Content area
Full text
The causes of obesity in children and young people are myriad and complex. To deliver the best care, nurses need to be aware of these multiple determinants and tailor care accordingly.
While statistics on childhood obesity differ, they all point to the fact the issue is an ongoing problem in New Zealand. Children who live in lower socio-economic areas, as well as Maori and Pacific children, are consistently over represented in these statistics^ 2
A survey by the Ministry of Health (MoH) in 2018/19 found that 11.3 per cent of children were obese, and Maori children were 1.6 times more likely to be obese than those of New Zealand European ethnicity.3
There are differences in the rates of childhood obesity between communities, which can be explained, in part, by ethnicity or economic deprivation, but also by the composition of the community.4 This latter predictor of childhood obesity can be due partly to availability of food outlets, such as supermarkets or fast food outlets, transport options and leisure resources.
Ante-natal predictors
Obesity in childhood is a strong predictor of obesity throughout adult development^ These predictors can start before birth, with maternal obesity and a poor maternal diet ante-natally. A high infant birth weight is also a predictor for obesity.6 These findings are true across ethnicities^ Co-morbidities of obesity can include poor cardiovascular health, obstructive sleep apnoea, sleep issues, psychological issues, type 2 diabetes and poorer social outcomes^ 6 So obesity in early childhood can lead to further hurdles and less positive health outcomes throughout the lifespan.
To assist health professionals working with children from two to 18 in managing weight and combating childhood obesity, the MoH has developed clinical guidelines.8 These suggest four stages: monitoring, assessing, managing and maintaining. These guidelines are aimed at health professionals working with families in a clinic setting. They emphasise the need for cultural competence for all health professionals working in this specialty area. They suggest early action, if a child is overweight. The guidelines also emphasise the importance of practitioners taking time with the family, of tailoring their communication style and of building relationships. They also stress the importance of recognising and working with Maori health providers, as well as community-based providers, to ensure better access to services and...