Childhood Obesity and the Role of the Government of Canada

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Background

Over the last 25 years, we have witnessed an alarming rise in the proportion of overweight and obese children. Obesity rates among children and youth have nearly tripled during this period and indications are that the rates of overweight and obesity among First Nations children are 2-3 times higher than the Canadian average. It is an issue that affects children everywhere in Canada - across the country and across diverse populations.

Like tobacco use, obesity substantially increases the risk of developing some of the most debilitating chronic diseases; obesity contributes to type 2 diabetes, cancer and cardiovascular disease. Obesity also affects physical health, and can impact on a person’s mental health (e.g., poor self esteem).

The economic costs are also significant. Direct and indirect costs associated with obesity have been estimated at $4.3 billion in 2001¹.

Health Risks

Childhood obesity is a particular concern because excess weight over time increases the risk of developing chronic health problems.

Obesity is one of the leading risk factors for heart disease and stroke, as well as for type 2 diabetes. Unhealthy weights, combined with risk factors such as age, family history and the presence of other health conditions, such as high cholesterol or high blood sugar levels, can greatly elevate the risk of developing a wide range of chronic diseases including:

• hypertension or high blood pressure;
• coronary heart disease;
• type 2 diabetes;
• stroke;
• sleep apnea and other breathing problems;
• some cancers such as breast, colon and endometrial cancer; and
• mental health problems, such as low self-esteem and depression.

Understanding the Causes

We know that weight gain results from a chronic energy imbalance, but many factors, including economic status, education, genetics, social factors, the built environment, culture and media, contribute to the high number of unhealthy weights in Canada today.

The problem is magnified among poorer families, who may have difficulty providing healthy food choices and physical activity opportunities for their children. Among First Nations, the causes of overweight and obesity are a complex combination of historical, economic and social factors.

A child’s social, physical and economic environments, including schools, home and the community, all have a significant influence on whether a child is at a healthy weight. Children may have fewer options than adults for healthy eating and physical activity in environments over which they have little or no control.

Research has shown that:

1. heavier mothers tend to have heavier babies, which is associated with obesity later in life;
2. children are more likely to be overweight or obese if they have overweight and obese parents; and
3. over-nutrition at a young age can have a lifelong effect on obesity.²

Efforts to address obesity among adults can therefore also help promote healthy weights among children. These efforts must also address the environments within which both adults and children live.

The Government of Canada’s Role

The answer to rising childhood obesity rates lies beyond the scope of influence of any individual Canadian, any government or any sector to address on its own.  Like with anti-tobacco efforts in recent decades, preventing unhealthy weights will take a long-term, multi-pronged initiative involving many sectors.  Multiple factors contribute to young people becoming overweight and obese, and these factors cannot all be changed immediately.  While a lot of work needs to be done, not only at the federal level but across all sectors and jurisdictions, there is a solid platform on which to continue building our efforts. 

Canada’s New Government is well positioned through existing activities and partnerships to promote healthy eating, physical activity and healthy weights. 

It plays an important role in providing national leadership and coordination, improving surveillance, helping to build capacity in communities, continuing to support knowledge development and exchange, providing information to the public and monitoring and evaluating interventions and innovations.

Leadership, coordination and strategic policy development

The Government of Canada plays a stewardship role in public health, providing leadership and drawing in players from across many sectors. The government also works collectively across departments and with other stakeholders on federal legislation, regulation and taxation levers, and with provinces and territories to assess gaps and support activities to promote healthy eating, physical activity and healthy weights such as Canada’s Food Guide. It does this through key initiatives such as the Pan-Canadian Healthy Living Strategy (PCHLS), the introduction of mandatory nutrition labelling regulations and mechanisms such as the federal, provincial and territorial forum on Sport, Physical Activity and Recreation and the Public Health Council Network.

Knowledge development, exchange and dissemination

Knowledge helps the general public, professionals and policy-makers in health promotion and other fields make informed decisions to improve the health of Canadians. The Government of Canada plays a key role in developing research capacity that generates knowledge on childhood obesity, and then facilitates the exchange and dissemination of that information. It does this through initiatives including the Canadian Institute of Health Research’s Institute of Nutrition, Metabolism and Diabetes, which funds obesity-related research, and the Canadian Best Practices Portal, a centralized access point for exchanging evidence of effectiveness for best practices related to chronic disease prevention and healthy living.

In addition, the Public Health Agency of Canada has established six National Collaborating Centres to focus on knowledge translation in six priority areas of public health including the determinants of health, public policy and Aboriginal health.

Surveillance

Surveillance is critical to the success of any obesity prevention and management approach, as it helps decision makers understand the health of the population and measure progress towards reaching policy objectives. Surveillance activities provide ongoing and timely information and indicators on the health of the population, the nature and scope of health problems, and the factors that need to be addressed in the population to improve health. Surveillance of childhood obesity rates and contributing factors adds valuable information for planning and evaluation purposes. The Government of Canada has led or participated in several important surveillance initiatives, such as the Canadian Community Health Survey, to gain an understanding of eating patterns, physical activity and overweight/obesity levels.

