Skip to main content
Normal View

Joint Committee on Health and Children debate -
Thursday, 4 Oct 2012

Childhood Obesity: Discussion (Resumed)

I welcome Mr. Gerry Duffy and Mr. Jorge Arroita, directors at Murduff Wholesale Limited; and from safefood Dr. Cliodhna Foley-Nolan, director of human health and nutrition, and Ms Fiona Gilligan, director of marketing and communications. Some of us will know Ms Gilligan from "Operation Transformation". This is our latest meeting on our priority topic of tackling childhood obesity. We had a number of meetings on this topic before the summer recess. Deputy Peter Fitzpatrick is our rapporteur for the report we will be producing at the conclusion of our deliberations.

Witnesses are protected by absolute privilege in respect of their evidence to the joint committee. However, if they are directed by it to cease giving evidence on a particular matter and continue to so do, they are entitled thereafter only to qualified privilege in respect of their evidence. They are directed that only evidence connected with the subject matter of these proceedings is to be given and asked to respect the parliamentary practice to the effect that, where possible, they should not criticise or make charges against a person, persons or an entity by name or in such a way as to make him, her or it identifiable. Members are reminded of the long-standing parliamentary practice and the rulings of the Chair to the effect that they should not comment on, criticise or make charges against a person or persons outside the Houses or an official by name or in such a way as to make him or her identifiable.

I call on Dr. Foley-Nolan to make her opening remarks.

Dr. Cliodhna Foley-Nolan

I thank the committee for its time. In light of the children's referendum, childhood obesity and being overweight must be factored into the issue of child protection. It is well accepted that children are growing up in hostile, toxic environments where obesity is concerned. As the committee has received a number of presentations, including many graphs and statistics, I will be statistic light this morning.

Unfortunately, one in five children in preschool is overweight or obese. This is the 2012 figure and increases to one in four in terms of eight year olds. The first communion is a milestone for children. One in four children requires clothes that are larger than what would have been required some years ago. Data from the late 1940s bring the issue into sharp focus, in that 14 year olds have gained 8 in. in height but are three stone heavier than their 1940s counterparts. This disproportionate increase in weight is a large physical burden.

We are in relative denial. According to research, parents and society in general are accepting of children being overweight, "generously sized" or so on. We do not recognise the issue. There is clear evidence that obesity and being overweight track into adulthood. One tends not to grow out of it. If one is overweight or obese at ten years of age, one is twice as likely to be overweight or obese as an adult. It is a real problem.

Thanks to our new investigative facilities and the current level of technology, we know that children begin depositing fat and calcium in their arteries from the time they become overweight. It is not confined to 50 year olds, 60 year olds and 70 year olds. We are also finding overweight children as young as ten years of age with high blood pressure. The terms "overweight" and "obesity" are not interchangeable, as they form part of a spectrum, but we tend to view obesity rather than overweight as being serious. If a child is overweight, metabolic damage is being done to his or her system. Of overweight children in the US, 50% show clear evidence of a metabolic syndrome, which is essentially pre-diabetes. In Ireland, 9% of overweight 12 year olds have pre-diabetes. Concrete evidence shows that there is nothing benign about being overweight as a child.

Parenthood in general is a blame game, particularly so in the case of overweight children. Is industry, parenting or something else to blame? The information clearly points to society. Genetics play a part, but we are over-reliant on this excuse. Genes are switched on by environments. If one is not exposed to certain environmental factors such as high-energy foods or inactivity, one's genetic predispositions will be less expressed. This is an important consideration.

There is some good news, in that early intervention and family intervention have been shown to work. It is not down to the child alone and one cannot just send a child on a programme. A change in or development of lifestyle is necessary. Many statistics support this viewpoint.

safefood has adopted a practical, evidence-based and realistic approach to the issues of healthy eating and tackling obesity. Our mass media campaigns, our work in schools and the evidence base we have built through commissioning certain forms of research comprise an approach that is based on science, provides parents and others with practical tips and tries to influence policy, which is the reason we are at this meeting.

