Childhood Obesity

Lyn Brown Excerpts

Tuesday 3rd May 2011 Westminster Hall

[Mary Macleod (Brentford and Isleworth) (Con)]

Thank you, Mr Gale, for the opportunity to introduce this debate on childhood obesity, which is, unfortunately, an issue that I understand far too well. Childhood obesity is a significant issue in my constituency of Brentford and Isleworth, which is part of the Hounslow borough—13.9% of children in reception are at risk of being obese, with the figure rising to 24.6% by year 6, or age 10—so I have a personal interest in finding out as much as I can about the issue and what we can do to address it.

I believe that there are two strong reasons why childhood obesity requires Government focus. First, the issue concerns children, who may not, therefore, be directly responsible for the situation in which they find themselves. We must, therefore, do all that we can to support and help them. Secondly, the potential long-term implications on the health of these children is serious, as is the cost to the state of their medical care, so it is our duty to do all that we can to address the issue.

This debate is timely, because there have been several recent developments on the issue. When I switched on the news this morning, there was a story about overweight people in middle age having a greater chance of dementia. On the children’s side, the Greater London authority has commissioned a report on childhood obesity in London, which looks in detail at the causes of childhood obesity and the effectiveness of intervention programmes. The London assembly has published a report on childhood obesity in London, “Tipping the scales”, which considers the role that the Mayor of London could play and puts the cost of treating childhood obesity in the capital at £7.1 million per annum. The current generation of obese children will cost the London economy £110.8 million a year if they grow up to be overweight adults. The Government recently launched their responsibility deal as part of the strategy for public health in England. They are also working on the paper on obesity, which will be published later this year. It would be good to hear from the Minister about any progress on that.

In today’s debate, I want to review the scale of the issue, talk about some of the possible causes of childhood obesity and look to the future to discuss what actions we can take. First, how significant is childhood obesity in the UK? The headline figures on childhood obesity in this country are alarming—29.8% of children aged two to 15 are either overweight or obese, which is almost one in three children. On current trends, two thirds of children will be overweight or obese by 2050. Breaking down the figures on childhood obesity throughout the UK shows that there is a particular problem in urban areas, especially London. Data for 2009-10 show that in London 11.6% of children aged four to five, and 21.8% of children aged 10 to 11, are at risk of being obese. I have already mentioned the figures for my area in London.

The figures are a significant worry for the future health of our nation as a whole, because evidence suggests that overweight adolescents have a 70% chance of becoming overweight or obese adults. Obesity is a disease with, potentially, very serious health implications, including, in the short term, breathlessness, feeling tired, and back and joint pains, and, in the longer term, hypertension, cardiovascular disease—mainly heart disease and stroke—type 2 diabetes, musculoskeletal disorders, especially osteoarthritis, and some cancers, including breast cancer and colon cancer. There are also psychological issues of low self-esteem, lack of confidence, depression and feeling isolated, which restrict a person’s potential ability to earn. Obesity is also associated with a higher chance of premature death and disability in adulthood. The long-term costs for the UK of this level of childhood obesity are vast. The 2007 Foresight report on obesity predicted that the NHS costs associated with overweight people and obesity will double to £10 billion per year by 2050, and that the wider costs to society and business will reach £50 billion per year by 2050.

Secondly, why is there an issue? Before we can decide how best to tackle childhood obesity, we need to understand more about what causes it. As one doctor once put to me, at its most basic level the formula behind obesity is simple—we put on weight when we take in more calories than we burn off through day-to-day living and physical exercise. However, we need to dig deeper than that to find out what is causing the problem, because, clearly, a number of factors are at play.

We are talking about children, so perhaps the biggest single factor is parental influence. Weight Concern reports that children with two overweight parents are 70% more likely to be overweight themselves. GPs to whom I have spoken in my area are often the first point of contact for parents on the issue, and they feel that, often, parents do not accept that their children are overweight. Given that perhaps more than a quarter of other children in the class are also overweight, they may feel that their child is normal. They may also feel that the suggestion that their child is overweight is a direct criticism of their parenting skills, and they are reluctant to accept that.

I am not a parent myself, but I have discussed this issue with friends and constituents who are. There is no doubt in my mind that there is a lack of knowledge and information that is easy to understand. Often, parents simply do not realise the number of calories that they are feeding to their children. For example, I am pretty sure that no parent would allow their child to sit and eat five spoonfuls of sugar, but some think nothing of giving them fizzy drinks containing the same quantity. Ask a parent how many calories there are in a bowl of chocolate-flavoured cereal and what percentage of a child’s recommended intake of sugar that represents, and I would wager that most would probably not know the answer.

