Childhood Obesity: Statements

The levels of overweight and obesity have been increasing despite the fact they are preventable. Childhood obesity and emerging inequalities are now recognised as key issues which need to be addressed. In fact, childhood obesity is reaching alarming proportions in many countries, which has the potential to negate many of the health benefits which have contributed to increased life expectancy.

One in four schoolchildren and one in five teenagers are now overweight or obese which can affect their immediate health, educational attainment and quality of life. Obesity carries a stigma in childhood and may be linked with bullying. Children with obesity are likely to remain obese as adults and are at risk of chronic illness. The Health Service Executive’s childhood obesity surveillance more recent data indicate that rates of overweight and obesity have shown decreases at age seven and stabilisation at age nine. However, the overall incidence is still a cause for concern.

Overweight and obesity are significant risk factors for many chronic non-communicable diseases. The links between obesity and heart disease, stroke, cancers, type 2 diabetes, mental ill-health, respiratory problems and musculoskeletal conditions are well established. These chronic conditions account for approximately three quarters of primary care visits and hospital admissions. To tackle the growing problem of obesity in the population in general and children specifically, the Minister for Health, Deputy Harris, and I launched A Healthy Weight for Ireland: Obesity Policy and Action Plan 2016-2025 late last year. It sets a short-term target for a sustained downward trend in levels of excess weight in children and a reduction in the gap in obesity levels between the highest and lowest socio-economic groups by 10%.

The obesity policy is the result of the Government’s desire to assist people to achieve better health and in particular to reduce the level of overweight and obesity, thus enhancing their quality of life. It has been informed by a comprehensive consultation with major stakeholders, health experts, health care providers, children and young people. The policy covers a ten-year period up to 2025. The vision is to turn the tide of the overweight and obesity epidemic. The overall aim is to increase the number of people with a healthy weight and set us on a path where healthy weight becomes the norm.

Obesity is a complex problem with nutritional, activity related, psychological, biological and social determinants. Consequently, any realistic solutions must be multifaceted and be implemented as part of a suite of measures. The obesity policy adds to the comprehensive suite of policy and legislation developed under the Healthy Ireland policy. The policy acknowledges the importance of an integrated approach across the Government to tackle the social determinants of health and well-being, and in particular those which contribute to health inequalities in the population.

No single sector or agency is able to solve this issue on its own. Individuals and families need to be supported to make informed choices in healthy eating, being physically active in order that they can achieve and maintain a healthy weight. The obesity policy and action plan strives to empower individuals, families and communities to enhance their own skills to improve their health. Many of the actions outlined in the obesity policy have already been commenced. For example, the Department of Health has published a working paper to inform consideration of a sugar-sweetened drinks levy from a health perspective. The policy objective is to reduce rates of childhood and adult obesity in Ireland by reducing the consumption of sugar-sweetened drinks, particularly among young people. The Department of Finance has consulted on its introduction in 2018.

Preparation of legislation on calorie labelling to help educate the general public on the calorie content of food portions is ongoing. A voluntary calorie posting scheme in existence since 2011 has been evaluated and a public consultation also took place in 2012. The results of both the evaluation and consultation are feeding into the development of the legislation.

Work will commence in 2017 on a new proposal for a nutrition policy and action plan. A working group has been established to develop a code of practice on food advertising and promotion, including product placement and sponsorship. It is anticipated this work will be published in 2017. A food reformulation working group is being established to reduce the sugar, fat and salt content of foods and beverages, in line with the EU food reformulation project. In the HSE, the new clinical lead post for obesity is currently being advertised. The healthy eating-food pyramid guidelines have been updated by a multi-agency working group, lead by the Department of Health, and were launched in December 2016.

In addition to these measures, what we do in our homes, schools and communities to help build healthy habits for all children and families is vital to childhood obesity prevention efforts. These healthy habits are critical in helping those children who are a healthy weight now to stay a healthy weight, while those who are overweight or obese achieve a healthier weight as they grow and develop. The key healthy habits are to reduce portion sizes, eat plenty of fruit, vegetables and salad every day, manage treat foods, replace sugary drinks with water, make being active fun and part of every day; have less screen time and encourage more sleep.

