Childhood Obesity and Diabetes

Iain McKenzie Excerpts

Wednesday 24th April 2013 Westminster Hall

[Mr Iain McKenzie (Inverclyde) (Lab)]

It is a pleasure, Mr Davies, to serve under your chairmanship. I also thank my right hon. Friend the Member for Leicester East (Keith Vaz) for securing this important and timely debate. Across the UK, childhood obesity is soaring and, with it, diabetes. We need to deal with childhood obesity sensitively and robustly, and we must not make the mistake of thinking that one solution will fit all children. Obesity in childhood is a complicated condition and can have many different causes. Childhood obesity often persists into adult life, and adults who are obese as children have a higher risk of diseases associated with obesity, particularly type 2 diabetes, hypertension, cardiovascular diseases and, yes, even cancer.

The UK has one of the highest levels of childhood obesity among developed countries. I will take a moment to discuss what has been happening in Scotland, because we share that problem. In fact, it is probably multiplied. In common with most of the developed world, Scotland is experiencing an obesity epidemic, and the west of Scotland heads up all the wrong health leagues in Europe. Scotland has one of the highest levels of obesity among OECD countries. Only the USA and Mexico have higher levels. Recent figures show that 26% of adults in Scotland are obese and 65% are overweight. For children, the corresponding rates are 15% and 31%.

Worryingly, the prevalence of type 2 diabetes is increasing rapidly in Scotland, as well as across the UK, with the largest part of the increase likely to be due to poor diet and low levels of physical activity, resulting in increased levels of obesity. Our diet in Scotland was a response to a life spent in the heavy industries, but it is totally unsuitable for a career spent in front of a computer screen. Activity levels are far too low to burn off our daily calorie intake. To give children the best start in life, early-life interventions need to begin before and during pregnancy, continue through infancy into early years settings, such as nurseries and childminders, and carry on into primary school.

In my constituency of Inverclyde, we have had to take steps to address the growing problem. Many years ago, we started to educate children and parents about healthy eating. In primary schools, our classes are in competition to see who the healthiest eaters are and which are the most active classes in their school. Our schools have sports co-ordinators, who introduce and encourage kids to participate in a wide variety of sports. It is not only that—our schools link up with local sports clubs to encourage kids to continue to be active after school and at weekends.

As we heard from my right hon. Friend the Member for Leicester East, we continue to have vending machines in our schools, but in Inverclyde we have put healthy foods in them. Fizzy drinks are no longer available in our schools; the only thing that can be bought from vending machines is water. Granted, it is difficult to get companies to participate in that, but our schools have been encouraged to do it off their own bat, if need be. Fast food and mobile vans have been banned from within a one-mile radius of our schools, so that if a child—especially those in secondary schools—wishes to partake in fast food outlets, at least they have to walk a distance to get there and back.

The early years offer the best opportunity to put in place healthy behaviours around food and physical activity, which will hopefully be sustained into adulthood. Central to that is the involvement of families. Encouragement must start within families to adopt a healthy lifestyle and eat healthier foods. Today, 15 out of every 100 primary school children in Scotland aged between four and a half and five and a half are dangerously overweight. Diabetes is a serious condition that causes heart disease, stroke, amputations, kidney failure and blindness, and more deaths than breast and prostate cancer combined.

Almost a quarter of a million people in Scotland have diabetes. New statistics in the annual Scottish diabetes survey show that the number of people with the condition has continued to increase alarmingly by about 10,000 a year. The majority of those people will have type 2 diabetes, a form of the disease that can be caused by an unhealthy lifestyle and can be so easily prevented. Across all four nations in the UK, we have seen a huge rise in childhood obesity.

We know that losing weight is about more than just altering your diet, but people are different. There are burners and storers. Storers find it difficult to lose weight, but love food—and love the wrong food—and do not take to exercise too keenly. Those additional factors lead to their heading in the wrong direction with their weight, and that can subsequently lead to diabetes. Let us not assume, however, that all is well with the thin people whom we meet, because poor diet can cause problems. We clearly need an approach that combines diet, exercise, the education of children—and, crucially, the education of parents—and psychological support. We need to increase physical activity at primary school and carry that on into secondary school. We need to encourage leisure activities for children to get them involved in sports and away from their computers and TV screens.

[Ms Abbott]

Does my hon. Friend agree that, while all the things he said are important, it is also important that children take an intelligent interest in what they are eating? In that respect, Martha, the young woman in Scotland who photographed and blogged about her school lunch, is an example of a young person who is engaged in food quality.

