire reports and print articles on the issue and do not necessarily reflect the true number of stories.

4. Centre for Physical Activity and Nutrition Research Centre for Physical Activity and Nutrition Research Obesity in Australian children (1995/97) Booth et al, ANZJPH 2001

5. Centre for Physical Activity and Nutrition Research Centre for Physical Activity and Nutrition Research Trends in childhood obesity Prevalence has probably doubled over the 10-year period 1985-95 In a cohort of 1438 Victorian children aged 5- 10 years at baseline, between 1997-2000/01:  10% became overweight  2% became obese Hesketh, Wake, Waters, Carlin, Crawford, Pub Health Nutr. (In press)

6. Centre for Physical Activity and Nutrition Research Centre for Physical Activity and Nutrition Research Children’s eating and physical activity behaviours have changed

7. Centre for Physical Activity and Nutrition Research Centre for Physical Activity and Nutrition Research Percent change in amount of food and energy density of food 1985-95

8. Centre for Physical Activity and Nutrition Research Centre for Physical Activity and Nutrition Research How active are Australian children?

9. Centre for Physical Activity and Nutrition Research Centre for Physical Activity and Nutrition Research Children’s physical activity habits We don’t know how activity levels have changed over time  Walking and cycling to school has declined  Fitness levels have declined Likely that children’s activity levels have declined Our data suggest children engage in relatively low levels of physical activity

10. Centre for Physical Activity and Nutrition Research Centre for Physical Activity and Nutrition Research Average time (mins/day) spent in moderate intensity activity Mins per day

11. Centre for Physical Activity and Nutrition Research Centre for Physical Activity and Nutrition Research Average time (mins/day) spent in vigorous intensity activity Mins per day

12. Centre for Physical Activity and Nutrition Research Centre for Physical Activity and Nutrition Research The world we live in has changed (Jeffery and Utter, Obesity Research, 2003) Overall cost of food has decreased Foods prepared away from home/ Availability of energy dense foods/drinks Portion sizes of some foods have increased Marketing of foods and drinks Urban sprawl and urban design Availability of private versus public transport The number of two-income families The time spent in paid employment Place of physical education in the curriculum

13. Centre for Physical Activity and Nutrition Research Centre for Physical Activity and Nutrition Research CHILD WEIGHT STATUS Child characteristics and child risk factors* Gender Age Familial susceptibility to weight gain Parenting styles and family characteristics DIETARY INTAKE SEDENTARY BEHAVIOR PHYSICAL ACTIVITY Parent food preferences Parents dietary intake Nutritional knowledge Ethnicity Child feeding practices Types of foods available in the home Family leisure time activity Parent preference for activity Family TV viewing Parent activity patterns Peer and sibling interactions Parent encouragement of child activity Parent weight status Community, demographic, and societal characteristics Leisure time Socioeconomic status Crime rates and neighborhood safety Accessibility of convenience foods and restaurants Work hours School lunch programs Accessibility of recreational facilities School physical education programs Parent monitoring of child TV viewing Contextual influences on childhood obesity Davison & Birch (2001). Obesity Reviews, 2, 159-171.

14. Centre for Physical Activity and Nutrition Research Centre for Physical Activity and Nutrition Research Preventing childhood obesity We have a poor understanding of the drivers of the obesity epidemic  Lots of candidates - little evidence A huge range of prevention strategies have been proposed  Education strategies to promote physical activity and healthy eating  Changes to urban environment to make it safer for children to walk  Policies to ban advertising to children or taxes certain kinds of foods

15. Centre for Physical Activity and Nutrition Research Centre for Physical Activity and Nutrition Research Community views of childhood obesity? Parent’s views on causes and what to do to prevent it not widely canvassed! This is despite evidence that many parents are concerned about their child’s weight Understanding community views is important:  To establish support for preventive initiatives  To identify where these is a need to educate the community about the epidemic

16. Centre for Physical Activity and Nutrition Research Centre for Physical Activity and Nutrition Research Our research… Aimed to examine community views:  Causes of childhood obesity  Beliefs about prevention Surveyed 315 adults randomly recruited at a major shopping centre Assessed views of importance of:  25 possible causes of obesity  13 potential preventive measures

17. Centre for Physical Activity and Nutrition Research Centre for Physical Activity and Nutrition Research Causes: Lack of physical activity %

18. Centre for Physical Activity and Nutrition Research Centre for Physical Activity and Nutrition Research Causes: Overconsumption of food %

19. Centre for Physical Activity and Nutrition Research Centre for Physical Activity and Nutrition Research Causes: Children’s lack of knowledge and motivation %

20. Centre for Physical Activity and Nutrition Research Centre for Physical Activity and Nutrition Research Causes: Physical activity environment %

21. Centre for Physical Activity and Nutrition Research Centre for Physical Activity and Nutrition Research Causes: The food environment %

22. Centre for Physical Activity and Nutrition Research Centre for Physical Activity and Nutrition Research Causes: Parental responsibility %

23. Centre for Physical Activity and Nutrition Research Centre for Physical Activity and Nutrition Research Causes: Modern technology & media %

24. Centre for Physical Activity and Nutrition Research Centre for Physical Activity and Nutrition Research Prevention: Government action %

25. Centre for Physical Activity and Nutrition Research Centre for Physical Activity and Nutrition Research Prevention: Children’s health promotion %

26. Centre for Physical Activity and Nutrition Research Centre for Physical Activity and Nutrition Research Conclusions Community recognises the causes to be multi-factorial Key causes: overconsumption of unhealthy food; parental responsibility; modern technology; TV viewing and the mass media Less community support for government regulation than for health promotion There is likely to be widespread support for health promotion activities aimed at preventing childhood obesity

27. Centre for Physical Activity and Nutrition Research Centre for Physical Activity and Nutrition Research For more information… Take a look at our paper: International Journal of Obesity 2003; 27: 1465-1471 Email me at: dcraw@deakin.edu.au See our website: www.hbs.deakin.edu.au/HealthSci/Research/default.asp