Childhood overweight and obesity are a global public health problem. In high-income countries, obesity follows socioeconomic patterns, in that people with a lower socioeconomic position are more likely to be overweight or obese than those with a higher socioeconomic position. Poor diet is a key risk factor for excess weight gain. It is also a risk factor that we can do something about.
In our study recently published in the International Journal of Epidemiology, we examined the contribution of unhealthy food and drink consumption to the development of socioeconomic inequalities in weight among children in Australia. We found that socioeconomic differences in unhealthy food and drink intake emerge from the first year of life and persist throughout childhood. Almost one in two children with a low socioeconomic position were consuming sweet drinks in their first year of life, compared with one in four children with a higher socioeconomic position.
We also found that the inequalities in the consumption of unhealthy food and drinks throughout childhood contributed to the development of inequalities in excess weight at the age of 10–11 years. This is the first study to demonstrate the effect of cumulative consumption of unhealthy food and drinks from birth and throughout childhood on socioeconomic differences in children’s weight.
Unhealthy (or ‘discretionary’) food and drinks are typically those with excess fat, sugar and salt, such as processed meats, pies and savoury pastries, commercially fried foods, potato crisps, confectionery and chocolate, sweet biscuits and cakes, and sugar-sweetened beverages. These items contribute up to 40% of Australian children’s total dietary intake.
Frequent consumption of unhealthy food and drinks in childhood is concerning, as it is during early childhood that taste preferences and dietary habits are established. Furthermore, obese children are likely to become obese adults, and the consequences, including adverse physical and psychological effects, are also likely to persist into adulthood. Greater consumption of unhealthy food and drinks in early life among children from lower socioeconomic backgrounds, accompanied by higher rates of overweight and obesity, means these children are set to carry a disproportionate burden of poor diet and excess weight from a very young age.
Parents of young children face an increasingly complex world when it comes to choosing food and drinks for their children. The ever-increasing availability of unhealthy options, prolific marketing, confusing product labels and misleading health claims create an environment that promotes unhealthy food and drink choices. We must change the environment to make the healthy choice the easy choice for parents and their children.
Recommendations from the WHO Commission on Ending Childhood Obesity call for coordinated government action to promote intake of healthy food and reduce consumption of unhealthy food and sweet drinks among children. This starts with providing nutritional advice to women throughout the antenatal period and supporting parents to introduce and offer a wide variety of foods to infants and young children.
We also need to foster healthy food environments through:
- health policies and nutrition curricula in children’s education and care settings
- mandatory removal of all sweet drinks from early childhood settings
- regulated food labelling and marketing, and
- taxation of sugar-sweetened beverages.
Momentum is building for such action. For example, more than 30 jurisdictions around the world have implemented a sugar-sweetened beverage tax, with demonstrable reductions in sugar-sweetened beverage purchases, particularly among low-income households. Yet much more can be done.
It is clear that there is no single solution to the problem of childhood obesity. Improving children’s diets must be part of a comprehensive, government-led strategy that tackles obesity risk factors from the prenatal period throughout childhood and beyond. This strategy must include an equity focus, to ensure that those with the greatest social and economic disadvantage are not left behind.
Chung A, Peeters A, Gearon E, Backholer K. Contribution of discretionary food and drink consumption to socio-economic inequalities in children’s weight: prospective study of Australian children. International Journal of Epidemiology dyy020, Epub 4 Mar 2018, https://doi.org/10.1093/ije/dyy020.
Alexandra Chung is a PhD candidate at the School of Public Health and Preventive Medicine, Monash University, and visiting researcher at the Global Obesity Centre (GLOBE), World Health Organization Collaborating Centre for Obesity Prevention, School of Health & Social Development, Deakin University.