The challenges are significant. This is not a sprint, as there is no quick-fix solution. It is a long-term project. The goals set by the World Health Organization, WHO, and our European counterparts involve halting the increase. We are not discussing something so dramatic as having a healthy childhood generation within three years. After we have halted the increase, we will decrease the levels to what they were in 2000. Most of us would consider that as being only yesterday.

We are fighting the denial and stigma associated with this issue, as well as the fact that parents and society attach blame to the terms "overweight" and "obese", which they perceive as being harsh. A challenge for us is to produce information and campaigns that engage, are adequately hard-hitting and do not alienate people from the realities of the situation.

Ireland possesses no exemplars of the final challenge facing safefood. We are familiar with the economic situation. There is no simple solution. The basis of our work is energy balance, that is, changing the amount of high-energy food that is available everywhere and is marketed to children and changing what occurs in schools and homes.

We have collectively been sitting on the sidelines or getting overexcited about individual pieces of research or advances in treatment methods, for example, diabetes drugs or bariatric surgery. These merely manage the few, in that they only help a relatively small number of individuals who have extremely established diseases. Although this is exciting, appeals in the short term and allows waiting lists for treatment to be discussed, we are giving it undue focus instead of concentrating on overweight children, the number of whom would fill the Aviva Stadium and Croke Park together. By focusing on a minute number of children, we are neglecting prevention and wellness for the others.

We do not have absolute answers - it would be dishonest and misleading of me to claim otherwise - but we have a pathway that will help.

I urge the committee to put more due emphasis on prevention and wellness at the expense, perhaps, of treating the few.

As you stated, the best line is about prevention and wellness and changing the message. I thank Dr. Foley-Nolan for her presentation. I welcome Mr. Duffy.

Mr. Gerry Duffy

I thank the committee for the opportunity to speak today. Any committee with the words "health and children" in the title is probably the most important committee of its kind. The Chairman does not look as ferocious as he does on the television.

The members have not begun asking questions yet.

Mr. Gerry Duffy

My colleague, Mr. Jorge Arroita, is a specialist on sugar-free foods. We have sent the committee documentation and we encourage questions but we are here to make the point for schools and their children to have less sugar. We have been told by some eminent doctors, especially in the US, that sugar is now more hurtful to people than tobacco, which is a frightening prospect. People must back that up as it cannot just be left as a statement.

The World Health Organisation provides some general statistics and there is also the promotion of healthy diets and physical activity in school. Fat versus sugar forms the basis of a new health debate. Dr. Robert Lustig is an eminent physician in the US who has come up with wonderful material on this issue. Calorie for calorie, sugar makes us fatter than any other food. Sugar-free schools in Sweden, Denmark and the USA have undergone many studies, with results indicating that pupils become more healthy and attentive in such schools. Statistics back up these findings.

We recognise that diet is not the only element to consider and children must also be more aware of physical activity. We do not want to keep hammering about not having sugar as everything is okay in moderation. Nevertheless, we are here to explain how a sugar-free diet makes everybody healthier. We must start in the schools, as there is now a tendency towards having vending machines in them. They are perhaps not as regulated as they should be. There is a facility, if required, to place vending machines with only sugar-free products in schools, and we can explain that process later.

We invite questions, which we will answer as best we can. We know the committee's time is very important and we will do our best to help promote sugar-free diets.

The opening remark about sugar being more harmful than tobacco might be revisited.

I welcome the witnesses. We all know that if we eat healthy food and exercise a little bit more, we would diminish weight and obesity problems more rapidly. The difficulty is getting people to do that. Professor Donal O'Shea has campaigned for a long time for us to address the serious issue of obesity in the general population and in children specifically.

The witnesses indicated there is no single solution but we must start somewhere. Do the schools have a role and what role should we have in terms of legislation, particularly with regard to sugar or fat taxes? Where could a start be made in addressing childhood obesity in particular? Some teachers have indicated to me that a difficulty they have in some communities is that the art or skill of cooking healthy foods is so diminished, parents are incapable of cooking food properly. Processed food is often fed to children. Where could the committee start in promoting and addressing the issue?