When I speak to parents about the issue, a common story emerges. Many start off with the best of intentions, breastfeeding their babies for weeks or months under the regular guidance of health visitors. Perhaps they then move on to religiously preparing pureed vegetables and home-cooked meals that they bag up and put in the freezer for their babies and toddlers. Gradually, however, as the years progress and as the influence of peers, TV and the media grows, as well as that of, critically, the children themselves, who become more demanding and fussy about what they eat, it is too easy to slip into bad habits from which it is very difficult to get them back.

I am not saying all this to give parents a hard time—far from it. What I am saying is that those who feed our children and organise their activities—typically parents and schools for the most part—are so critical to this issue and need to be supported in any way we can. Jamie Oliver and many others in the school environment have worked hard to make progress in improving the quality of the meals that are provided to children when they are at school, and they should be commended for that work.

As I mentioned earlier, there are many factors at play, and I want to touch on another key one. Deprivation has been shown to play a significant part in levels of obesity, with children from the poorest backgrounds being much more likely to be obese. When families are struggling financially, they are more likely to be attracted to cheap, high fat, energy dense and poor foods, many of which are marketed with “buy one, get one free” deals.

The 2007 Foresight report on obesity highlighted the full range of factors that it believed were behind the trend towards obesity and made the point that there are lots to consider. However, to summarise the causes, the issue is about parents who have been overweight themselves, those who live in an urban area and those who come from a lower-income household.

Thirdly, what can be done in the future? Given that so many different factors influence childhood obesity, this is clearly not just a health issue, although I am pleased that a Health Minister is responding to the debate. The issue is also affected by planning, housing, transport, education, business and other things. Therefore, although the model we are aiming for is spearheaded by the Department of Health, it must be integrated across all areas. The Government have already taken important steps. Public health funding has been ring-fenced to ensure that sufficient focus is given to the matter and, in March, the responsibility deal was launched.

In the White Paper, “Healthy lives, healthy people: our strategy for public health in England,” the Government stressed that localism is key. A partnership approach will be encouraged between the Government, local authorities, health representatives, education, business and the voluntary sector. In addition to putting in place the right environment for change with that partnership approach and by integrating policies across Departments, we need to tackle the problem head-on by making nationally recognised programmes available to address childhood obesity.

I am a fellow of MEND, which is a social enterprise that has evolved from a 20-year partnership between Great Ormond Street hospital and the University College London institute of child health. MEND is the child-weight management partner of more than 100 primary care trusts and 15 local authorities in England. MEND stands for Mind, Exercise, Nutrition, Do it, which sums up the approach that it takes to covering each of those important elements. At a recent parliamentary event for MEND, I met a young boy called Charlie and his mother, who had been through the MEND programme. Over 10 weeks, the whole family learned about portion sizes and how to read and understand food labels. They set goals as a family and took part in fun physical activities. Charlie told me that taking part in the MEND programme has not only helped him to lose weight, but given him new confidence. He now enjoys taking part in many school activities. The changes put in place have made a real difference to the whole family, including to Charlie’s sister. He now looks forward to going out shopping with her and her friends to buy new clothes, when previously he absolutely dreaded doing so.

Like many other programmes across the country, MEND builds in a number of best practices to ensure success. The programme is about working with the whole family to ensure that changes are made to the weekly shop and family activities. It focuses on nutrition and physical activity, and it aims to start young. One school in my constituency, Hounslow Manor, works with children from reception to achieve the greatest possible long-term impact. The programme also aims to deliver in a community-based way to reduce the stigma around the programme and build the real support networks that can make a difference.

In the GLA intelligence unit report published this month, MEND was evaluated as a cost-effective approach to obesity intervention. Other cost-effective programmes in the UK include the local exercise action pilots, which focus on increasing physical activity. Other such programmes include one to reduce television viewing in the US and the regulation of television advertising of high-fat, high-sugar products at certain times, which was introduced in Australia. I would like research to be directed at how we can extend the online elements of programmes that are provided to children. Children enjoy learning in an online, gaming-style environment, and it would be good to see how that could be used in obesity programmes to build up such an approach.

[Lyn Brown (West Ham) (Lab)]

I am thoroughly enjoying the hon. Lady’s contribution. I have stayed here from the previous debate just to listen to what she has to say and because I have a personal interest in the issue. Does she agree that getting children involved in cooking enables a child to explore foods that they might otherwise not try? That enables a family to experience better, more wholesome home-cooked food, rather than the processed rubbish that is thrust at them from television screens every day.

