Giving Obesity the CHOP

Obesity newsI am once again drawn to research from a team at the University of Westminster, a renowned institution that doles out so-called science degrees in homeopathy. This time the paper in question, published in the inaugural issue of the International Journal of Food Safety, Nutrition and Public Health (2008, vol 1, issue 1, pp 16-32) is on that perennial favourite: what to do about the obesity epidemic.

Ihab Tewfik, a senior lecturer in the School of Biosciences, at Westminster, reports that “the prevalence and severity of people suffering from obesity has increased markedly worldwide,” and adds that “The WHO declared obesity a ‘crisis of epidemic proportion’.” Nothing of which I can be too critical in those statements, except for one small point.

While obesity and the diseases and disorders for which it is purportedly a risk factor – type II diabetes, hypertension, hyperlipidemia, atherosclerosis, cardiovascular disease, stroke, and heart attack – are almost certainly on the increase in North America, Western Europe, and pockets of the Pacific Rim, the use of the term “worldwide” is rather ironic. This is especially true given that the WHO and other international organizations consistently report massive cases of disease, malnourishment and poor water supply across great tracts of the earth’s surface from Africa and South America to Asia and the former Soviet Union.

Anyway, Tewfik and colleagues have proposed a conceptual framework for a three-year intervention programme that could be adapted to the prevention of childhood obesity, which is a growing problem in many parts of the world, if not quite worldwide.

Ironically, they have named the framework, with one of those shoehorned acronyms, as CHOP, for Childhood Obesity Prevention and explain their approach as follows:

The approach is based on a behaviour modification model without giving foods. Family, school and children are essential counterparts to achieve meaningful improvement. Advocated by policies makers and embraced with favourite environmental factors, CHOP programme could be the conceptual framework for nutrition intervention that can be effectively integrated within the national health framework to attain public health goals.

Apparently, what this boils down to is giving children healthy foods, increasing physical activity and workout limits, limited TV and other screen times, implementing a non-food reward system, and allowing self-monitoring. As part of this approach schools will intervene in teaching children that they should eat five portions of fruit and vegetables each day, that they should cut the amount of fat they eat, limit their screen time and be active every day.

It all sounds like good, solid advice. Indeed, it’s the kind of advice the medical profession, nannyish governments, and even grandparents, have been offering for decades. Unfortunately, growing children are notoriously reluctant to take advice, especially when it comes to avoiding sweets and crisps, eating their greens, and switching off the Playstation (other gaming consoles are available).

The Westminster researchers, however, suggest their CHOP system would be convenient once the appropriate team, policies and resources have been successfully assembled. One has to wonder at a cost to whom these resources might be assembled. They do concede that, “In some circumstances this conceptual framework may be regarded to be too ambitious to attempt de novo within three years especially in some developing countries, where lack of access to health care, to drinkable water, to food, to education and housing is prevalent.”

It’s probably not necessary to implement it in places where food is in limited supply, surely. But, even in apparently developed nations, I’d suggest that costs will be severely prohibitive while children will be reluctant to partake (what positive rewards will replace treats and screen time?). Moreover, by their own admission, obesity is on a rapid climb among adults too and one has to wonder how these resources will be applied to persuade parents and carers of increasingly obese children will themselves be persuaded to take part if they do not appreciate the potential benefits.

Tewfik, I. (2008). Childhood Obesity Prevention (CHOP) programme: a conceptual framework for nutrition intervention. International Journal of Food Safety, Nutrition and Public Health, 1(1), 16. DOI: 10.1504/IJFSNPH.2008.018853

12 thoughts on “Giving Obesity the CHOP”

  1. Sarah, that’s kind of what we’re finding re the sweets. As to dental genetics, my father didn’t see a dentist till he was in his late fifties, he’s still got all his own teeth, has never had toothache, no fillings nothing and I have to say my teeth seem to be similarly as strong, as do those of both my kids.

  2. My hippie mom kept the sweets out of the house, and told me that carob was chocolate. (It most certainly is not.) As soon as I got an allowance I regularly spent it all on 1 cent raspberry jujubes (200 at a time, if I recall correctly). But besides a few cavities (which of course are now being linked to genetics), I picked up good eating habits and am in healthy shape as an adult. So yeah, no-brainer advice from those Westminster researchers… yet the whole paper seems like waste the time of peer-reviewers and journal editors… And this CHOP idea sounds like a self-indulgent attempt to brand common sense.