I welcome our panellists. The opening remarks from Dr. Foley-Nolan in the context of other looming events were well made and taken. To follow Deputy Kelleher's remarks, this is an holistic response and we cannot seek to place the burden of responsibility on the school environment. There should be a very clear and definite parental responsibility, as these are the people most critically involved in determining a child's diet. There has been a significant change in lifestyles in recent years but there is a need to continue to emphasise the important legacy that parents give to children in terms of general health and well-being. This does not just concern academic achievement or other interests that seem to have taken a much greater importance than well-being, which is the critical factor.

It is important to acknowledge that significant voluntary work is done by sporting organisations around the country, and as a parent, I acknowledge what I see in my own community from a variety of sporting organisations. They are providing an opportunity that most certainly was not there in my time and for decades after my involvement in sport. Wonderful work is done, which should be acknowledged, and the issue should be a balance of all the elements.

I pay tribute to the initiatives taken by safefood, particularly the Stop the Spread initiative, which merits recognition this morning. I know it is not directly a part of our engagement at this meeting but I am concerned that this campaign, for some time, has been in hiatus or parked because of the intervention of the corresponding Minister in the Department responsible for health north of the Border. Some 12 months a review was sought of safefood's role in the issue of nutrition and related matters, including childhood obesity. Will the witnesses share the current position and has the review got under way? Given that the Stop the Spread initiative was significant and award winning in terms of marketing impact, is it expected that the project will be completed and that safefood can continue as one of the six cross-Border implementation bodies to continue with its broad remit, as it had up to the end of 2011 at least?

The Deputy is straying from the subject matter.

The committee would join with the Deputy in his remarks, as it has done previously, regarding the role of safefood. We hope the remit will continue on an all-island basis.

I welcome the guests. This is a very important subject, which is really a ticking time bomb. It concerns health and life expectancy as well as complications down the road.

There are huge costs involved in dealing initially with the issue of people being overweight and obese and the complications from that down the road. I welcome the practical way put forward to halt the rise in the levels of obesity, to try to decrease the levels and to deal with the stigma associated with it. As previous speakers have said, this needs to be done on an holistic basis across the board. The approach needs to take account of lifestyle, healthy eating, fitness, outdoor activity, parental responsibility and education in schools. All these areas need to be rolled into one, as it were, in the approach to this problem. Do the witnesses consider that the campaign run by Road Safety Authority, which has been very successful, could be used as a template for the introduction of a campaign to deal with this subject?

I will take questions from Deputies Fitzpatrick, Naughten, Keating and Troy, if that is agreeable to members and witnesses.

I welcome the witnesses to this committee. The main reason we are dealing with this issue is to make people aware of the damage that being overweight and obese can do to one's health. It is important to show people how they can combat this problem. Obesity levels in Ireland have risen dramatically in the past 20 years. In the 1990s, only one in ten Irish men was obese, and the level today is put officially at one in four. In the same period, the level of obesity among women has risen from 13% to 21%. The fact of being overweight and obesity are now the most common childhood disorders in Europe. Of all five to 12 year olds, one in ten is overweight and a further one in ten is obese. In total, 22% of five to 12 year olds are now overweight or obese. One in five Irish teenagers aged between 13 and 17 is overweight or obese, with 11% being overweight and 8% being obese. There has been a significant increase in teenage obesity since 1990, with an eightfold increase in males, from 1% to 8%, and a twofold increase in females, from 3% to 6%. Obesity and being overweight are defined as abnormal or excessive fat accumulation that may impair health.

It is important that witnesses who appear before the committee tell us the truth, the facts and figures, and that is the reason the witnesses are before the committee today. In terms of whatever information they give the committee, I ask that they know that it is 100% correct.

I advise members who hope to be in the Dáil Chamber to hear the address of the President of the European Parliament, Mr. Schulz, that the deadline is 10.25 a.m.

