Children hungry to lose weight
A diet program to reduce childhood obesity among school children in
Graham Donaldson, senior chief inspector for Her Majesty's Inspectorate of Education (HMIE), said in the latest progress report issued last week, that Hungry for Success has been successful in meeting many of its goals to encourage school children to eat ‘healthy’ and increase their fruits and vegetables. “There have been notable improvements in the quality of school meals in
According to the news, the Inspectorate’s report recommended intensifying the program for greater diligence, increasing physical activity, and consider testing “lunch-time lock-ins” to prevent secondary school pupils from leaving the campus for lunch.
Hungry for Success was part of the comprehensive Scottish Diet Action Plan to get everyone in Scotland to eat healthier and reduce “overweight/obesity” and related diseases. If anything was going to reduce obesity rates across the Scottish population, based on popular wisdoms, this vast government initiative would do the trick.
In July 1996, Eating for Health: A Diet Action Plan for Scotland, (known as the Scottish Diet Action Plan) was published by the Scottish government. It served as the “blueprint for action” for the next decade of governmental health policy to “result in better health for all.” Its recommendations encompassed every facet of society, including 71 actions across nine sectors. The Scottish Diet Action Plan “aimed to shape consumer tastes, increase consumer demand for healthier food; supply food for a healthier diet through changes in the supply chain; help people understand healthy eating better through training, labelling and better public sector catering and to influence those who govern and monitor changes in health.” Its “target of greatest importance” was to increase consumption of fruits and vegetables and complex carbohydrates.
This massive initiative included every popular healthy eating idea that’s probably ever been proposed, such as: nutritional advice was given to every household in Scotland; public health education campaigns ensued, cooking shows and resources were devoted to ‘healthy’ eating; expectant mothers were intensely targeted for education to breastfeed and improve infant and children’s diets; “sustainable agriculture” was employed ”to get more local produce eaten by local people;” farm shops and farmers markets grew; food labeling was expanded to increase proper choices; food producers reduced sugars, fats and salts in food products to comply with new healthier nutrient standards; dairy fats were discouraged and fish oils encouraged; supermarkets were employed to bring healthy food to low-income communities; livestock was bred to be leaner, and even sugar was to be removed from children’s medicines.
Hungry for Success, geared to school children, had “enormous public and political support” and was well-funded, with $126.09 million (US dollars) committed to its first three years and more for the next three.
As part of Hungry for Success, “whole school approaches” to healthy eating were undertaken and health education was heightened throughout school curriculums to “raise dietary awareness in schools.” All staff involved in health education were provided special training in nutrition and diet. Nutrition standards and diet policies were established for school meals and were monitored. According to the HMIE inspectors' report published by NHS Health Scotland, the Hungry for Success program succeeded well beyond the original recommendations and even ended the sale of sweets and fizzy drinks in school meal halls. They found “substantial” improvements had been made in food choices and food service throughout Scotland. School meal standards were restricted even more per expert recommendations in 2003, and primary schools were to have these fully implemented by 2004 and secondary schools in 2006, and the inspectors reported success in meeting these goals. All schools had become “health promoting” schools.
Hungry for Success also introduced a course on cooking for all secondary pupils nationally, established in the late 1990s. Other Hungry for Success initiatives that saw “substantial success” according to the inspectors included ensuring that all “tuck shops” and school vending machines “reinforced the health promotion and health education messages of the school,” which were monitored as part of school inspections. Primary children were provided free fruit (100% of pupils by 2005). Low income children were given free breakfasts and eligible for other healthy eating initiatives to provide free produce with meals.
To sum up, healthy eating to prevent childhood obesity has been made the focus in schools since 1999. So, how did it succeed?
Its first target goal — increasing fruit and vegetable consumption in kids — proved a failure. Despite years of nonstop messaging and even giving children free fruit in school, the report concluded “there is no evidence as yet that it directly impacts the total fruit consumption of primary school children.” Remember the similar program — called the School Fruit and Vegetable Scheme — undertaken to distribute free produce to more than 2 million children in 18,000 British schools? It was designed to create lifelong healthy eating habits in the pupils and cost $284.24 million just during its first two years. The program failed to increase the long-term fruit and vegetable intake in the children.
And, [this will be of no surprise to JFS readers who understand the causes for the diversities of sizes among children] Hungry for Success also failed to have any impact in achieving its primary goal: reducing rates of “overweight and obesity” in children. Hence, those calls in the opening of this article for stepped up intensity of interventions. The HMIE inspectors lamented that Scotland “faces rapidly rising childhood obesity.” They said that these figures from Scottish NHS National Services “led to widespread concern,” as they exceeded goals for the UK:
By reporting only the percentages of growing children crossing new arbitrary thresholds labeling them “overweight or obese,” it’s easy to create the illusion of a problem. But it doesn’t reveal the changes in actual heights and weights among children or give you the larger picture.
Researchers at the Department of Public Health, UMDS, St. Thomas’ Campus in London, tracked the growth of English and Scottish children from 1972 through 1994, recording the actual data for heights and weights measured each year among representative samplings of thousands of children, ages 5 - 10, as part of the National Study of Health and Growth study. They published their results in the Archives of Diseases in Children. For this discussion, we’ll look at the data for Scottish boys and girls.
From a health perspective, the actual figures gave every indication of good news for the general well-being of Scottish children. The most dramatic change seen over the decades was an increase in height, said the researchers. This indicated improved nutrition and health. The ten year old boys were an average of 3.13 cm taller and girls 2.73 cm taller than just two decades earlier [this growth in height was nearly twice that recorded among children in England]:
Weights “increased reasonably linearly,” the researchers reported. The ten year olds, for example, gained an average of 3.32 kg over those same decades. The Scottish children naturally added more weight than the English children, since they also grew significantly taller.
Looking at the increases in weights in boys and girls, they do follow reasonably close to the increases seen in height.
Weights increased slightly more than heights proportionally, but this also indicates healthier children. Plotting actual heights and weights on growth curves finds, for example, that in the early 1970s the weights of average Scottish ten year old girls were below the 50% percentile for weight compared to heights that were above the 50% percentile. They were disproportionally thin. By the 1990s, their heights and weights were more balanced, both averaging just above the 50% percentile. This would indicate that they were healthier, had better nutrition, and possibly higher levels of maturity. But even these changes, seen over decades, are not extreme or warrant concern. The actual differences in mean weight for height index, according to the researchers’ report, had actually increased by only 0.012.
So, at the time the Scottish government developed its massive Hungry for Success program to eradicate childhood obesity, there was no epidemic of childhood obesity. Nor was there any indication that children were horribly nourished. And in the years since, its own evidence shows it has not succeeded in changing that. No one had asked the right questions.
Dr. Peter March, co-director of the Social Issues Research Centre in Oxford, UK, analyzed the Health Survey for England data since 1995 and said “there has been very little change [in child obesity rates] over the last decade, contrary to the lurid warnings that the current generation of children will die before their parents.” He concluded: “There have been no significant changes in the average weights of children over nearly a decade. This can be taken as evidence that there has been no ‘epidemic’ of weight gain.” You now also have decades of earlier figures to add for the full picture, and are probably wondering how an entire nation, like us, could become convinced of a crisis.
When growth of children is couched in terms of BMI, it is easy to forget this includes their height and is not just a measure of their weight. (Body mass index = weight in kilograms to the square of height in meters.) When using the percentages of children crossing arbitrary thresholds on growth charts by BMI, rather than small changes in actual weight and height, it is also easy to create a false sense of a tremendous epidemic of gargantuan children.
The facts are so inconvenient to agendas.
© 2008 Sandy Szwarc