Professor Louise Baur Early Prevention of Obesity in Childhood Interview

Professor Louise Baur Early Prevention of Obesity in Childhood Interview

A world-first research centre exclusively focused on tackling the childhood obesity epidemic will launch this week at the University of Sydney's Charles Perkins Centre (CPC).

Globally renowned experts from seven universities across Australia, New Zealand and the UK will join forces through the new Centre of Research Excellence in the Early Prevention of Obesity in Childhood, to be housed at the CPC.

The new NHMRC-funded Centre will pursue cutting-edge research into the prevention of obesity in childhood, examining the crucial early years of life to better understand the importance of good nutrition, exercise and the effects of screen time in children aged zero to five.

'Currently one in five children in Australia is already affected by overweight or obesity by the time they start school. By just focusing on intervening at primary school level, it's already too late," said Director of the Centre Professor Louise Baur from Sydney Medical School.

'The first few years of life are really vital for establishing patterns for good health, wellbeing and happiness across the lifespan. Yet significant changes in our broader environment have made it harder for children to eat well and be as active as they might have been a generation ago.

'We know that behaviours that are really important for lifelong health and wellbeing – eating well, being active and sleeping patterns – are all established in early childhood. Intervening early and knowing how best to support parents in this crucial phase is essential in raising healthy children."

For the first time, leading researchers will share data from existing trials – including from the first worldwide randomised trials into childhood obesity prevention – to help develop new methods and tools to monitor obesity-related behaviours in young children.

The $2.5 million Centre, which is funded until 2020, will bring together specialists from a variety of disciplines including paediatricians, dietitians, health experts, economists and exercise physiologists, bringing a multidisciplinary approach to the complex childhood obesity problem.

'It's currently very difficult to measure at the population level the kinds of activities young children are engaged in: what they are eating, how much they're exercising, how much screen time they're exposed to and the amount they are sleeping," said Professor Baur.

'This information provides vital clues for policymakers and health practitioners, helping them to devise more effective public interventions on wide-ranging issues related to childhood obesity, from improving babies' sleeping patterns to decreasing the amount of screen time."

Another aim of the research group is to assess the economic impacts of good health and nutrition in early life and the flow-on effects into adulthood.

'Very few obesity preventions in early childhood have been subjected to economic evaluation, and yet information on cost-effectiveness, equity, affordability and sustainability are all vital to decisions about program implementation," said Professor Baur.

'This Centre will make a substantial contribution to ending the burden of childhood obesity in Australia and internationally by addressing these significant knowledge gaps, and will help to translate world-leading research into effective and targeted policy programs to reverse the concerning upward trends in childhood obesity."

The CRE in the Early Prevention of Obesity in Childhood will officially launch with a half-day seminar on Thursday 21 April.

What: Centre of Research Excellence in the Early Prevention of Obesity in Childhood launch seminar.
When: 9am to 1.30pm, Thursday 21 April

Where: Level 6 Seminar Room, Charles Perkins Centre, University of Sydney
Cost: Free, registration requested

Presented by the Charles Perkins Centre at the University of Sydney

Interview with Professor Louise Baur

Question: What changes have we recently seen in the childhood obesity epidemic?

Professor Louise Baur: There is a bit of good news: In primary school aged children there appears to be a plateauing of obesity prevalence in Australia, although not a decrease. However, there are more marked differences socially. Children from socially disadvantaged areas are more likely to suffer from obesity. Children in outer urban and regional Australia are more likely to be affected than urban children. And children from Middle Eastern, Mediterranean, Asian and Indigenous background are also more likely to be affected.


Question: Why do you believe childhood obesity has become an epidemic?

Professor Louise Baur: It's not just children, but also adolescents and adults that are affected by obesity. We are all responding physiologically to what I see as a 'pathological" environment. The food and physical activity environments in which we live, work and go to school have changed dramatically in the past few decades. The default is to eat less healthily and to be far less active than in the past. Children are driven to and from school, rather than walking. Parents are more concerned about neighbourhood and pedestrian safety than in the past, so keep children indoors or in cars. Children spend more time in passive entertainment – TV, DVDs, tablets, videogames and so on – and less time in active creative play outside. Children and adults also eat far more takeaways than in the past, have larger serve sizes and are exposed to numerous forms of marketing of junk foods! No one thing has changed – many things have changed.


Question: What advice do you have for parents surrounding the importance of good nutrition in children?