Last year, I launched the healthy food for life campaign, which contains as an important message four of these key healthy habits. The campaign involved several stakeholders, particularly the HSE, which co-funded the campaign materials. In 2016, the health and well-being division of the HSE established the healthy eating active living policy priority programme. Its remit is to mobilise the health services to improve health and well-being by increasing the levels of physical activity, healthy diet and healthier weight across services users, staff and the population as a whole, with a focus on families and children. The programme co-ordinates and drives the implementation of a series of evidence-based actions across the health services and with external partners to strengthen capacity to promote healthy weight and prevent childhood obesity.

Three out of five adults and one in four children are overweight or obese. The unfortunate truth is that, as the World Health Organization has predicted, Ireland is on course to become the most obese nation in Europe by 2030 unless we take action now. Tackling childhood obesity is a key priority for me as Minister of State.

We are very supportive of the action plan. The Minister of State has been before the House previously to discuss her plan, and what is contained in it makes quite a lot of sense. Some of the figures she has read out are amazing. One in four Irish children is overweight or obese. Two out of three adults are overweight or obese. The cost to the State of overweight and obesity is approximately €1.13 billion annually, directly and indirectly. The WHO has forecast that Ireland will top the European obesity league table in the next few years. As the statics really jump off the page, it is about time a Minister decided to tackle this worsening issue.

Fianna Fáil supports the development of a national plan for physical activity. In this regard, I notice there has been much talk recently about exercise in schools. I have a brother and sister who are PE teachers. It is amazing how certain habits start at home. The number of kids who come to PE class with notes and have excuses to try to opt out of PE is very frightening and has become a greater problem over the past number of years. Parents must examine this and take it seriously. There are evidently certain circumstances and cases in which people, for whatever reason, may not be able to swim or engage in a certain physical activity, but this seems to be becoming more prevalent. Schools play a very important role in tackling this because school is where many of our younger people either will or will not get a grá for physical activity. This is a very important starting point.

Fianna Fáil wants a 20% tax on sugar-sweetened drinks, as we have proposed previously. It would generate approximately €60 million in revenue. Fianna Fáil wants to see an expanded prohibition of TV advertising of high-salt and high-sugar foods, as the Minister of State will be aware, and as we have discussed. We also wish to promote active travel, such as cycling lanes and safe walking routes to school, among the population generally. We had started to roll this out and, in fairness, it has been continued by Fine Gael over the past number of years. We wish to target resources at schools and communities of lower socioeconomic standing. In this regard, better education in particular will be very important. So many foods can be so much cheaper and easier to use. The easier option may not be cheaper, as we could prove by examining the cost of much fresh fruit and so on but it does not end up being cheaper as in the long run, it will cost the State a lot of money. Education on food and exercise is therefore a very important tool. There is no national standard to measure what food is healthy, tasty or nutritional in secondary schools. Primary level is also very weak in this regard. Fianna Fáil wants specific planning protocols to create no-fry zones in the vicinity of schools. I remember from my time on the council that schools were always taken into consideration when it came to public houses, bookmakers and fast food outlets but it amazes me nowadays to see some fast food outlets are getting planning permission in close proximity to schools. It really is incredible. This is a very important area as well.

Fianna Fáil is disappointed that the issue of vending machines in schools was not examined. If there are to be vending machines for snacks, what could be included in them? Again, fresh fruit and better options are a must in any vending machine in a school. This would have to be implemented. We wish to see the school meals programme extended in disadvantaged schools and non-DEIS areas. As we know, immense work has been done on the DEIS areas over the past number of years but many schools teeter on eligibility for DEIS status and the roll-out of proper meals in these disadvantaged areas would be a great help.