[Mary Macleod]

I thank the hon. Lady for her contribution and absolutely agree with her. The issue is about the whole family, including children, understanding what goes into food. If they understand more about that and participate and get involved in it, they will have a better understanding and knowledge of what it is all about.

How should we start to deal with the issue? I want to consider a couple of things that are happening and that might have an impact. The first is the move from a primary care trust-based model to GP commissioning consortia, and the other is the upcoming London Olympics. As we move towards GP commissioning, we need to consider the impact on the obesity service provision. Currently, providers such as MEND have suggested that decision makers in the new model will require clear information and guidance in the commissioning process for weight management programmes. They have also suggested that the commissioning process itself could be simplified and redesigned to ensure that it focuses on clear and consistent information and measured outcomes. The commissioning model will help in pulling together best practice. That is certainly the case in the Great West commissioning consortium, of which Hounslow is a part. It is already starting to focus on some of the public health issues that need to be addressed.

The 2012 London Olympics and Paralympics will soon be taking place. Those events provide us with a fantastic opportunity not only in London, but elsewhere around the country to build on the legacy that will be left. What better Olympic legacy could we have than a whole generation of children who appreciate the benefits and enjoyment that come from regular participation in sport? The Mayor of London is working hard to encourage schools in London to participate in his Get Set programme, which involves school children taking part in a host of sporting and cultural activities related to the games. A majority of my schools have signed up to that. We need to make sure that other such programmes are happening across the country and that the influence of the Olympics lasts well beyond the event itself.

As part of the obesity paper, the Government will also no doubt want to consider the approach they should take on the use of legislation in the food and drinks industry. In its recent report, “Stepping up to the plate—industry in action on public health”, the Food and Drink Federation offers its view on the progress the industry is making, particularly in the areas of reducing salt, fat and energy in popular products and in improving food labelling and marketing. There is more that the food and drink industry can do in that area—for example, having clearer labelling, so that people know exactly what they are eating.

In conclusion, nearly one in three children in the UK is overweight or obese, and much more can be done to give them a better quality of life. We need to protect the long-term health of children and avoid unnecessary short and long-term financial burdens on the NHS. There needs to be a broad integrated and co-ordinated approach across Departments. We need to raise awareness about planning permission for fast food outlets very near schools and to ensure that we share best practice and measure outcomes from all the obesity intervention programmes. We want to use the London 2012 Olympics as a starting block to encourage more young people into sport and to engage in physical activity as much as possible. We need to integrate ideas, such as encouraging schools to grow food, into the curriculum and to support and encourage parents to restrict television and do more things outdoors. We also need to encourage eateries to sell healthy options and have better labelling, so that people know what they are eating. In addition, we need to encourage more exercise. I have signed up for the Race for Life that will take place this month in Battersea, so I will be running my 5 km for charity as well as for my health.

I came into politics to help to make a difference to my constituency and the country as a whole. I feel very strongly that by improving health outcomes on childhood obesity we can definitely make a real difference to many people.

[Justin Tomlinson (North Swindon) (Con)]

I pay tribute to my hon. Friend the Member for Brentford and Isleworth (Mary Macleod) for her excellent speech. I would also like to echo the comments my hon. Friend made with regard to the MEND programme. I met a child from my constituency who had taken part in the programme and it had made a real difference. As Members of Parliament, we should be extremely supportive of the MEND programme.

I am interested in this debate for a variety of reasons. I am the vice-chair of the all-party parliamentary group on heart disease. Heart disease runs in my family and I have always had an eye on trying to be as active and as healthy as can be reasonably expected. I am also a vice-chair of the all-party parliamentary leisure group. I am a big, unashamed sports enthusiast, because sport can play an extremely important and positive role in encouraging an active and healthy lifestyle. My hon. Friend set out the picture, but I just want to concentrate on three areas that have a significant impact on child obesity levels: planning issues, food and organised sport.

On planning issues, prior to becoming the MP for North Swindon I was a councillor for 10 years. I represented a new build housing estate that had many good things and many poor things. One of the biggest challenges was the huge differences that hampered a child’s ability to run around: back gardens are now a third of the size they were in the 1960s; front gardens all too often simply do not exist, with cars literally driving right in front of the front door, and we then wonder why children do not have the opportunity to run around; and there is a lack of accessible, useable open space. I was for ever being told that the ward I represented had a huge amount of open space, but I could not see that. All I could see was concrete, and I wondered what was going on. I did a little bit of digging and it transpired that open spaces included hedges and heritage sites, neither of which are suitable for jumpers for goalposts. We do not need premier league-standard open spaces for kids to run around. When I was growing up, the bit of open space in the middle of my estate was almost vertical. That was handy, however, as some of my friends were more technically gifted than me and some of my other friends, so we had the advantage of kicking downhill all day long.