I welcome the witnesses. I compliment Safefood on the tremendous work it is doing and on the marketing campaigns in which it has been involved and which are ingenious. Such work needs to be continue to be done and supported. My question, which is related to that, is on the marketing, advertising and packaging of food. Many food products are advertised as healthy foods but they have a very high sugar content or a food product may be advertised as being 95% fat free, which means it has 5% fat content. If one is lucky enough to find a food product that is low in sugar and fat content, one will find that it probably contains about one third of the total recommended daily salt content. My question is how the consumer can choose foods, processed foods mainly, in a sensible and straightforward manner because one would nearly want a degree in nutrition to work out exactly what is in some of these foods. One finds what appears to be a health food product but it transpires it is not healthy and some of the foods that are not marketed as healthy are far healthier than the ones being marketed and promoted as such. How can that challenge be addressed?

That is a very good point.

I will be brief. I join the Chairman and members in welcoming our guests. This is a very important issue. It has often been said that when we have healthy children, we have a healthy society, and I go a long way in agreeing with that. I have a great interest in this subject because my background is in the area of fitness and sport and my specialist qualification is in the area of child and teenage fitness, not only physical fitness but fitness of body and mind.

I am sure the witnesses would agree it is important to get the balance right between having a healthy diet and, on the output side, more regular exercise, an area in which I have great interest. I notice that, increasingly, more local authorities, including my own, about which I am delighted, are rolling out the provision of more equipment in our parks which is free for people to use.

I was interested in what Mr. Duffy said about the sugar-free school project. I would keen to find out more about it in terms of the research he has done on it throughout Europe. I suggest that time might be provided to discuss that issue alone. The idea is one I am sure we as legislators would be pleased to take on board and we could examine how the committee and the Dáil could promote it in the community. I would be interested in exchanging details with Mr. Duffy in order that we could interact on that issue.

That is a good point.

I welcome the witnesses. They mentioned the school programmes and I would be interested to hear their opinion on introducing a school programme - similar to the programme under which a green flag being is awarded to environmentally friendly schools - under which recognition would be awarded to schools that are health conscious from the point of view of promoting healthy eating as well as exercise. The witnesses might also give their opinions on the introduction of a sugar tax or junk food tax. Would they consider that to be beneficial? The money collected from it could be ring-fenced for the promotion of healthy eating.

This problem is prevalent in low income families, lone parents and disadvantaged families, and people are facing cutbacks in terms of their discretionary spend, be they in the area of social welfare with the proposed cutback in children's allowance or other areas. What are the witnesses' opinions on how this problem can be counteracted? There is a perception that it is more expensive to eat healthily than it is to eat junk food which, in that way at least, one can afford to feed one's children. Unfortunately, in the current climate, sometimes people have no choice but to buy cheap food because it is better than no food and people do not have the money to buy proper food.

Mr. Duffy can begin to deal with the questions and then I will call Dr. Foley-Nolan.

Mr. Gerry Duffy

None of the Deputies has mentioned the involvement of the parents and schools. If nothing else, can I implore the members to be aware it is incumbent on us to examine forensically children's school lunchboxes? The food children bring to school at a very early age is highly improper. I implore the members to ensure parents - because this starts with the parents - know what they are putting into their children's lunchboxes. That is very important. We in the South tend not to provide meals for schools while meals are sometimes provided for schools in the North. It is up to the parents to put into their children's lunchboxes what we believe would be right and proper and also that schools provide the right food via a tuck shop or vending machine. This is very important but we need to educate people. Sugar is killing our children and I implore this committee, as of today, to please recognise that.

From Mr. Duffy's experience, how manageable is the move to have sugar-free schools?

Mr. Gerry Duffy

In County Louth we have engaged with the De La Salle secondary school and a school in Ballapousta have asked us if we have a sugar-free flag to fly on its premises. That is something we would very much encourage and look into, but sugar-free food needs to be at the top of the list. I implore this committee to act as we are sitting on a time-bomb. This is very important. What is being put into children's lunchboxes is terrible and we need to address that as of now. I can hear that people are starting to worry and we need to do something.

Did I hear Mr. Duffy say that sugar is killing our children?

It is a wonderful suggestion to get that important message across.