Some of the figures the Minister of State has read out have been shocking. As I said, one could mull through the different figures and facts all day and one after another would cause surprise. In this regard, Fianna Fáil has been happy to support the action plan. We talked about it in the House the other day as well. The Minister of State has our support. I hope she will take into consideration the few recommendations and alterations we propose regarding the involvement of schools and exercise, vending machines in schools and education on foods. These are very important. As for the marketing and advertising end of things and what can be done in that regard, we believe a sugar tax is a prudent way forward. It has been talked about for quite a while and has been kicked around but we believe now is the time. It could be rolled out on a small scale and see how it goes from there. We saw even in the past few days the problems caffeine drinks and added-sugar drinks have caused, with the death of a young chap very recently. We believe this is an area that must be clamped down on. The reality is that younger people are being told lies through marketing and advertising campaigns, such as the advertisements for a drink that says it gives you wings and all sorts of rubbish.

We appreciate the Minister of State's presence. She has been a big advocate of this since her first day and, indeed, we talked about it I think on St. Stephen's Day or the day after when we met in the studio of Radio 3. She spoke about the roll-out of it then and she has been good to her word.

Sometimes I get a little fed up being here. We are not passing legislation. We are just making statements. We should spend our time introducing legislation, and legislation such as this is so important for our future, our young and their health - not just their physical health, but also their well-being.

I have to hand it to the A Healthy Weight for Ireland document. I have gone through it but it fails to set meaningful targets that would actually do something. It is much more positive on measures to tackle childhood obesity. Yes, we should reduce obesity levels - that is a given - but I am not confident the required measures are in this inspirational roadmap laid out for our children. I acknowledge the key actions grid towards the end of the document, but actions must be directed towards those groups which the report itself states are most at risk, such as those living in disadvantaged circumstances, as stated clearly on page 13. The Department of Health stated that there is currently no grant scheme to support community initiatives to promote healthy living initiatives. Strategies become dust-collectors on shelves unless one involves local communities and hands over to them the power to work on them and have ownership of them. Can this be done without adequate resourcing? That we should develop this whole-school approach to healthy living is a great sentiment but who will foot the bill? The teachers? No. The parents? Definitely not; they are overburdened.

However, we should not waste any time making this legislation. I offer a suggestion to the Minister of State. Action point 1.9 of her strategy seeks to develop proposals for a levy on sugar-sweetened drinks, while action 1.10 examines other fiscal measures to reduce unhealthy food consumption. Sinn Féin's pre-budget submission on a sugary drinks tax and the proposals we put forward in this regard came nearly a year ago. There should be a 5% sugar-sweetened drink tax, and the revenue from that tax should be reinvested to promote healthy lifestyles. The proposal was not about punishment or increasing the cost of such items for revenue creation, which would be felt, of course, mostly by those in lower-income families. Rather, it was about deterring certain behaviours and the consumption of these unhealthy drinks altogether. In an ideal Ireland, revenue from the sugary drinks tax would be extremely low because we would see children drinking water in our schools and homes.

Yesterday, I visited my alma mater St. James's national school in Basin Lane, Dublin 8. It was the first to achieve the Early Focus project in this fairly disadvantaged area. They described the project to me as being about physical and mental well-being. They bring the children in and many of them may not have had breakfast. The project allows for breakfast and they are teaching the children to love water. It is difficult for a child, who has probably been brought up with the blackcurrant and orange squash and the fizzy stuff, to appreciate and love water. Once they do, they find themselves a lot more alert and more able to listen. They are more confident also. I recommend that the money we could save from sugary drinks to go into that sort of project and roll it out across primary schools. It has done wonders at the St. James's school and they have the achievement award to prove it. They are the first in the country to do so. I am immensely proud of them.

When we consider the resourcing, we could look at what is being done in Britain. Income from their sugar tax will be ring-fenced for school sports up to 2020, as well as being used to expand the numbers of breakfast clubs and to fund some schools. Perhaps the Minister of State could explain why she allowed the money that could be saved to run away from her. If we implement the school sports programmes and the healthy breakfast areas, it would result in positive changes in the trends for childhood obesity. One cannot increase the price of something without offering an alternative. With a choice between an unhealthy breakfast and nothing, one will stretch for the unhealthy option. If we really want children to eat better, we must reinvest the tax and offer them an alternative. We are not pioneering in this respect; there is precedent in Britain and in Mexico. Mexico had a higher rate of childhood obesity than the United States of America, which is astounding, and it passed a sugar tax that will be reinvested into health promotion. They recognise that the potential for economic harm from reduced junk food and soft drink sales is now insignificant compared to the damage that will be done in ten years if they did not invest in this way and if they allowed obesity to continue. One of their core reinvestments will be ensuring that every school has fresh drinking water for pupils. We have water in abundance here. If we make it more expensive to buy sugary drinks, we must reinvest to provide water. We must commit and pledge to provide fresh, clean, accessible drinking fountain in every school across the State. This type of proactive taxation and reinvestment is the only model that will work to tackle childhood obesity.

