Student Voice: Childhood Obesity Crisis – The Call to Ban Sugar in Schools

‘Mens sana in corpore sano’ (‘A healthy mind in a healthy body’)

Roman poet Juvenal, 55 AD

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Background

In a national study of Australian young people’s perspectives, health ranked as the second most important domain for having a good life. The World Health Organisation (WHO) defines health not just as the absence of disease or infirmity, but as a multidimensional construct that incorporates physical, mental, and social wellbeing (WHO 1946). But why should educational institutions care about health? Besides an obvious correlation of ill health and diminished capacity to concentrate on schoolwork and study, chronic conditions can require considerable time to manage and affect physical, social, and emotional development resulting potentially in reduced school attendance and poor educational outcomes.

A recent government survey on children’s health identified obesity as one of the most urgent health problems. Australia now has the dubious distinction of being the fifth most obese country among OECD countries, with one in four Australian children overweight or obese. Overweight and obesity in children and adolescents have become a major public health crisis with ramification extending into the educational sector: Multiple studies in over 30 OECD countries have established a correlation between obesity and poor academic performance. This has consequences not only for the individual, who might be limited in their academic development and future career, but also in terms of productivity of our society and overall economy. Thus, schools engaged in health-focused programs can play an important part in improving students’ health as well as their academic outcomes, which finally benefits our society at large.

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The Problem 

Obesity — which is now classed as a disease— is an energy imbalance between calorie consumption and expenditure and can be measured in children by Body Mass Index (BMI) combined with age-specific growth charts. Many factors can cause and influence obesity, from diet and lifestyle to genetics. Regardless of the cause, obesity may lead to detrimental effects on body and vital organs as well as potentially to significant mental health issues such as depression due to stigma and discrimination. Furthermore, many obese children today are developing health problems previously observed only in adults, such as diabetes, heart disease, stroke, and potentially even some cancers. Most shockingly though, childhood obesity can lead to a shortened life expectancy. In fact, obesity and overweight has become the fifth leading global risk factor for mortality.

Considering that already 1 out of 4 young Australians aged 2-17 is overweight or obese, prevention programs are crucial to stem the rising tide of childhood obesity, which is fast reaching epidemic proportions.

A number of studies have demonstrated a significant association between childhood obesity and poor academic performance. These studies provide evidence that obese students fare worse than their non-obese counterparts for a variety of educational outcome measures such as school grades, absences, engagement, and repeating a grade.

Not only should it be the responsibility of the family but also of the school to ensure that students have access to foods that promote good nutrition. Some schools have initiated health awareness programs, either with government funding or volunteer and community support. Also, basic health classes have been integrated into Australian curriculums, covering amongst others, the fundamentals of healthy behaviours and nutrition. This is a promising approach, as there seems to be a significant link between nutrition programs in schools, such as lunch programs and snack options, and student achievement. However, in light of the rising obesity trend, more needs to be done.

Possible Health Interventions by Schools

The NationalAction Plan for the Health of Children and Young People 2020–2030 as well as the Australian National Diabetes Strategy 2016–2020 recommend schools to be an active part in the fight of the obesity crisis in young people. Schools play a major role in the habits of children, because students spend a large part of their day in the school setting. Interventions are particularly effective, if they include healthy food provisions in schools, are of longer duration, and encourage specific food consumption patterns such as an increase in fruit and vegetables. This approach is especially effective for primary-school-age children, but needs to continue into secondary schools. Program success factors appear to centre on

• changing the availability of foods at school;
• incorporating a mix of educational and environmental interventions; and
• ensuring sustained duration of interventions.

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One of the main culprits of unhealthy food and drinks is sugar. The WHO recommends limiting daily intake of added sugar to around 3-4 teaspoons for children, but many school-aged children are consuming on average more than 20 teaspoons of added sugar daily. Thus, eliminating or reducing sugary drinks and food in school settings could be a crucial step in the right direction. For example:   

1.   Substitute high-sugar drinks with water or low-sugar drinks: Students need to stay hydrated, but water is all that is needed. Fruit juice is the most common drink supplied by parents and schools for school lunches, but despite sounding like a healthy choice, fruit juice contains large amounts of sugar. Instead, schools could offer more water fountains and encourage bringing refillable water bottles or sugar-free cordials.

