Preventing obesity among
young people in Ireland:
Approaches and future challenges
Dr Colette Kelly
Health Promotion Research Centre
National University of Ireland, Galway
colette.kelly@nuigalway.ie
Overview
 Overweight/obesity among youth
 Social interventions to prevent obesity among youth
 Social determinants of health approach
 School & community settings approach
 Current approaches in Ireland to prevent obesity among young
people
Prevalence of Childhood Obesity
 “global epidemic” (WHO, 1998)
 43m under 5 overweight/obese in 2010 (4.2%)
 estimated at 60m in 2020 (9.1%) Am J ClinNutr 2010;92 (5):1257-1264
 European Childhood Obesity Surveillance Initiative (COSI)
24% of 6-9 year olds overweight/obese
Child Obesity in Ireland
 1 in 5 Irish children aged 5-12 years are overweight or
obese (IUNA, 2005)
 19% of 13-17 yr olds are overweight/obese (IUNA, 2008)
 1 in 4 nine year olds overweight/obese (GUI, 2009)
 Girls more likely than boys to be overweight (22% vs 16%) and
obese (8% vs 6%)
 Children’s weight related to social class
Social determinants of obesity
 Energy imbalance – physical inactivity and poor diet helps to
largely explain the obesity epidemic
 In Ireland, physical activity is insufficient for optimal
health….&
 A large proportion consume energy-dense, nutrient-poor
foods & drinks and not enough fruit &vegetables (HBSC 2007,
2012; IUNA 2005; 2008)
 Obesity is strongly determined by social, cultural and
economic factors and physical environment
Social determinants of health approach
 Population-based prevention strategies for childhood obesity -
seek to support and facilitate increased physical activity and
healthier diets in the context of a ‘social-determinants-ofhealth’ approach
 A combination of population-based measures, implemented
at
 national level
 local ‘settings-based’ approaches :
 school- and community-based programmes
The need for population-based strategies..
 Unhealthy diet and physical inactivity – major risk factors for
NCDs
 Global Strategy for the Prevention and Control of
Noncommunicable Diseases (WHO, 2000)
 Global Strategy on Diet, Physical Activity and Health (2004)
 2008-2013 Action Plan for the Global Strategy for the Prevention
and Control of Noncommunicable Diseases (WHO 2008)
Population based strategies
 Thus - interventions for obesity prevention occur across the
 whole population,
 operating in a variety of settings and
 at multiple levels of government
 Local intervention allows action to be tailored to meet the
specific context and nature of a problem
 But national guidance & funds can ensure effectiveness and
sustainability of action at a population level.
Framework for action on childhood
obesity prevention (WHO 2007)
Multiple stakeholders – e.g. national,
regional and local government, NGOs, civil
society, academia and private sector
Supportive environments-schools
 Health Promoting Schools (HPS) emerged in 1980s
 The whole school environment – an important arena for action
if a school is to promote health
 Healthy school policies, school’s physical & social environment,
individuals’ health skills, action competencies, community links
and health services
 One of the HSE priorities for 2011-12 is to implement the
HPS model in Ireland
Supportive environments - Communities
 IDEFICS - Identification and prevention of Dietary- and lifestyle-
induced health EFfects In Children and infantS)
 A cross-sectional survey in over 16,000 children aged 2–10 yrs
from 8 European countries &
 Intervention activities - target diet, physical activity & stress
 Community-oriented intervention programme (2 years)
 3 at community level, 6 at school level and 1 for parents
Int J Obesity (2011), Vol 35, S1
IDEFICS: a new model for obesity prevention?
IDEFICS settings approach for development of community-oriented
programme for tackling behavioural change in the community
(De Henauw et al. 2011)
Supportive environments- Communities
 EPODE – “Together let’s prevent childhood obesity”
 EPODE is a coordinated capacity-building approach for
communities to implement effective & sustainable strategies to
prevent childhood obesity
 First launched in 10 pilot communities in France in 2004
 Expanded to 500 communities worldwide
(Borys et al. 2012)
EPODE (Borys et al. 2012)
 Promotes multiple stakeholder involvement:
 Central level – ministries, health groups, NGOs and private
partners
 Local level – political leaders, health professionals, families,
teachers, local NGOs and business communities
 Four pillars of EPODE methodology
Political commitment – at national & local level
2. Resources – e.g. to fund services and implementation
3. Support services – e.g. social marketing, community
practitioners
4. Evidence – evaluate process, impact and outcomes
1.
EPODE
Community-based initiatives (CBI)
(Bemelmans et al., 2011)
 Summarises information on 83 CBI across EU
 Inspire development of new initiatives or improvements of on-
going CBIs
 Important conditional factors - prioritizing childhood obesity and
facilitating the implementation of CBIs within a national policy
framework, but the local context and the community needs should
be the primary entry point.
 To achieve an optimal CBI, the evidence suggests ‘the more
comprehensive, the better’.
Current efforts in Ireland
 HSE National Steering Group on Obesity
 HSE Framework for Action on Obesity 2008-2012
 Special Action Group on Obesity – Minister for Health
 Restrictions on marketing of food & drinks to children
 Promotion of physical activity
 Calorie posting on menus – consultation by FSAI
 The introduction of a tax on sugar sweetened drinks ?
 Nutritional labelling ?
 Revised healthy eating guidelines ?
Current efforts/considerations in Ireland
 Social marketing campaigns e.g. Little Steps campaign
 PA campaigns – Be Active after School programme (Be
Active ASAP)
 Health Promoting Schools
 Public Health Policy – ‘Health and Wellbeing Policy’......
 Food environment surrounding schools......?
Preventing obesity
 Healthy public policies
 Evaluation of programmes
and policies
 Supportive environments
 Life-course perspective
 Community action
 Multi-disciplinary approach
 EATWELL project
 Capacity building across
sectors
 Participative approaches to
the design of prevention
programmes
Challenges
 Resources
 Social inequalities
 Sedentary lifestyles
 Transport and infrastructure
 Communication & Marketing
 Industry
 Less focus on adolescent obesity to date
 Workforce capacity & competence
 Time....
Thank you