The obesity problem, from a dental health practitioner’s perspectiveNews
Posted by: The Probe 22nd April 2020
The results from the latest National Child Measurement Programme (NCMP) for England were published in October 2019.[i] The prevalence of obesity for reception-year children had increased to 9.7% in 2018/19, from 9.5% in 2017/18; for children in Year 6, it had shown no significant change, at 20.2%. For children in poorer areas, obesity rates were more than double what they were for those living in affluent parts of the country.
We all know the serious conditions connected to being overweight, backed up by a growing body of evidence. With thousands of children having such an unhealthy start in life, healthcare professionals from all disciplines are surely wringing their hands in frustration. In 2018, the government announced the second phase of its plan to halve childhood obesity by 2030, alongside a host of measures to help it achieve its goal.[ii] Among these were plans to introduce clear food labelling in restaurants and a ban on the sale of energy drinks to children.
The link between obesity and social deprivation indicates a more fundamental problem, though. If you practise – or ever have practiced – in an area with high levels of poverty, you may not be even mildly surprised that so far, nothing is hitting the mark. The first part of the government’s childhood obesity plan was announced in 2016, so no real inroads have been made in three years.
When families are living below the poverty line, lectures about lifestyle choices won’t be welcome. The correlation between low income and poor health, including poor dental health, is long established, too.[iii] How do we reach these families and support them to make simple changes? What other help is out there for schoolchildren?
There are around 2,600 school nurses in the UK, covering several schools each.[iv] In the Royal College of Nursing’s School Nurses’ Toolkit, the focus of the role across the four countries is outlined.[v] ‘Emotional health and wellbeing’ is listed at the top for all four, followed by ‘substance misuse’ then ‘safeguarding/child protection’. Obesity/nutrition/healthy eating is part of their remit too, but the conclusion is that we have too few school nurses, doing too much and being spread too thinly.
If we think about the obesity problem from a dental care professionals’ perspective, what should the focal point be? We get to see school-age children along with their families, so have a unique opportunity to encourage all of them to take steps in the right direction. Excessive sugar consumption isn’t the only reason why children are getting fatter, but discussing why and how they should cut down is a good basis for preventive appointments. Explain that it’s perfectly normal to have a sweet tooth – in fact, you could say that we’re all born with one. Our first nutrition – whether breastmilk or formula milk – is sweet. As we get older, offering an upset child a sweet treat is a tried-and-tested method of cheering them up. So, discuss ideas for inexpensive, sweet-tasting alternatives (a current bun rather than a muffin, a bagel with low-sugar jam). A sensible balance should be aimed for, with the occasional treat. Tell them about the red, amber, green system on food packaging. Hidden sugars, like in certain breakfast cereals, are a problem, so find better choices altogether. Eggs are cheap, high in protein and ‘healthy’ fat – scrambled, boiled or poached, with toast, they’ll fill the family up all morning. This is another key point – eating low-sugar, yet hearty meals will keep children from wanting something sweet and comforting to fix a mid-morning or afternoon slump.
Although talking in absolutes is often unhelpful, fizzy, sugary drinks have no nutritional benefits; they don’t even quench thirst! Although the jury is out whether long-term consumer behaviour will change as a result of the Sugar Tax, switching to plain water will save money too. So, talk with families about eliminating fizzy drinks. Their bodies and their teeth will thank them in the future.
The child obesity problem has many threads and needs a collaborative effort from all healthcare agencies, and government. Reducing their sugar intake can help children lose weight, alongside making other changes. Dentists, dental hygienists and dental therapists can help them eat less sugar by showing them and their families what the long-term impact of consuming too much will be. Cutting down on sugar is a central tenet of preventive dentistry alongside regular appointments and good, daily cleaning; TANDEX brushes and interdental brushes are good value, high-quality and effective.
No matter how big, a problem can look less insurmountable if you deal with it in
bite-size chunks. General dental practitioners, as part of a preventive approach, should be addressing issues like obesity. Helping children consume less sugar should be a key focus of preventive appointments; simple lessons that will have a significant, positive impact on their all-round health, as well as – hopefully – improving the statistics.
[i] National Child Measurement Programme, England 2018/19 School Year. NHS Digital,
10 October 2019. Link: https://digital.nhs.uk/data-and-information/publications/statistical/national-child-measurement-programme/2018-19-school-year (accessed October 2019).
[ii] New measures announced to halve childhood obesity by 2030. Gov.UK, 24 June 2018. Link: https://www.gov.uk/government/news/new-measures-announced-to-halve-childhood-obesity-by-2030 (accessed October 2019).
[iii] Poverty and health. The Health Foundation, 30 January 2018. Link: https://www.health.org.uk/infographic/poverty-and-health (accessed October 2019).
[iv] The School Run. How a school nurse could help your child. Link: https://www.theschoolrun.com/what-is-a-school-nurse (accessed October 2019).
[v] An RCN Toolkit for School Nurses. Link: https://www.rcn.org.uk/professional-development/publications/pub-006316 (accessed October 2019).
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