Poor Health and Nutrition in School Age Children

Abstract

The incidence of childhood obesity is increasing dramatically in Australia and worldwide. In Australia, the severity of obesity has adverse impacts on national health and wellbeing. Research found that 27% of school-age children are obese or overweight in Australia. To identify the main issues associated with poor health and nutrition in school age children, this essay has conducted a review of academic journals. This research is targeting the following issues by using secondary research methods: consumption of junk food, consumption of sugar-sweetened drinks, and parenting styles. Solutions, such as ‘Quick Service Restaurant Industry (QSRI) Initiative for Responsible Advertising and Marketing to Children’, ‘the Fresh Tastes @ School strategy (FT@S)' and ‘Skill-based healthful eating programs’ seem moderately successful. However, further research is recommended to solve the issue of children’s poor health.

Introduction: Health and Nutrition (essay)

In Australia, it is reported that over quarter of children aged between five and seventeen years were obese or overweight in 2014/2015 (Huse et al. 2018), and this trend of childhood obesity has been increasing at an alarming rate over the last 30 years. It is important to consider poor health and nutrition among children because poor diet during those ages has adverse health effects not only on children, but may also lead to long-term overweight, and increase the risk of chronic diseases such as diabetes, cardiovascular diseases in adulthood (Pearson et al. 2014). This research aims to investigate the major issues associated with poor health and nutrition and focuses on three issues, namely, the consumption of junk-food, sugar-sweetened drinks and parenting styles and suggests and evaluates solutions that improve children’s overall health such as ‘Quick Service Restaurant Industry (QSRI) Initiative for Responsible Advertising and Marketing to Children’, ‘the Fresh Tastes @ School strategy (FT@S)' and ‘Skill-based healthful eating programs’. For the purposes of this report, school-age children are defined as ‘five to eighteen years old’.

Major Issues

Junk food

The first significant issue associated with poor health and nutrition among school-age children in Australia is the consumption of junk-food. Junk-food, including fast-food, snacks and soft drinks are energy dense, and contain high amounts of sugar and fat (Boylan et al. 2017). There were connections drawn between the consumption of junk food and certain behaviour. For example, Boylan et al. (2017) and Pearson et al. (2014) found that children who had longer screen time, consumed more junk food than those who spent less time in front of modern media, like television or internet. This could be influenced by the advertising of junk food on television because the advertising of unhealthy foods is frequently shown on television and the internet during children's viewing time and this may stimulate them to consume the advertised foods (Pearson et al. 2014). In addition, Chung et al. (2018) found that children with low socioeconomic status are more likely to consume junk food. This is consistent with another study by Boylan et al. (2017), in which a strong correlation was found between the consumption of unhealthy foods and beverages, and socioeconomic status. Although the consumption of junk food was found to be in decline from 2010 to 2015, it remains important to address unhealthy food consumption as an Australian health survey showed that junk food accounted for an average of 35% of total daily energy intake for under fourteen-year-old , and 41% among older children aged fourteen to eighteen (Boylan et al. 2017).

Soft drinks

The link between junk food intake and high consumption of soft drinks has been researched extensively. Soft drink consumption is another significant issue for Australian school-age children in having unhealthy dietary habits. Research shows that sugar-sweetened beverages (SSB) are associated with weight and obesity in both children and teenagers (Clifton et al. 2011). In terms of soft drink consumption, Louie et al. (2016) found that male students are more likely to consume soft drinks than females, because male students tend to have their sugar intake through sugar-sweetened beverages, rather than cakes and biscuits. Moreover, Scully et al. (2017) found that high soft drink consumption is associated with purchasing soft drinks mostly at schools. The problem is that schools sell inappropriate drinks to make profits (Ronto et al. 2017) despite government guidelines stating that these beverages should be prohibited in the school canteens (Scully et al. 2017). Although Scully et al. (2017) stated that there is not a significant relationship between high soft drink intake and weight, students who are obese and overweight consume more SSB than those who are underweight or normal weight (Clifton et al. 2011).

Parenting styles

In addition to junk food and sugar-sweetened beverages, parents’ behaviour and personality can affect children’s eating habits, by determining their children’s eating patterns. According to Alsharairi and Somerset (2015), children who are cared for by authoritarian parents were negatively influenced by their eating patterns. The eating habits of children with authoritarian parents tend to be less healthy because those parents restrict their children’s consumption of food hoping their children see them as good role models. This then may lead to unhealthy eating habits as a reaction to such high levels of control (Alsharairi and Somerset 2015). In contrast, permissive parents give their children freedom of behaviour and allow children to decide by themselves with no limits on their food intake. As a result of freedom, children were less likely to take fruits and vegetables but more likely to have junk foods at meals because parents are not controlling their children’s food intake (Alsharairi and Somerset 2015).

In opposition to those parenting styles, authoritative parents consider, accept and support their children's needs. Children under the care of authoritative parenting styles tend to have a balanced diet and healthy food choices. This is because these parents have a consistently lower intake of unhealthy food themselves and they limit unhealthy foods for their children. This is supported by Pearson et al. (2009) who state that if parents do exercise regularly, eat more fruits and vegetables instead of junk food, then they can encourage their children to do the same.

