On Friday, The Australian carried a prominent front-page story whose headline made the bold claim, “Childhood obesity epidemic a myth”.
The story was based upon a review, not yet published in a journal, by University of SA researcher Tim Olds, involving 27 Australian studies of children’s weight conducted between 1985 and 2007.
As reported in The Oz, the study found that the prevalence of overweight and obesity among Australian children has plateaued over the past five to ten years. The news story linked to an editorial, titled “Intellectually flabby” regurgitating the tired, old unconvincing argument that the “nanny state” should leave such public health issues up to individual choice.
The Olds review put quite a different slant on its finding to that suggested by the Oz’s headlines, saying:
…there is no doubt that in the larger historical picture the prevalence of childhood overweight and obesity has been increasing, and that the condition brings with it a heavy burden of present and potential mental and physical health issues.
While the flattening is, at least on the face of it, a rare piece of good news in the fight against childhood overweight, it should be remembered that the prevalence in Australia is still high by world standards, and certainly higher than desirable. It is also possible that the plateau represents a temporary lull, and that without continued efforts we may again see a rise in prevalence.
What the Oz news story and editorial didn’t mention is that, as the Olds paper acknowledges, there are so many methodological difficulties with such a review that it would be prudent to consider its findings suggestive rather than conclusive.
I asked Olds for his opinion of the Oz’s coverage.
“The article was fine but the headline (doubtless a rogue subeditor) was ridiculous,” he emailed back.
“I expected, but am still concerned about, the rather over-dramatic interpretations of the findings. Basically these data mean that we have a critically ill patient who is not getting worse. This doesn’t mean they were never critically ill, or that we don’t have to care for them now.”
The Oz, which has a history of giving prominent display to stories questioning public health concerns about obesity, is fighting a phoney war.
To claim that a possible plateauing in obesity rates — which has now been reported in a number of countries — means the epidemic never existed is simply not logical (using the Macquarie Dictionary definition of epidemic as “a temporary prevalence of a disease”). Just because the numbers of people affected by any epidemic will rise and fall does not mean that something was not an epidemic or does not remain a serious health problem.
And, as Deakin University’s Professor of Population Health Boyd Swinburn points out, a plateauing in overall obesity rates certainly doesn’t mean problem solved. It may, for example, disguise a trend for the problem to have worsened in some groups but improved in others.
The history of many other public health problems suggests that we can expect obesity to become less of a problem for children from wealthier backgrounds, while remaining a significant and perhaps even escalating problem for children from poorer backgrounds and certain ethnic groups.
“The plateauing may be disguising increases in disparity,” says Swinburn.
Swinburn’s advice for policy makers is: “…not to believe The Australian headline for a start, and to read into the detail of the report and realise we still have a problem which affects over a quarter of our children.”
As for the media, he thinks it’s well past time that we moved beyond simply reporting on the prevalence of the problem, and started investigating the effectiveness of potential solutions.
Lesley King, executive officer of the NSW physical activity, nutrition and obesity research group based at the University of Sydney, would also like to see more focus on solutions.
“The important question remains what are we doing about the problem?” she says.
“Have we made the environment one that protects children from risk of gaining excessive weight, and made sure that it promotes active lifestyles for everyone regardless of where they live and ensures that healthy food choices are always available and affordable for children and their families? Not yet.”
Not that I’m expecting to see that sort of analysis on page one of the Oz anytime soon.
Melissa Sweet is the author of The Big Fat Conspiracy: how to protect your family’s health (ABC Books, 2007)
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3 thoughts on “Beware the phoney fat wars”
Dr. Elizabeth Denney-Wilson
January 12, 2009 at 2:55 pmThanks Melissa for drawing my (holiday-brain) attention to the review from Tim Olds and indeed the comments following the Australian editorial. As a “dill” who has been paid to “do a study” in the past I’d like to make a couple of comments. I agree with boyd Swinburn that it is almost certainly the case that similar socioeconomic disparities in the prevalence of overweight as are seen in adults are evident in children. The data from the SPANS 2004 study suggested a trend toward greater prevalence of overweight in the lowest socioeconomic quintile and other research done by Jenny O’Dea and others has found evidence of a socioeconomic gradient as well. In the US a gradient is clear. Targeted interventions are clearly needed in certain social and ethnic groups.
My second point is that even if the prevalence of overweight has levelled off at 24%, that still equals almost one quarter of children with excess weight and a very high likelihood of carrying that excess weight into adulthood and developing chronic disease. My PhD research found that among 15 year old boys, even the overweight (ie not obese) were significantly more likely to have risk factors for type 2 diabetes, CVD and fatty liver. Not all of the overweight boys had risk factors, but all but 1 obese boy had risk factors, and several had 3 or more.
Lets not forget that in Australia over half of adults are overweight or obese-and the prevalence of childhood overweight was low when they were kids ergo most of them must have been lean as children! Without targeted interventions to prevent weight gain we could be looking at even bigger numbers of overweight adults as this generation of children reaches adulthood.
A “levelling off” at 24% is too high, and suggesting the problem is done and dusted is public health madness.
Ev
January 12, 2009 at 2:41 pmTh Oz’s stance on a number of things has been constantly baffling to me. My question on reading this, and their stance on Global Warming is, “what can they gain by taking this stance?”. I guess with GW it’s all about appeasing big business advertisers, but here I see no motive. I don’t believe it was an honest mistake, but it’s a poor indicator of the intelligence of the editor if it was a mistake.
roger gestetner
January 12, 2009 at 2:55 pmso what do you expect? anything that could possibly preserve newscorp’s advertising base is going to get a good run, no matter how much reality needs to be warped. if you need any further evidence, calculate the weekly worth of the alcohol industry spend across all newscorp publications and it suddenly becomes clear why the Oz gives a free plug to the Distilled Spirits Industry Council of Australia every time it makes one of its brain-damaged statements about the federal government’s war on binge drinking by young people.