Mr. Gerry Duffy

We all need to know this now.

Mr. Jorge Arroita

The summary is that too many calories means we will get fat, but carbohydrates turn the pressure on and if one's carbohydrate intake breaks fat down, one wins.

Deputy Billy Kelleher asked how we could engage children, parents and schools. One of the most important things is that people need to count carbohydrates, although I know it is hard work. I have a daughter with diabetes and all the time need to count the carbohydrates for her to know exactly how many doses of insulin she needs. The more carbohydrates one needs, the more insulin one needs. When one eats more food, the body processes more insulin and if one does not process all of the carbohydrates, they will be stored as fat. That is the reason we are fat. Reducing carbohydrates is the most important message of all.

It is important to show from an early age in schools how to cook and eat. Cadburys is producing a new chocolate bar with less than 100 calories and it will sell for 50p in Northern Ireland. It states it will be brilliant because people will be slimmer. That is false because all of these products contain more sugar. When there is less fat in a product, there is more sugar to make it more tasty. It is exactly the same in the case of salt and fat content. What we have to do is to reduce the intake of sugar of children in order that real sugar comes from vegetables. They will be processed better and one will have real sugar rather than the sugar contained in processed foods.

Dr. Cliodhna Foley-Nolan

I come back to one of my key points, that there is not a simple answer and that it is not about cutting down on one nutrient. It would be handy if it were; therefore, it is inaccurate and false - this has been shown over and over again - to say the problem involves one nutrient. We spoke a lot about parents and schools and they are important, but the food environment is crucial. Saying people should have wills of iron when they go to a supermarket is not realistic. We have to work with industry in having less processed food and having less temptation on every corner in order that people are given an even chance to purchase what is reasonable. The mumbo jumbo about adding this and that and less of this and the other to processed food is not based on science.

Deputy Denis Naughten's point is valid, which we have not addressed generically, that a propaganda war is ongoing regarding certain foods.

Dr. Cliodhna Foley-Nolan

Absolutely.

The Deputy is correct that one would need a PhD to go through the ingredients on labels in the shops.

Dr. Cliodhna Foley-Nolan

We have attempted by means of a campaign during which we used the term "superfoods" which has been used to describe items such as exotic beans to say we are talking about fruits, vegetables, lean meat, wholegrain and so on. These are the superfoods, as the Chairman said. However, it is not easy to counteract the marketing budgets of these industries. There are parallels with the tobacco industry and so on. They are also plying us with statements about products that they claim are healthy because they do not contain as much as X, although they contain more of Y and are convenient. For example, what could be more convenient: a chocolate, an apple or a potato?

Deputy Billy Kelleher referred to cooking skills and so on. The issue also arises from what children are seeing in the home or supermarket. If one walks into a supermarket, one almost needs an extra coat because there are so many rows of frozen readymade meals and other products. These items are being plied to us and our job is to counteract this as much as possible.

We spoke about the next phases. The Minister for Health has brought together in his Department a special action group on obesity, SAGO, of which safefood is a member. We always worked closely with the other organisations, but there is greater cohesion, which is welcome. I ask the committee not to get hung up on one simple answer. What we are talking about is a sustained approach on which we have been working on the past few years and on which SAGO is now working.

There is room for a Government statement on the matter. Several members referred to a sugar, sweet and beverage tax. It would not solve the world's problem, but there is evidence to show that it would have an impact. It would also be a statement from the Government to the population and industry that we need to get our act together and that this is a serious matter.

If one is a parent who works and has to collect three or four children from the child care provider or a sports event to bring them home, it is convenient to go to the fast food section of the shop to pick up a frozen pizza or meal. How can this mindset be changed? As Deputy Robert Troy mentioned, a sugar tax would act as a barrier. In saying one size does not fit all, how does one fit all the pieces to make it healthier for all of us to live and become sugar free in so far as we can, while allowing us the freedom to make our own choices? If I decide in the morning to buy ten Mars bars, that is my choice.