Solutions and current projects

One solution to improve children's overall health is lowering the consumption of unhealthy food such as junk food and sugar-sweetened drinks. Since children's food preference is influenced by advertising on television, ‘Quick Service Restaurant Industry (QSRI) Initiative for Responsible Advertising and Marketing to Children’ has been introduced to fast food chains in Australia. This regulation aims to restrict inappropriate advertising to children; QSRI provides nutrient criteria guidelines and only food and beverages which are recognised as healthy options are allowed to be advertised to children (Wellard-Cole et al. 2019). However, the system does not seem to be efficient due to the fact that junk food advertising is still frequently shown on television but focused on brand rather than children’s meals. Indeed, unhealthy food, which does not meet the healthy nutrient criteria is indirectly advertised to children (Hebden et al. cited in Wellard, Glasson & Chapman 2012).

To encourage children to eat healthier food, the major fast-food companies have introduced healthier menu items. Mcdonalds launched Healthier Happy Meals for children in 2007, and so did Hungry Jacks in 2010. Despite these efforts and the fact that this change is a positive progress to lower the fast food impacts on children’s dietary intake, Wellard, Glasson and Chapman (2012) states that these items have not been popular among children.

In terms of the accessibility of junk food and soft drinks, students who can purchase those at schools are likely to be high consumers of unhealthy food. Schools, therefore, have a responsibility to providing healthy food for students. In 2005, the NSW Department of Health and the NSW Department of Education and Training (cited in Delaney et al. 2019) introduced a campaign, ‘the Fresh Tastes @ School strategy (FT@S)' for schools and students. The aim of this strategy is to encourage students to eat healthier food, and it is a mandatory set of rules on what school canteens in NSW can sell. This campaign uses the colours of traffic lights, red, amber and green, to categorise various canteen food options. Green foods (‘fill the menu’) are healthier options, which should be promoted to students as the best choice and provide the majority of canteen food. Amber foods such as fruit juice and dried fruits (‘select carefully’) should only be offered for sale on a few days of the week as they contain excess amount of sugar. Red foods including deep-fried food, cakes, confectionery and sugar-sweetened drinks are ‘occasional’ foods, which are restricted to be sold on less than three in a school term. However, this project does not seem to be successful in promoting healthy food to students at schools. Hill et al. (2015) studied the changes of the school canteen food by this campaign from 2007 to 2010. Their findings present that although there was an effort to encourage consumption of green items, there was significant change in proportion of green food intake between those years. Moreover, in 2007, 265 schools participated in the guidelines for menus and only 95 of these provided their menu for assessment in 2010. Also, it is difficult to generalise about the effect of this campaign as it targets only primary schools in NSW, not for all schools in Australia. Additionally, small schools, which have less than 159 students, and remote schools appear to have more red items on the menus (Dick et al. cited in Hills et al. 2015). This may be because there is a barrier for them to have healthier diets due to distance and high cost of healthy food. For these schools, it is difficult to receive enough financial support and have healthier food with reasonable prices due to geographical conditions (Hills et al. 2015). Therefore, such schools in disadvantaged areas are more likely to sell unhealthy foods and drinks than urban schools. Future campaigns should consider the disadvantages of school size and locations when promoting healthier food options in school canteens, in order to reach all Australian school aged children.

Although the junk food industry and schools have taken action to improve children’s diets, it is the parents who mainly provide food for their children. Therefore, targeting parents and improving the home environment is crucial (Pearson et al. 2014). Currently, secondary schools in Victoria offer ‘Skill-based healthful eating programs’ for parents and children. This program is designed to enhance the ability of understanding nutritional information through labels on foods including canned, frozen and takeaway food. During this program, participants are also taught cooking skills by using fresh food rather than relying on convenience food and takeaway food. This seems effective for children; however, parents who work during school hours find it difficult to participate even if they are invited to attend this program (Fordyce-Voorham 2011). Thus, further programmes should be designed with more flexible times so that children’s guardians to participate.

Conclusion

Obesity is arguably one of the most common diseases in Australian society. This report identified three major issues associated with poor health and nutrition among school-age children namely consumption of junk food, soft drinks, and parenting styles. These issues are links in a chain which negatively affect children’s overall health. This report found some solutions and current projects of these solutions, teaching children and parents cooking and providing nutritional information have been somewhat successful. However, the ‘the Fresh Tastes @ School strategy (FT@S)' and the ‘Quick Service Restaurant Industry (QSRI) Initiative for Responsible Advertising and Marketing to Children’ programme in fast food chains have not been successful in improving food choices. There is a need for more flexible educational support and stronger government regulations to prohibit the sale of inappropriate food.

This study has limitations because a secondary research methodology was used, and the issue requires a wider investigation related to poor health and nutrition among children. Although the Australian Government has made considerable progress in understanding and responding to obesity, the rate of obesity among children is not significantly decreasing. Indeed, more research needs to be conducted with larger samples and at different locations.