I was the lead member for leisure on Swindon borough council for four years and a lot of the focus in tackling child obesity was on organised sport through leisure centres. The most significant opportunity for children to be active, however, is through open spaces where they are unsupervised, can put down jumpers for goalposts and follow the latest TV trends. If Wimbledon is on TV, out come the tennis rackets; with the Tour de France, out come the bikes; with the Ashes, out come the cricket bats; and football, in my case, was played for the majority of the year. I welcome the fact that in my constituency the council invested £6 million, working in conjunction with the national lottery fund, in the Lydiard park facility, and that we have fantastic parks such as Coate Water and Mouldon Hill right on the doorstep. On a sunny day, and we have been blessed in the past month or so, one can see thousands of families coming out and kids being able to run around.

Another interesting observation was that on Friday, following the fantastic royal wedding, I went to visit a number of royal wedding parties where communities had reclaimed the streets as open spaces. While parents sat around toasting the happy occasion, the children ran around and were extremely active, and I was touched by that. That shows the importance of having those open, accessible community spaces.

I echo the comments my hon. Friend made about food labelling. It is essential that parents, and children themselves, can make informed decisions. I am not one of those food zealots who says that we should never eat junk food, or unhealthy food. It is all part of a balance. I charged around as a youngster and was then sometimes fuelled by food that was deemed to be not particularly healthy, but it is about striking a balance. We need to see clear, uniform food labelling. I am a big supporter of the traffic light system. We have it here in our parliamentary restaurants and that makes a difference to my choice of food. On this occasion, the EU is dragging its feet. I encourage the Government to continue to put pressure on to ensure that all retailers use a uniform and clear system. I know that they are doing so. I welcome the Government’s public health responsibility deal, which has seen retailers such as McDonald’s, Pizza Hut and KFC committed to reducing trans fats. That is the big secret killer and we need to do so much to remove trans fats, reduce salt and display calories—all coming together as part of the informed decisions.

Hon. Members have already talked about cookery skills. I am a big advocate of basic cookery skills. I would go as far as to say that it should be a compulsory element of the national curriculum. I am a big supporter of the Let’s Get Cooking campaign, which is in its fourth year of a five-year £20 million programme funded by the national lottery. It encourages schools to take up cookery. I visited Haydonleigh primary school, in my constituency, a few weeks ago. Not only were the children taking part in a cookery session, the parents and grandparents were also coming in and getting involved so that, when they went home, it was not just a one-off, two-hour cookery session, but something that would become part of their home life. Echoing the point about allotments that was raised earlier, the school had its own allotment, and was using the fruit and vegetables that were grown in the school. Wherever possible, schools should be allowed to do that full cycle. Basic cookery skills are essential for later life. It was not so long ago that I left university, where the idea of cookery for the vast majority of my colleagues involved the ping of the microwave and a three-minute wait. We certainly need to do something about that.

Finally, and probably what I am most passionate about, is organised sport. Not so many months ago, we had a debate on the school sport partnership and I was openly critical of the proposed changes. I am delighted that the Government changed their position, because where school sport partnerships work well, they can help maximise sporting opportunities. One frustration with the debate at the time was that, despite approximately £170 million a year being invested in SSP, we had not seen a massive increase in competitive sport activity. The reason for that is that children are sports-gifted, generally, because their parents have encouraged them at a young age and, by and large, whether a school is offering that sport or not, they will have joined a sports club and carried on. The SSP, however, was about the other children—those children who would otherwise just sit in front of the TV, not taking part. The advantage of the SSP was that it offered a menu of different sporting activities and there was always something for everybody to capture their imagination. I have spent many happy times touring schools and sporting groups to see what different sport captures them. A lot of people will no doubt bash television today, but television often inspires children, whether through traditional sport or through programmes such as “Pineapple Dance Studios”—suddenly, there will be huge swathes of children dancing around in a dance hall. Yes, it is not a competitive sport as such, but it is extremely active.

The SSP in my constituency saw the number of schools taking part in two hours a week rise from 33 to 68 —a fantastic result. The changes have allowed the SSPs nine months to secure continued funding from schools. Where there are good SSPs, they will be successful. Where some of the SSPs were not so good, those schools are now free to commission their own sports coaches. That is essential because there are a limited number of teachers with confidence, particularly in primary schools, to offer that wide range. A number of teachers said to me that they needed help. Another welcome Government measure that would indirectly improve the situation is fast-tracking the troops to teachers programme, because often troops are up for outdoor active lifestyles. They will be able to come in and get the kids engaged in something that is healthy and active.