To build on the existing database in the area of food and nutrition, the Government has worked closely with the provinces and territories in a variety of food and nutrition surveillance activities including:

• Collecting data on what Canadians are eating;
• Measuring contaminant levels in some foods;
• Developing methodological and data collection tools and standards;
• Providing guidance on interpreting surveillance data; and
• Analyzing and interpreting data to inform programs and policies.

The Government of Canada is also partnering with the provinces and territories and the Canadian Fitness and Lifestyle Research Institute to conduct the Canadian Physical Activity Levels Among Youth Survey (CANPLAY) program, the first nationally-representative study measuring physical activity in children and youth.

Community-based programming and community capacity building

Promoting health requires cooperative action across all sectors and levels of government. Social, economic, physical and environmental factors must be addressed to create environments that will support Canadians in making healthy choices. The Government of Canada provides funding to community-based projects that address these factors under several programs.

• The Maternal Child Health Program provides home visits to First Nations families on reserve during pregnancy, infancy and early childhood.
• The Aboriginal Head Start promotes the health and well-being of children, through a comprehensive program that includes components on health promotion, nutrition, parental involvement, Aboriginal culture and language, social support, and education.
• The Aboriginal Diabetes Initiative funds obesity-prevention projects for children, including the development of healthy school policies that emphasize healthy snacks and children’s camps that focus on preventing obesity through promotion of healthy lifestyles. The program also addresses the prevention of diabetes during pregnancy, which lowers the risk of obesity for infants later in life.
• The Canada Prenatal Nutrition Program aims to improve the health of both infant and mother by supporting activities related to maternal nourishment, breastfeeding support and education and counselling on health and lifestyle issues.

The Health Portfolio also leads the federal Healthy Living and Chronic Disease initiative, which focuses on the full spectrum of health promotion and chronic disease prevention. The Healthy Living component of this initiative emphasizes physical activity, healthy eating and their relationship to healthy weights.

Public information

Social marketing is an important mechanism to communicate messages to Canadians to help them make informed decisions in order to improve their health and the health of their children. The Government of Canada leads a number of activities that provide information on healthy eating and physical activity to the public. Key federal public information initiatives such as Eating Well with Canada’s Food Guide, the first-ever food guide for First Nations, Inuit and Métis, the Physical Activity Guides for Children and Youth, the annual WinterActive and SummerActive community mobilisation initiatives, and a campaign to promote the Children’s Fitness Tax Credit.

Monitoring and evaluation

The Government of Canada monitors and evaluates activities to strengthen the design and delivery of programs and policies for Canadians, including those that address childhood obesity. The federal government also plays an important role in analysing innovations through measures such as partnering with the Pan-American Health Organization to establish a Policy Observatory on Non-Communicable Diseases. The Observatory will promote the systematic analysis of information on key policies, including their context formulation and implementation processes, any mitigating and constraining factors, as well as the real and potential impact of such policies.

Working with First Nations and Inuit

The Government of Canada also recognizes that rates of overweight and obesity are high among Aboriginal children and have taken action to promote healthy weights specific to this population. It is committed to working in a respectful and collaborative manner with First Nations and Inuit leaders to improve the health of First Nations and Inuit. It has signed joint work plans with First Nations and Inuit leaders to develop approaches in areas of mutual interest to improve First Nations and Inuit health. These relationships have also been extended to include other levels of government. For example, a groundbreaking Tripartite 10-year First Nations Health Plan has been signed between the province of British Columbia, Health Canada, and the First Nations Leadership Council in British Columbia to help close the gap in health status between BC First Nations and other British Columbians.

Looking Forward

The Government of Canada acknowledges that childhood obesity is a complex issue. The federal government has an important role to play in providing leadership and coordination, improving surveillance, helping to build capacity in communities, continuing to support knowledge development and exchange, providing information to the public and monitoring and evaluating interventions and innovations. It also continues to work to better understand the determinants of health, which will inform decisions on the best interventions and mechanisms to use to address these determinants.

The Government of Canada is committed to collaborating with many stakeholders to promote healthy eating and physical activity and healthy weights. To reduce obesity levels among children and youth, particularly in vulnerable populations such as First Nations and Inuit, the Government of Canada will continue to build upon the solid foundation of initiatives in place to better understand and address the challenges of unhealthy weights in children.

For more information

Canadians can find information on healthy eating and physical activity by visiting www.HealthyCanadians.gc.ca .

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¹ Katzmarzyk PT, Janssen I. The economic costs associated with physical inactivity and obesity in Canada: an update.  Can J Appl Physiol. 2004 Feb 29(1):90-115

² Law C, Power, C, Graham H, Merrick, D. Obesity and Health Inequalities. Obesity Reviews. 2007