Professor Louise Baur: Here are some fairly simple suggestions:

Be a healthy role model for your kids. They will do what you do. So eat well and be active – and enjoy doing so
As a family, eat breakfast every day
Drink water (rather than soft drinks or juice)
Eat together as a family once a day at the table, without the TV being on!
Have healthy snacks in the cupboard and fridge, rather than biscuits and chips.

Watch portion sizes
Encourage children to participate in meal preparation

The Sydney Children's Hospitals Network has some great factsheets for parents on healthy nutrition and activity, as well as obesity. Check out: https://www.schn.health.nsw.gov.au/parents-and-carers/fact-sheets


Question: What do you hope to achieve with the Centre of Research Excellence in the Early Prevention of Obesity in Childhood?

Professor Louise Baur: We have a big overall goal: The Centre of Research Excellence in the Early Prevention of Obesity in Childhood aims to reduce the prevalence of obesity and obesity-related behaviours in the first five years of life in order to transform the health trajectories of the next generation.

We will be national and international leaders in:
analysing data from intervention trials, including shared data from the first high-quality early childhood obesity prevention trials to have been conducted internationally
developing new methods and tools to monitor obesity-related behaviours – activity, food intake, screen time, sleep - in this age group
assessing the economic implications of different early childhood interventions
identifying the factors that promote successful implementation, at scale, of prevention programs
ensuring our research has impact by helping collaboration and knowledge-exchange between researchers, practitioners and policy-makers


Question: Who should attend the Centre of Research Excellence in the Early Prevention of Obesity in Childhood launch seminar?

Professor Louise Baur: The seminar is for professionals working in child health, health promotion, early childhood, obesity prevention, health policy, physical activity, nutrition and public health.


Question: Why does this need to be addressed between the ages of 0 and 5 years?

Professor Louise Baur: One in five Australian children is already overweight or obese by the time they start school. Thus, waiting until school-age to intervene may be too late.
Many obesity-related behaviours – poor diet quality, decreased physical activity, increased sedentary behaviours and decreased sleep duration – are established in, and track from, early childhood.
Larger body size and rapid growth in the first two years predict the development of obesity, both in later childhood and in adulthood.
Life-course studies suggest that interventions in early life, when biology is most amenable to change, are more likely to have sustained effects on health.

Of course it is very important to address obesity in other age groups as well! But early childhood is a critical period.


Question: Can you share your top tips for parents to get their children to eat vegetables?

Professor Louise Baur: Children do what you do. Eat well and your children will tend to copy you.
Involve your child in food preparation – they are more likely to eat the food.
New foods can be rejected several times when you first offer them. Children will eat what is familiar to them.
Always provide some vegetables on the plate.
Serve small portions.
Do not force feed – that is very unpleasant
Don't give extra foods or favourite foods as a reward for eating
Try to keep the meal calm
Be patient


Question: How is sleep related to childhood obesity?

Professor Louise Baur: There are probably several factors all playing a role. Getting too little sleep could increase food intake by: increasing hunger, by stimulating appetite hormones; by giving people more time to eat; and by prompting people to eat less healthily. Too little sleep could also decrease energy expenditure by decreasing physical activity – people feel more tired and hence curb their activity levels, and they tend to watch more TV

Some more information can be found at:

http://www.hsph.harvard.edu/obesity-prevention-source/obesity-causes/sleep-and-obesity/

Question: How much exercise is required for children under 5 years?

Professor Louise Baur: You can check out the national physical activity guidelines for all age groups at: http://www.health.gov.au/internet/main/publishing.nsf/content/health-pubhlth-strateg-phys-act-guidelines#npa05

For children aged 0-5 years:

Physical Activity Recommendations
For health development in infants (birth to one year) physical activity – particularly supervised floor-based play in safe environments – should be encouraged from birth.
Toddlers (1 to 3 years) and pre-schoolers (3 to 5 years) should be physically active every day for at least three hours, spread throughout the day.

Sedentary Behaviour Recommendations
Children younger than 2 years of age should not spend any time watching television or using other electronic media (DVDs, computer and other electronic games).
For Children 2 to 5 years of age, sitting and watching television and the use of other electronic media (DVDs, computer and other electronic games) should be limited to less than one hour per day.
Infants, toddlers and pre-schoolers (all children birth to 5 years) should not be sedentary, restrained, or kept inactive, for more than one hour at a time, with the exception of sleeping.


Interview by Brooke Hunter