2.   School canteens should avoid offering sugary snacks or lunches at their canteen, as this could be interpreted by students and parents as sanctioning an unhealthy diet.

3.   If possible, schools should offer healthy alternatives as snacks or for lunches. This could include salad bars with fresh fruit and vegetables(already implemented in some pre-schools as “Eat a Rainbow” program with colourful fruits and vegetables) and improve the nutritional value of the menu by increasing the range of healthy choices available.

4.   School administrators may consider removing vending machines that provide and encourage sugary and fat-laden snacks.

5.   Educators should consider encouraging students and parents to pack nutritious snacks.

6.   Students and teachers should be encouraged to make healthy choices and learn about nutrition.

CONCLUSION

Australia’s childhood obesity epidemic deserves urgent attention. Clearly, no single solution creates sufficient impact to reverse childhood obesity; only a comprehensive, systemic program of multiple interventions is likely to be effective. However, schools can play a pivotal part in supporting children to develop good eating habits early in life. This will not only enhance students’ academic performance, but more importantly promote students’ wellbeing throughout their lives.

Obesity — which is now classed as a disease — is an energy imbalance between calorie consumption and expenditure and can be measured in children by Body Mass Index (BMI) combined with age-specific growth charts. Many factors can cause and influence obesity: from diet and lifestyle to genetics. Regardless of the cause, obesity may lead to significant mental health issues such as depression due to stigma and discrimination. Furthermore, many obese children today are developing health problems previously observed only in adults, such as diabetes, heart disease, stroke, and some cancers. Most shockingly though, childhood obesity could lead to a shortened life expectancy. In fact, obesity and overweight has become the fifth leading global risk factor for mortality.

Considering that already 1 out of 4 young Australians aged 2-17 is overweight or obese, prevention programs are crucial to stem the rising tide of childhood obesity, which is fast reaching epidemic proportions. Some schools have initiated programs, either with government funding or volunteer and community support. Also, basic health classes have been integrated into Australian curriculums, covering amongst others, the fundamentals of healthy behaviours and nutrition. However, in light of the rising obesity trend, much more needs to be done.

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References:

https://www.aihw.gov.au/reports/children-youth/australias-children/contents/health/the-health-of-australias-children

https://www.commonwealthfund.org/blog/2018/rising-obesity-united-states-public-health-crisis

https://www.garvan.org.au/research/diseases/obesity?gclid=EAIaIQobChMIhKLtnNL17gIVymkqCh2apwxyEAAYAiAAEgLaK_D_BwE

https://www.aihw.gov.au/reports/overweight-obesity/overweight-obesity-australian-children-adolescents/contents/summary

https://www.aihw.gov.au/reports/australias-health/overweight-and-obesity

https://www.healthdirect.gov.au/obesity-in-children

https://ncci.canceraustralia.gov.au/prevention/overweight-and-obesity/overweight-and-obesity-children-and-young-people

https://www.cdc.gov/obesity/strategies/index.html

https://www.cdc.gov/obesity/childhood/causes.html

https://www.cdc.gov/nutrition/healthy-food-environments/saladbars2schools.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4801195/

https://www.sahealth.sa.gov.au/wps/wcm/connect/Public+Content/SA+Health+Internet/Healthy+Living/Healthy+Communities/Local+Community/OPAL/OPAL+Case+Studies

https://www.pc.gov.au/research/supporting/childhood-obesity/childhood-obesity.pdf

Obesity Prevention in Children and Young People_fulltechnical report_University Sydney.pdf

AIHW_Overweight and obesity among Australianchildren_2020.pdf

https://www.oecd-ilibrary.org/sites/641a2e79-en/index.html?itemId=/content/component/641a2e79-en

https://collected.jcu.edu/cgi/viewcontent.cgi?article=1008&context=honorspapers