  3. Parents do play a role, of course. But, I think once kids are pubescent, peers actually take over in terms of where they go, unless you’ve got very tight apron strings. As to the Barbie carriers, the daughter was only about 8 or 9 so, probably doesn’t quite apply.

  4. David Bradley, you’re right, the rebel teen years are a well known phenomenon, and I understand that peers are an incredibly important factor in a young person’s life. However, parents do have a powerful role in modelling smoking, drinking, relationship and, indeed, eating behaviour, as your original picture of the barbie balloon mother and daughter indicates.
    Mina, the food dudes programme looks like an excellent idea:
    ‘The Food Dude Programme, developed by psychologists at Bangor University, is an initiative to encourage and maintain healthy eating habits in children.’
    David Brown, five slender children is good!

  5. We raised five slender children on a high-fat diet; plenty of full fat dairy, eggs, and red meat. It’s sugar, especially the fructose portion, that is contributing to the increased incidence of obesity.

    It’s time to discard that idea that “fat makes you fat.” Certainly, fat in conjunction with sugar, contributes to fat stores – omega-6 vegetable oils more so than animal fats and coconut oil.

    David Brown
    Nutrition Education Project

  6. Despite parents’ best efforts it seems that their kids are influence (particularly in their early teens) almost 100% by the morals and viewpoints of their peers not be health campaigns, proverbs, and certainly not by parents…

  7. Good, solid advice, indeed. It sounds like a chicken and egg situation: the children need to be trained well, but the parents need to do that training, and to set a good example. It reminds me of the proverb, ‘Train up a child in the way he should go; even when he is old he will not depart from it,’ Proverbs 22:6 (ESV).
    Perhaps the motivation could be the eventual consequences, a bit like the anti-smoking advertisements seen here in the UK: making clear the effects, and even dramatising them. ‘It’s for their own good,’ as I’m sure many parents used to say.

  8. John, I totally agree, I hoped my item was sarcastic enough of the research for my thoughts to come through maybe not.

    As to the photo…the woman’s daughter was in tow when I snapped the original, and she too was very overweight and also rather ironically carrying a Barbie balloon. I didn’t think it fair to show the daughter too even though it would have been more pertinent to the post and even if I’d blacked out eyes for her and her Barbie too.

  9. Oh, one more thing regarding my last post.

    The picture shown is not of an obese child. It is of an at least middle-age woman who probably would not have survived in her current condition some fifty years ago. Children see these people regularly and think nothing of it. Do we wonder why children no longer sing “Fatty, fatty, two by four, can’t get through the bathroom door”? If we do wonder, I answer that that: they know it is politically incorrect; and they are in the same group anyway.

  10. Childhood Obesity Prevention. CHOP? A better acronym should be COP. Sounds like food police to me, quite frankly. As bad as obesity is, and admitting the costs to national health programs and taxpayers are high, I would not want to see the advent of food police in our educational systems or anywhere else. What kind of COP would be following, based, of course, on precedence.

    I regularly observe obese children, and more often than not, with their obese parents, particularly at eating establishments. Children are eating what their parents give them — fat, sugar, carbohydrates, etc., bottled jumbo-sized, in fourteen oz. cups, in little plastic bags, deep fried, quickies from the drive-through, etc. And the parents who are eating the same thing are probably giving their whining “ankle biters” this garbage just to shut them up — that being the same reason that hours at the Playstation are tolerated.

    The problem starts with the parents, can be solved by the parents. But it can’t be stopped by the COPS. But then, in our society, who cares? If little Sally develops obesity related health problems, society will pay for it while the parents go home, swig a jumbo cola, chased by a sixteen ounce beer along with the delivered pizza while watching the Tube.

    CHOP, I think, is a very bad idea, in my opinion. After all, doctors and related specialists have been telling us for years how to solve the problem. But nobody listens. As long as life is too easy, food is (in most Western nations) too plentiful, and the consequences of bad behavior leading to obesity is the cost of society in general, there will be no real attention given by parents to their children’s problems, or even their own problems.

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