[Mr McKenzie]

I absolutely agree with my hon. Friend and I will give her an example. During my time in local government, I took the opportunity of taking a few school meals with the kids. Was the message getting across? Yes, because they told the teacher that I had only two pieces of fruit and had not taken my five pieces of fruit. The message gets across if it is emphasised time and again.

As I said, we need to increase physical activity at primary school and carry that on into secondary school. The competition for young people’s leisure time has never been greater. Many prefer to play a sport on the Wii than try it for real. The issue is not only with the young, but with the elderly. A unique group called the Globetrotters has recently been set up in my area. It encourages the elderly to be more active and its members have, in their actions—their steps are counted and their trips are mapped out— walked to the moon and are on their way back. “Walking to the moon and back” is the group’s most ambitious trip to date. The Globetrotters is a fantastic example of what can be done from a perspective of physical exercise not needing to be that challenging.

The food industry, as we have heard, needs to take responsibility for the fizzy drinks and sweet foods targeted at children. Healthy eating patterns, as we know, are formed in childhood and taken into adulthood, and new research has warned that suffering obesity as a child may take a bigger toll on health in adulthood than was previously thought. If we do not put in place a varied approach to tackling obesity, a major and irreversible time bomb will be ticking away at our children’s and our nation’s health. Obesity will cost the NHS billions. Obesity-related illnesses already cost the NHS an estimated £5.1 billion a year. If we are to get to grips with it, we need to do a lot more together, starting right now, before the problem becomes worse and the NHS can no longer cope.

--- Later in debate ---

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to take part in the debate. I have several things in common with the right hon. Member for Leicester East (Keith Vaz), not least that we support the same football team. I have done so since 1969, and I hope we shall be in the premier league next year. The second thing is that we are type 2 diabetics, as a result of our lifestyle—from about the same time, as I became a diabetic some five years ago.

I acknowledge that I am a diabetic because of the lifestyle I had. Hon. Members may know the experience of being offered a well man check by the doctor, who always says there is good news and bad news; we say, “Tell me the bad news first.” The doctor five years ago told me, “The bad news is you are diabetic. The good news is you can manage it if you really want to.” That was the thrust of it. He said “You can ignore this, and shortly you will be on tablets, and then on injections.” He was not scaremongering, but just wanted me to know exactly what the condition meant. He said, “Your diabetes will not kill you, but what will kill you will be all the things that come from it: your blood pressure and heart, or amputations and stress levels.” I know fine rightly that I became a diabetic because of my lifestyle five years ago. The fact is I love Chinese food; five days a week I had a sweet and sour pork and two bottles of Coke. It never changed—I like it, and so that was what happened. As well as that there was all the stress of the job—previously I was an Assembly Member in Northern Ireland, and a councillor. I love long hours, and they do not bother me at all—and that probably applies to every other hon. Member; the hours were not an issue, but the stress is.

Clearly I had to make changes. Looking back into my ancestry, no one—not my mother, father or grandparents—had diabetes. I was the first in my family, so the cause was clearly my lifestyle. I make that point because of the question of heredity and the hope that I would not pass on my difficulties to my children or my wee granddaughter, four-year-old Katie-Lee. The question is how to instil in children and grandchildren the necessary control, so that they eat the right food, in the right way. I was on diet control in January, and am now on two Metformin tablets in the morning, and two at night; there is nothing graceful about growing old. We may need tablets to keep us going, and probably most of us in the Chamber are of that ilk. The question for me is what I can do as a grandfather, and as an MP, to protect my granddaughter and children, and everyone else, from becoming diabetic.

The UK has the fifth highest rate in the world for type 1 diabetes in children. That can lead to serious health problems such as blindness and strokes, to name but two. Some 24.5 children in every 100,000 aged 14 and under are diagnosed with the condition every year in the UK. Statistics are real to those of us who are focused on the disease and how to deal with it. The UK’s rate is about twice as high as the rate in Spain, which is 13 in every 100,000, and in France, which is 12.2 in every 100,000. The league table covers only 88 countries where the rate of incidence of type 1 diabetes is recorded. There are around 1,038 children under the age of 17 living with type 1 diabetes in Northern Ireland, and almost one in four of those reached diabetic ketoacidosis before a diagnosis was made. DKA can develop quickly and occurs when a lack of insulin upsets the body’s normal chemical balance and causes it to produce poisonous chemicals known as ketones. If undetected, those ketones can result in serious illness, coma and death. We all know people who have come through that, and I am aware of people who have succumbed to diabetes.