Dr. Cliodhna Foley-Nolan

Indeed. Being sugar free is not the answer, but being processed sugar free would make a considerable contribution. Having four children, commuting, etc. is no joke, no matter what environment one lives in. In that instance, it comes down to shopping and planning.

Awareness is the most important aspect. For months I have been saying it should start with parents at the kitchen table.

Dr. Cliodhna Foley-Nolan

It starts during pregnancy.

The first step is that when children leave the house in the morning with their lunch boxes, the parents have been educated about the food they should be given. We have to make people aware. Many in my constituency are looking for advice on weight and obesity. It is most important that when groups appear before the committee, they give us the facts and figures. In turn, we can give the correct information to the public.

I thank the delegates. I am sorry I was not present for the entire presentation.

I am a doctor and practise cancer medicine. In our field in the past decade there has been a greatly increased focus on diet and obesity. It is now appreciated that it is one of the great unappreciated risk factors for a number of cancers. Statistics have emerged which show that if there was a substantial reduction in the obesity rate, there would also be a substantial reduction in the incidence of cancer. Surprisingly, I have also seen data that indicate that if one has cancer, the chances that one will do better with treatment are higher if one is not obese.

It could be argued that it is, after smoking, the second biggest cancer risk factor our population is facing. The key factors appear to be calorie and fat intake and its metabolic effect on us. I speak with some personal authority in this regard because three or four years ago I made a concerted effort to talk to people about weight and counsel them in a big way. This is something cancer doctors often skip over. Of course, the fact that there are so few of us does not help, but it does work. Recommendations from doctors carry more authority than something seen in an advertisement on television. We need a major increase in emphasis on nutritional education in our medical schools, of which we have so many. We should try to do this.

I am now 25 kg lighter than I was ten years ago. I had reached a crossroads in my life and decided it was unhealthy to be so heavy. In fact, a brave young woman who was a patient of mine and a triathlete and raising funds for us said to me, "You know, you are very overweight. I don't know if you are going to save my life, but I am going to save yours." She forced me into a programme of exercise and diet. Sadly, she is no longer with us. Anne Burns was a wonderful woman whom I recall crying when I told her she could not take part in the run in a triathlon because she had secondaries in her spine. She was an extraordinary woman about whom we have spoken in public on many occasions.

The lesson I learned which may not sit with what the delegates are saying is that there is really no food that is dangerous if we eat it in moderation and that no food is safe if eaten to excess. Simply banning salt, sugar or chips would not work. We must get the message across that the total volume, multiplied by the number of calories, and the efficiency with which we absorb food are what make the difference. I am a scientist and hate being unscientific, but I have observed that many of my patients who are middle-aged ladies with breast cancer and have weight problems never eat sugar. They made a decision to give up sugar in tea and coffee and do not eat cake or chocolates, but they cannot understand why they are fat. When I ask what they have for dinner, they tell me they eat healthily and have a little chicken and potatoes. I then discover they are having a great bowl of carbohydrates - either potato, rice or pasta.

We have a much bigger job on our hands. I have not got my head straight on whether we should have a sugar tax or a fat tax. I am not sure about this.

That will be part of another day's debate.

I understand that. However, part of me thinks that if someone is responsible, not terribly well off and likes to take their kids out once a week for a meal at McDonalds, that is not so bad. The problem is with people who are doing it on a daily basis or three times a week and are not giving their kids a balanced diet. Why should we punish the person who has an occasional hamburger by making him or her pay more for something that is not causing a problem?

The main thing we need is educational and health intervention. The presentations contain pictures of people having their waists measured. We need to start doing this for schoolchildren. We need to take in children for nurse-led health screening where they will be weighed and measured and if they have a clearly defined obesity problem, the alarm should go off and there should be interventions. We need this and an educational job on our professions.

Will the delegates comment on the current status of the review and where the Stop the Spread campaign is at?

Recently a medical consultant told me about a parent who had presented with a child who was overweight. They examined the lifestyle of the family and discovered that the child who was aged 16 years and very overweight did not get up until 2 p.m. When the doctor advised what the family needed to do, they simply did not want to hear it. There seems to be a problem where some parents insist that it is everyone else's problem but their own, no matter how much information is put before them. They cannot accept that the issue is not only one of food but also of exercise and lifestyle. Schools are proactive, but parents need to be convinced that they must be involved at an early stage to make sure the problem does not reach the stage where medical advice is required. There seems to be a problem in getting that information through to children and parents.