I am also a fan of working with local sports groups. If children are given a taster session, they make sure that they then have an opportunity to continue. In my constituency, we set up a successful sports forum with the active involvement of about 60 different sports groups. They share best practice and help secure extra funding, but they also link in with programmes such as the SSP, going directly to the schools and saying, “Why don’t you try this and we can then get you involved?”

[Lyn Brown]

I have enjoyed the hon. Gentleman’s contribution very much. I was involved in the culture sector when I was in local government, and in the Local Government Association, and I recognise many of his arguments. Does he agree with me that the biggest problem we have, following on from our schools sports intervention, is that when children leave school there is no exit strategy for young people to enable them to continue in the sports that they played? I played badminton for my school up until the age of 16. By the age of 16 I stopped and there was no local club, or link with my school and a local club, for me to continue my activity. That is where we fall down.

[Justin Tomlinson]

I thank the hon. Lady for that useful contribution. She is right. A lot of what we are doing is putting in the building blocks for a long-term future to tackle health issues. Organisations, such as the sports forum, can talk to people of all ages and ask people to engage. Local authorities and sports groups have a role in that. One of the best things that I saw was Swindon borough council’s Challenge Swindon campaign, which brought together offices, pubs and sports groups and got them all involved in different sports. It aimed to get people to try something and then continue to do it.

We face a number of other challenges. The lack of volunteers is always a challenge, particularly in sport. A huge number of sports groups would like to be able to do something, but there are not sufficient parents with the time to be able to do that—a particular problem for organised sport.

Private finance initiative schools are another challenge: when I was a councillor, the majority of schools in my area were PFI schools. We had a high-density development and a wonderful piece of open space, but a fence and a set of high hire charges blocked children from utilising what was their school until 4 o’clock in the afternoon. Sports clubs came to me on a number of occasions saying that they simply could not afford to use the facilities, which could not be opened because there was not enough flexibility. It was a crying shame that they were left unused.

An issue that I have brought into other debates is the cost of insurance for transporting children. As we push things such as the school Olympics or outdoor active learning, insuring a teacher to take a minibus can cost more than £1,000. I have urged the Government to create a national insurance scheme for teachers and sports clubs using minibuses.

We must not forget the Olympics and the Olympics legacy, about which we had a debate in the main Chamber last week. It is all about the legacy. We will have an enjoyable Olympics, when we are bound to win some medals, but the key will be the lasting legacy. That is why I was so supportive of the principle of school sport partnerships. A big advert for a whole variety of sports that different children will have never thought of trying will be on the television, and the ones we do particularly well in will inspire children to go and re-create them. We must ensure that we do all that we can. Going back to the point about insurance, if we want the school Olympics to work, we need to be able to get children from one school to another in order to compete.

My slightly more radical proposal is to do with how leisure and youth services work in local authorities. In the old days, leisure was very much about competitive sport, with the traditional youth service organising youth activities. The two would never meet in the middle. Times have now changed massively.

I remember that on a Friday night the leisure centre would put on an ice-skating disco for the teenagers—again, not technically a sport, but 600 teenagers building up a head of steam and racing around chasing after the person they thought particularly attractive was a sporting activity. It was absolutely fantastic. Under my radical proposal, the youth service with its mobile buses would have been better off pitching up at that facility, to offer advice, advocacy and support to those who wanted it, and letting leisure be the attraction to bring people in. Likewise with the point made about the Pineapple dance studios and the street dance, often the biggest challenge is to get young girls active, but hundreds of children want to do dance and cheerleading.

Youth and leisure services should sit around the same table, pooling their funds and facilities—the leisure centres often have the better facilities—and working together. They would then be on hand. My hon. Friend mentioned the Get Set programme, and I have written to all the schools in my constituency, encouraging them to do as much as they can.

In conclusion, we need to learn three lessons. First, it is important to have balance in an active and healthy lifestyle. We can sometimes be a bit too zealous in saying, “You should not watch TV. You should not play computer games.” When I was growing up, as soon as the sun was shining, I was charging around outside. I would not have dreamed of watching TV or playing computer games. However, in the evening, that is what I did. That is a fine balance to have.

Secondly, we should allow people to make informed decisions through clear labelling and to do things for themselves. To do that, they need the skills, which is why I am such a fan of the cookery lessons.

Finally, everything should be fun. Children like fun things. Give them the open spaces—as I said, it does not matter if the open spaces are vertical, because children are creative and will come up with their own way of dealing with such things. However, let us at least give them the opportunity to have a better lifestyle.

Several hon. Members rose—