Unfortunately, the Minister for Finance, Deputy Noonan, has already decided that the sugar tax will be reinvested somewhere else when it is introduced next April. I do not know where that somewhere else is going to be. If we do reinvest the funds elsewhere, the tax that could have been saved, we might consider the ordinary families who struggle with their obese children and who try to find motivational coaches. There is a privatisation of that sort or agency that takes their money and tells them they will take the weight off their child or teen. If we really want to tackle obesity, we need to generate a revenue to streamline it directly into dealing with it. If we tax the 5%, we have something to reinvest in promoting healthy living for children. The WHO report was published today and it is quite astounding. Some 200,000 adolescents and children worldwide were asked about their lifestyle in questionnaires. The report shows the amount of time they spend in front of a screen, the amount of time they do not engage socially and the time that they do not exercise their bodies and their brains. They do not get to use their imaginations in playgrounds, chatting to their pals or making up games when time is spent on one screen and when that is their view while buried in that screen. It is quite alarming.

Perhaps the Minister of State will also comment on what was described earlier during the Oireachtas Joint Committee on Transport, Tourism and Sport. The committee heard that a large meal could be as dangerous as the impact of alcohol on driving.

I thank the Minister of State for coming forward on this matter. It is a major challenge in this State. The former Senator Eamonn Coghlan, who has a lot of experience around physical activity, always raised the issue of physical activity in schools. We have much work to do in the area of physical activity for children. People have better energy levels, improved self-esteem and mood when they engage in physical activity. We have a major challenge where we have the whole knock-on effect of overweight people and obesity. Four in five children in Ireland are not meeting the guidelines for physical activity. In Northern Ireland, it is three in four children. People slip into situations where they do not have enough physical activity. A survey has shown that the average amount of time that pre-school children spend watching television daily is 2.2 hours.

Some of the issues have changed. Consider, for example, the simple activity of getting to school. In 1981, some 50% of children walked to school. I know there are risks associated with children walking to school but when they do not walk to school, the activity is removed. By 2014, walking to school was done by only 25% of children. This is a change and we have not made up for that in relation to physical activity. Eamonn Coghlan had strong views around how we can change this within schools. Once children see their classmates involved in an activity, they too want to become involved. This is something we could keep in mind.

On obesity and children who are overweight, I was speaking to a medical practitioner who gave a talk to GPs. The issue was raised about how GPs discuss it with parents. GPs said that they would not bring up the issue of their child's weight with parents. One GP gave the example that when he did bring it up with a mother, she left the practice altogether, along with her husband and children just because the GP raised the issue of her child's weight. We need to be careful how it is approached. For example, 54% of parents who had an overweight child were not aware that their child was overweight. Some 20% of parents with an obese child were not aware that their child was obese. There is a huge learning process to go through and we need to work on it.

Moving on from schools and parents, sometimes questions need to be asked about the food we provide in our hospitals and the services in our health care sector and if the food is meeting the criteria for healthy living. People in many hospitals are getting very proactive in rolling out meals. Hospitals have been asked why they serve chips and they reply that this is what the patients want. What the patients want may not necessarily be for the benefit or in the best interest of the patient. In fairness, hospitals are beginning to look at this issue. It is about giving new ideas to people when they are away from home and to show them there is a healthier way of living and it is about food. There is also a need for the issue to be very carefully managed when it comes to children in hospital. Careful management is also needed around what is offered in vending machines in schools, or in any facility, and whether it is healthy eating. Some schools have been very proactive about withdrawing vending machines.

This is despite the fact that they were good income earners for schools. We have a lot of work to do and there are many areas to tackle through our education and health systems. We have to involve medical practitioners, community nurses and many other people in a programme to tackle childhood obesity.