Dr. Cliodhna Foley-Nolan

I will answer two points briefly. Deputy Caoimhghín Ó Caoláin referred to the Stop the Spread campaign. There is a lull, which is a source of professional disappointment and we hope the matter will be sorted out as quickly as possible. The next phase we were planning was to work on increasing parents' awareness of childhood obesity. We started with adults because adult obesity is less contentious.

This brings us back to Senator Colm Burke's point. This is a delicate and sensitive issue and it is easy to see education and responsibility as the solutions. A person who has had a heart attack or a diagnosis of a serious illness will be much more amenable to lifestyle changes. No one wants to be told his or her beautiful eight year old or preschooler who is a little overweight has a health problem. This does not come easy for parents. We need to normalise the measuring of weight and waist sizes in order that it is not seen as a criticism or an insult. It should be the same as having a child's eyes checked.

At what age is it appropriate for that intervention to start? I know there are programmes on food awareness in the community and tackling food on a low income. At what age is it appropriate to go into a school and say action needs to be taken?

Dr. Cliodhna Foley-Nolan

The Chairman is still missing the point a little. Those community and preschool programmes are conditioning parents to see that they need to be health aware in the same way as they need to be aware of children's hearing. Everyone knows a hearing problem will affect a child's speech and learning at school, but health awareness is still under the radar. We are working towards its normalisation, and then screening. They have to be hand in hand.

I have battled with weight all my life. I weighed nearly 15 stone when my GP told me I was heading for diabetes. We have all done safefood, Weigh2Live and "Operation Transformation" programmes, but it was not until I was told by my GP that I was heading towards diabetes that I realised I needed to cop on.

Dr. Cliodhna Foley-Nolan

Without personalising it unduly-----

I have battled with weight all my life. I live on my own and do not cook for myself. I eat in a carvery, buy a pizza or fast food or have a sandwich. There are families who are on the move 24 hours a day and seven days a week. How do we tell them they must cook and be health aware? Everyone is busy now, no matter what he or she does. I agree that families must be convinced of the need to eat healthily, but some parents simply do not get it. How do we make that happen?

Mr. Gerry Duffy

There was a reference to availability. We need to give people choice. A child will choose a Mars bar over a sugar free bar, unless the healthier item is at the right price point, tastes good and we give it to them where they can get it. Education is vital.

I have to be careful how I ask this question, especially with the media present, because I am conscious of public health issues. Does Dr. Foley-Nolan have any concern that the possibility of causing eating disorders through being conscious of weight made people shy away from the issue of addressing children's weight? I have a personal professional perspective on this. I think we became neurotic about dealing with the subject of weight, especially with young girls but also with young boys, in case we drove them towards anorexia. Does Dr. Foley-Nolan have a comment on this? Was that a valid concern, because I have my doubts about it?

Dr. Cliodhna Foley-Nolan

It is an important issue and also part of the stigma, denial and sensitivity. We considered it when we were conducting the Stop the Spread campaign. It was aimed at adults, but, like lots of television programmes aimed at adults, it did not stop children watching and thinking.

We did a lot of research on whether there was evidence that educational and awareness programmes were promoting or in any way triggering eating disorders and the evidence is that it is not an issue. One of the other challenges we have is that parents of teenage girls or girls going into puberty, in particular, tend to shy away from this. The fear has probably been overstated. Basically, eating disorders are a psychological issue. All the excellent voluntary agencies and support agencies say that it is a control issue that will come out in this way. It is another thing we must work with. We are working with the voluntary agencies and get them to check out the things we say to ensure they are happy with them and see them as positive and constructive rather than negative in any way.

