Want to stop the obesity epidemic? Let’s get moving

OBESE NATION: It’s time to admit it – Australia is becoming an obese nation. This series looks at how this has happened and, more importantly, what we can do to stop the obesity epidemic.

Here, Jo Salmon looks at the role physical activity and exercise play in healthy lifestyles, while Billie Giles-Corti and Carolyn Whitzman discuss ways to change our obesogenic environment through urban design.

Moving throughout the day should be as natural as breathing and as habitual as brushing your teeth. As well as the obvious health gains, there are social, economic and environmental benefits from having a physically active society.

Inactivity is a leading contributor to the burden of disease and plays a major role in Australia’s obesity epidemic. The infographic below shows just how quickly obesity is increasing in Australia and how the trajectory will continue unless we change our ways.

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How much activity is enough?

Current public health guidelines recommend adults undertake at least 30 minutes of at least moderate-intensity physical activity five days per week. This need not be structured exercise; three ten-minute brisk walks a day (to the bus stop or to buy lunch) is sufficient.

Recommendations for children vary depending on their age. Kids under five should accumulate at least three hours of physical activity every day – this includes any level of movement, from light-intensity play through to vigorous activity. Five- to 18-year-olds should aim for at least 60 minutes of moderate- to vigorous-intensity activity per day.

Limits to television viewing, computer use and video games are also recommended for young people: zero screen time under two years; a maximum of one hour per day for two- to five-year-olds; and no more than two hours per day from five- to 18-year-olds.

Who’s responsible for our activity levels?

The Commonwealth Department of Health is in the process of reviewing and updating its physical activity recommendations across the lifespan. But government initiatives and policies that promote physical activity and movement are the responsibility of more than just the health department.

Few people consider the role of state justice departments, for instance, in ensuring we have a safe environment to walk the streets free from concerns about our personal safety or that of our children. Or the role of bodies such as Parks Victoria, which are responsible for maintaining, improving and identifying new locations for accessible parks and public open spaces.

Urban planners, property developers, architects, engineers, teachers, local government agencies, as well as the transport, sport and recreation, and health sectors all have important roles to play in a coordinated approach.

If you want your kids to get more exercise, play and be physically active with them. Mike Baird

How can we get Australians moving?

It’s never too early to begin promoting movement and physical activity, particularly if it’s intended to prevent unhealthy weight gain.

The Melbourne InFANT Program at Deakin University has identified that first-time parents with three- to 18-month-old children are particularly receptive to information about their child’s healthy eating and physical activity behaviours. They’re also interested to learn about the risks associated with extensive television viewing time from a young age. This type of program could be offered to all first-time parents through their child and maternal health centres.

Programs in preschools such as the NSW Tooty Fruity Vegie initiative promotes the consumption of fruit and vegetables and teaches young children basic movement skills such as throwing, catching, jumping, skipping and kicking. This program has had a significant impact on the participants’ skill mastery, even several years later.

It’s disturbing that the single largest decline in physical activity during childhood occurs when a child starts primary school. Children sit, on average, around 5.7 hours out of a 6.5 hour school day. There’s no doubt the curriculum is crowded, but it is possible to meet these educational demands in active ways, such as playing hopscotch maths, delivering standing lessons, or giving active homework. Some of these curriculum-based strategies are currently being tested by a team from Deakin University.

Active transport to school initiatives (such as the Walking School Bus) have received support from state and local governments but funding is rarely sustained. There may be a role for the transport sector and urban planners in promoting active commuting or public transport to and from school by identifying safe routes, further subsidising fares or even introducing free travel for children on their school route.

One policy initiative for schools to consider is early dismissal of children who are walking or cycling home from school. This should be a strong incentive for children to use active transport and would reduce the injury risk from the car pick up rush after school hours.

What about the role of families and parents in supporting children’s physical activity?

There are surprisingly few published studies worldwide that have examined the most effective approaches for promoting a child’s physical activity in the home. Family-based initiatives are challenging: the home is a private space and as health researchers, is it our business to be telling adults how to parent their child?

We do know, however, that some parents value and seek advice about their child’s weight or activity levels. So encouraging parents to play and be active with their children, along with limiting screen time, is generally a sensible way to promote physical activity.

The sport and recreation sector can play a more substantial role in promoting family-based activities, not just through children’s participation in organised sports but through engagement in active play; linking in with programs run by the Heart Foundation (Jump Rope for Heart) or by working with Parks Victoria in running free activity programs in our extensive public open spaces.

This is just a brief snapshot of some programs and policies that could be offered to encourage and support more active lifestyles for children. I haven’t touched on the potential role of the primary health care sector in encouraging activity among adults, or on the duty of care of employers to ensure that their staff are not sitting for hours every day at a work desk.

Hopefully in future we’ll see more sectors and organisations help to make active lives the easy choice. It’s important that government and non-government physical activity policies and initiatives support all members of the population to be active – from early childhood to older adulthood.

This is part thirteen of our series Obese Nation. To read the other instalments, follow the links below:

Part one: Mapping Australia’s collective weight gain

Part two: Explainer: overweight, obese, BMI – what does it all mean?

Part three: Explainer: how does excess weight cause disease?

Part four: Recipe for disaster: creating a food supply to suit the appetite

Part five: What’s economic growth got to do with expanding waistlines?

Part six: Preventing weight gain: the dilemma of effective regulation

Part seven: Filling the regulatory gap in chronic disease prevention

Part eight: Why a fat tax is not enough to tackle the obesity problem

Part nine: Education, wealth and the place you live can affect your weight

Part ten: Innovative strategies needed to address Indigenous obesity

Part eleven: Two books, one big issue: Why Calories Count and Weighing In