I have long been a strong and vocal advocate for the urgent need to tackle the growing obesity epidemic – especially childhood obesity.
A recent report compiled by the World Health Organisation predicted Ireland was on course to be the fattest nation in Europe by 2030.
As the situation stands, 61% of Irish adults and 1 in 4 primary school children are overweight or obese.
It is in this context thus, that I welcome the introduction of the Obesity Policy and Action Plan. I am delighted measures such as calorie posting on restaurant menus, food labelling and the introduction of healthy options in school vending machines have already commenced.
However, the fact remains that once obesity has developed, treatment can often be unsuccessful. As such, I believe early prevention efforts are urgently required.
Undoubtedly, the seeds of the current obesity crisis facing our adult population were planted in childhood or even earlier.
To date, the World Health Organization, Obesity
Canada, the U.S. Institute of Medicine and the U.K. government have all acknowledged maternal obesity and pregnancy as primary targets for prevention of downstream childhood obesity.
A recent study conducted by ‘The Best Start Resource Centre’ in Canada has identified maternal obesity as a strong risk factor for impaired downstream physiological health in offspring.
According to the report – the odds of offspring being overweight at age 7 years have been shown to increase by 3% for every 1 kg over the recommended weight gain guidelines of the expectant mother.
These children are at increased risk of metabolic disorders later in life with increased offspring size being a key indicator in this relationship.
The study went on to reveal that for the expectant women themselves – there is compelling evidence that those who are obese during their childbearing years, are at high risk of developing type 2 diabetes, hypertension, respiratory issues, cardiovascular disease and depression.
Moreover, the risk of any form of obstetrical complication is three times more likely in mothers who are obese as compared to mothers who are not obese. As BMI goes up, so does the risk of negative prenatal outcomes for the mother and/or the baby.
The most notable complications obesity can cause in early pregnancy include increased risk of spontaneous abortion and recurrent miscarriages.
Here in Ireland, a research paper entitled: “Trends in maternal obesity 2009–2013” revealed that:
• 1 in 6 women presenting for antenatal care is obese
• 1 in 50 are morbidly obese
• The number of severe obesity cases increased by 48.5% over the time period
These statistics were taken from a study of over 40,000 women through the Coombe from 2009-2013
So what can be done to tackle this worrying trend?
Obesity is considered a modifiable risk factor. During pregnancy, women are far more motivated to adopt healthy behaviours believing their child may benefit, as evidenced by reduced alcohol consumption and smoking.
Past efforts to advise women on healthy weights for pregnancy have focused less on maternal obesity and more on the concerns about low birth weight delivery outcomes.
The following measures, I believe, could be implemented to curb the growing trend of maternal obesity in Ireland – they include:
• Educating women of child-bearing age through the media and health care providers about the impact of their health and weight on their own well-being and on the health and well-being of their children.
• Adopting a standardised prenatal education curriculum and ensure courses are accessible and affordable for all women.
The prenatal period is a crucial time of growth, development and physiological change in mother and child. It provides a window of opportunity for intervention via maternal nutrition and physical activity that can benefit the mother and baby.
Finally, I would like to touch on the subject of breast feeding and obesity reduction.
The health benefits of breastfeeding are widely acknowledged. Breastfeeding has long been recommended for the health of the mother and the baby.
A systematic review in Canada indicated that women who are overweight or obese are less likely to initiate breastfeeding or tend to breastfeed for a shorter period of time.
There are a number of potential factors including biological, psychological, behavioural and cultural.
Exclusive breastfeeding for six months has been shown to reduce maternal gastrointestinal infection, helping the mother lose weight.
The report by The Best Start Resource Centre in Canada, revealed that children who were breastfed — however briefly — were 15 per cent less likely to become overweight in childhood compared to those children who were never breastfed.
Encouragement to breastfeed could be more vigorously promoted through prenatal classes, written materials, prenatal appointments etc.
In conclusion, a healthy, active pregnancy may well contribute to minimizing the intergenerational cycle of obesity. As such, we must now ensure the measures we adopt to tackle obesity reflect this.