Mr. Jorge Arroita

We were talking about education in the early years. I have two children aged seven and five. My children cook for me on most days. I showed them how. Playing with food is a game as well. One of the things one can do is spend 15 or 20 minutes in the school once a week to show children how to make dinner. When they come home they can cook for the parents. Trust me, it is not hard to do.

Second, sugar-free schools not a solution, but will help. This has been proven in Sweden, Hungary and Russia which have been doing these types of things. It has dramatically reduced obesity in children, the visits to the school nurse were reduced, disciplinary problems were reduced, there was improvement in test scores and lower absenteeism rates. Another thing is eating sandwiches and pizzas all the time. That is all carbohydrates. The more carbohydrates one eats, the more fat one gets. There is no fat in Coca Cola - it is sugar. What will happen if one drinks plenty of Coca Cola? One will obviously get fat. That is a problem for the American people.

Will the witness address Deputy Ó Caoláin's point about the North-South aspect?

Dr. Cliodhna Foley-Nolan

My understanding is that a final and formal decision will be made at the North-South Ministerial Council. We are optimistic. A review is a good idea as a review can produce very positive results. That is our hope. Of course, it is a little undermining and disappointing that this has taken a long time.

Are you hopeful that we can get the message across that there is a better way of eating and a better lifestyle choice with healthy exercise?

Dr. Cliodhna Foley-Nolan

We know from the evidence that we are getting the message across. However, it is a slow burn. That is why we need all the encouragement and support we can get from the committee in terms of policies and adequate funding, which we have. We should be let get on with the job.

Would you support the concept of a sugar-free school? The Minister for Children and Youth Affairs, Deputy Frances Fitzgerald, recently raised the issue of planning restrictions in areas around schools in respect of fast food outlets and so forth. What is your view on that?

Dr. Cliodhna Foley-Nolan

With due respect to the people on my right, they have a product which has a certain market. I do not see schools as a market for it primarily. It is, perhaps, for people with diabetes. One is still talking about all processed carbohydrates. It is not as if one has food that has some fibre in it such as fruit. If one eats sweet things in the United States, although they might be low in sugar or sugar-free, they are even sweeter than they are here. In a way, therefore, one is substituting one sweet for another, albeit that it no longer has the calories in it.

Mr. Jorge Arroita

One is getting the fibre. Healthy products are sugar-free products. They do not produce tooth decay, they are fat free and they taste fantastic.

The other difficulty, which Senator Crown mentioned, is the issue of body image. It is a growing issue for young men as well. Young men are becoming fixated with the six-pack, the buff body and the image of being the super-cool hero.

Dr. Cliodhna Foley-Nolan

Yes, they are taking supplements and so forth.

How harmful is that?

Dr. Cliodhna Foley-Nolan

There will always be fashions. Whether protein supplements are a challenge is a different subject. While they are inextricably linked, the issue is to try to divide cosmetics from health. There is the appearance issue, but that can be played on to some extent to encourage positive behaviour. On the other hand, certainly from a parental and health service point of view, our focus would always be on the health issues. Confidence comes into it, and looking and feeling well are important. However, we must also think of what is happening in the internal organs.

I thank the witnesses for their attendance. On a personal level, I thank Ms Fiona Gilligan who is in the Visitors Gallery. She is the director of marketing and communications for safefood. She was the liaison person with Members of the Oireachtas for the Weigh 2 Live campaign and with Operation Transformation. She has done trojan work and I thank her for that. One of safefood's most successful campaigns, as well as the Weigh 2 Live, was the "Take On the Takeaway" challenge on television. That showed one could beat the takeaway in terms of the quality of the food as well as the cost and time.

Dr. Cliodhna Foley-Nolan

The thing about time is that we all prioritise our time. There are 24 hours for each of us but life is busy as well.

I thank all the witnesses for presenting a challenging opportunity to us. The issue of sugar-free food and a reduction in carbohydrates is one we must examine and deal with. It is important that in the course of our debate we arrive at a policy that will allow us to tell a generation that it can live healthier and longer and need not be as dependent on fast food as is the case now.

The joint committee adjourned at 10.40 a.m. until 9.30 a.m. on Thursday, 11 October 2012.
Top
Share