The number of people living with types 1 and 2 diabetes has increased by 33% in Northern Ireland during the last five years; that is the largest increase in the United Kingdom, compared with 25% in England, 20% in Wales and 18% in Scotland. The total number of adults with diabetes—those aged 17 and over—registered with GPs in our small part of the UK is just shy of 76,000, and 1,038 young people under 17 are known to have type 1 diabetes, which is another significant rise. Prevalence in the Northern Ireland population is now more than 4%. Some 10,000 people have diabetes without having been diagnosed with the condition. It is scary stuff, when we realise what is happening in our region. I had occasion to speak about that with the right hon. Member for Leicester East before the debate.

Through my colleague, the Northern Ireland Health Minister, I encouraged the purchase of insulin pumps for type 1 diabetics, which was done last year; we have also encouraged the provision of training for family members, guardians and health staff in the use of the pumps. When a Minister is committed to the issue, things can happen.

I have every confidence in the Minister who is present for the debate. In my short time here I have witnessed her contribution in her role, and her commitment to change and to taking hard decisions. I do not agree with everything that she does, but I admire her commitment to the job, and many things that she has done have not gone unnoticed.

Approximately 90% of the 3.7 million people in the UK diagnosed with diabetes have type 2. I have brought that issue to the attention of the Northern Ireland Health Minister, as I am very aware of the ticking time bomb that diabetes is, and the key initiatives in operation in Northern Ireland. He is clearly doing a great job, including setting aside funding to employ additional diabetes staff—specialists, nurses, dieticians and podiatrists: all help that a diabetic needs, but perhaps not enough. All the hon. Members who have spoken have done so with honesty; if we put all the ideas together in a big pot, perhaps we will find a way forward. We need to instil good eating habits in children that will not lead to diabetes later in life.

Rates of obesity—because that is the twin thrust of the debate—tend to rise with increasing disadvantage across developed countries, particularly among women. In 2006 in Northern Ireland, 18% of children aged between two and 15 years were reported to be obese. In 2008-09, the child health system reported that 5.3% of primary 1 children surveyed were obese. The hon. Member for Southport (John Pugh) said that when we were young, many years ago, for someone to be of a certain size was unusual. It is not any more. In the survey I mentioned, 22.5% of the children were described as overweight or obese. That is a massive number.

We need to educate parents on what they are teaching their children through their lunches and dinners. Some schools in my area implemented a healthy snack policy, where twice a week children were not allowed to bring in crisps or chocolate, but had to bring in fruit or a healthy option. That is fantastic, and it is good that it happens, but some parents pointed out how much more expensive it was. We should consider how to make healthy food more affordable for young families in the present economic difficulties.

[Mr McKenzie]

On that issue, is the hon. Gentleman concerned, as I am, about supermarkets that employ the tactic of making their fruit ripen as early as possible, so that families have to make several trips to purchase healthy options for their child’s lunch box?

[Jim Shannon]

Many parents have made me aware of that. There is a key role for supermarkets and how they do things. When we go to the supermarket—let us be honest—we can always find a multipack of crisps or chocolate. By the way, there is nothing wrong with that as long as it is done, like anything in this world, in moderation. Children love a treat, and why should they not have one if it does them no harm?

Unfortunately, it is more difficult to find a multipack of fruit juice, or bags of fruit on offer or sliced up. It is much handier for parents to pick up a bag of crisps for their child’s break than to take the time to cut up fruit when they cannot afford to buy the pre-cut fruit that they want. I believe that we need to change that by encouraging supermarkets to put regular offers on healthy options, and perhaps by looking at tax incentives to make such options a realistic lifestyle choice, and not just a fad to go for for a wee while.

One of the community groups in my area, the East End residents association, has put on a cooking class for its ladies group, which showed them how to cook healthily for the family in a quick and cheap way. Women of all ages learned how they could cook on a budget, but still provide a healthy and satisfying meal. That is also key, and I suggest that funding might be set aside for community groups and churches to put on such classes, which could make real lifestyle changes to entire households.

Unfortunately, at the moment there are few homes that can afford to have only one parent in work, with the mother at home cooking and cleaning—that now has to be fitted around another job—but we must educate people and teach them that short cuts can be made so that healthy meals and snacks for families are still provided. Will the Minister kindly address that and explain what can be done to educate and help those who simply do not know how to do the best for their families? A surprising number of families cannot do so, so we should try to achieve that if we can.

In conclusion, it is clear that something needs to be done. If there is one message from every speaker, it is that we all agree that something needs to be done; the question is how best to deliver that. Many children and adults will not be able to live a healthy life because of something that they could have made small changes to prevent. I congratulate the right hon. Member for Leicester East on bringing this matter to the Chamber. Many more hon. Members would like to make a contribution, but I can say one thing—every one of us, as elected representatives, has constituents for whom this issue is key. We look forward to hearing the response from the Minister, as well as the speech from the shadow Minister, the hon. Member for Hackney North and Stoke Newington (Ms Abbott).