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The Perspective
The Perspective

June 14, 2016

Emergency doctors address a less obvious health emergency: childhood obesity

Group of Emergency Department staff at the Colour Run!

Dr. Dan Magnus is a Clinical Fellow in Paediatric Emergency Medicine at SickKids

This weekend as I stood at the Toronto 5-km Color Run with my face covered in paint and a multi-colored group of colleagues and friends from the SickKids Emergency Department, I had a moment to pause briefly to reflect on why we were there.

As emergency doctors we had thought about a variety of 'emergency' issues to advocate for this year: falls, open windows, burns, helmets, safe sports, sun safety and the list goes on. But we decided to focus on a slightly less obvious issue that is seriously affecting children; obesity. While the effects of obesity feel less immediate than these serious injuries, they are no less of an emergency. We are seeing the consequences of obesity and lack of exercise every day in the emergency department with children newly diagnosed with diabetes, mental health issues and other health issues relating to obesity.

One in five Canadian kids is overweight and about one in 10 is obese. These numbers are even higher in vulnerable populations such as the poor and the marginalized. We know that preventative measures are the key to improving the lives of children with respect to obesity and health, and for many years now the health community has been targeting two key areas of behaviour change – better activity and better eating.

Kids do not eat enough fruits and vegetables as a proportion of their daily dietary intake and foods high in sugars are a particular problem. Access to healthy foods is a challenge as the cost of more nutritious foods is often a barrier, especially for low-income families. The food industry, advertising and government unquestionably have a role to play in this arena. In the meantime however, we know that obesity and food insecurity are closely linked, and in 2012, 1.15 million children in Canada were estimated to live in households experiencing some degree of food insecurity. Children and families need better information, choice and purchasing power to make the right choices when it comes to healthier foods.

Limiting sedentary behaviours and increasing physical activity are also hugely important. The Canadian Physical Activity Guidelines recommend a minimum of 60 minutes of moderate physical activity daily and at present very few children are meeting this goal. At the same time there are significant concerns about adherence to the Canadian Sedentary Behaviour Guidelines for Children and Youth which recommend daily screen time of no more than one or two hours for younger or older children respectively. Yet less than 20 per cent of children are thought to be meeting these targets nationally.

At the Hospital for Sick Children, The Centre for Healthy Active Kids and its clinical program STOMP (SickKids Team Obesity Management Program) is leading the way in encouraging healthy eating and activity and preventing obesity as well as supporting children already affected. In the Emergency Department a group of paediatric emergency doctors are organizing an advocacy project focused on encouraging physical exercise for children and preventing obesity by raising awareness and engaging with children and families. But we all need to focus our attention on this modern epidemic because estimates suggest that this problem is going to get worse and it is our children that are going to suffer. We need to intensify the debate, create public health and political measures to combat sugars and unhealthy diets, promote and facilitate active living and invest more money in programs and research to find innovative solutions.

For more details see the Centre for Healthy Active Kids.