In my constituency, Cork North-Central, where income levels are not very high, there is a proactive programme which involves parents. In one family, the first two children are into crisps and fizzy drinks but the parents got involved in an education programme and realised there was a better way of looking after their children. As a result, the third child is focused on eating fruit and other good food and this has made a huge difference to the parents. I sometimes wonder if our education system leaves out areas related to living and lifestyle. The youngballymun project and the Knocknaheeny project in Cork have made huge progress with parents in healthy eating and in living better and longer lives. The benefits of eating healthily go to parents as well as their children and it is important that we focus on all these areas.

I appreciate the support we have received from Healthy Heart, which makes a number of points on the gap in policy, food in schools, marketing to children and families on low incomes. It states that school food accounts for a growing proportion of children's food intake but is not subject to any national guidelines or standards, despite the identification of obesity as a major threat to the current and future health of this generation of children. The haphazard approach to food provision also extends to the State-funded school meals local project scheme and the school completion programme. It states that these are excellent programmes but that they incorporate no mandatory requirement for the supply of healthier food options or for monitoring the quality of food provided. The most recent step in the organisation's fight to protect children from obesity is a petition - Stop Targeting Kids - aimed at the marketing of foods which are high in fat. A report published by Irish Heart last summer, Who's Feeding the Kids Online?, exposed how junk food companies are targeting children in a much more individualised way online than they ever could through television advertising. High-tech analytics are used to target children, which is both insidious and very dangerous.

We have to realise that many people live on low incomes but the most recent results from the childhood obesity surveillance initiative, COSI, reveals a higher level of overweight and obese children from lower socioeconomic backgrounds such as those attending DEIS schools. We have to respect people who have a disposition to obesity, as we do people who are actually obese, and it is important not to apportion blame in these areas. These things have to be challenged but it must be done respectfully. Food is fuel for life - our mothers knew that. They did not have to go and read it somewhere to find out. It is fuel for our bodies, our minds and our spirits. Food is not a commodity to be traded. It is the life, soul and health of a nation and its children and adults.

It is also important not to see this as a First World problem rather than a Third World problem. Third World problems are characterised as situations where people do not enough food on which to live because they are forced to produce cash crops and sell them to get hard currency. I do not accept that. This is has been allowed to become a problem in the First World because we have not treated food as a necessary ingredient in being healthy, rather we have treated it as a commodity which we can have as we please.

At the end of June last year, Brexit hit us out of the blue. There is no way anyone can say that childhood obesity has come out of the blue. We have known for decades that this was the direction in which Ireland and other countries around it were moving. I have spent my life working in the area of disability and I know where obesity leads. It gives rise to a range of conditions such as diabetes, which is next door to stroke, amputations and eye problems among others. Ministers say they would love to be able to do more for people with disabilities but do not have the money. This issue is about stopping people developing disabling conditions and it has to be seen as a major investment.

There has been a complete cultural change in respect of this issue and there is an increased awareness of its seriousness. The Minister said that tackling obesity in childhood is a key priority and I do not doubt that. I do not believe there is anybody in the Oireachtas who does not believe it is an issue for children and adults, though some Members have differing views on climate change. However, we need to get serious about how it is dealt with. Cultural change is one of the ways. Supporting good behaviour, such as with "no-fry zones", is another way of dealing with it, as is involving communities in schemes such as getting kids to walk to school. Education is another area to focus on and public planning plays a huge role. The planning of the past has happened, however, and we have a contest between roads and the ability of children to walk safely to schools, which is an issue that we will not solve overnight.

At the beginning of the Second World War, the people of Britain were told that they would starve if they did not double food production.

They appealed to the farmers of Britain to increase production. Farmers, whether they are in Britain or Ireland, if they can produce more and sell more, they are up to the challenge. Their reply was that they could not produce more. However, they finished up doubling their production. The point is that if one has to do something, one will find a way to do it.

Child mortality in Britain after the Second World War and after rationing and all that went with it had been significantly reduced from pre-war levels. Let us think about that. Food was being rationed, but it was rationed in a way that women and mothers got the milk and children got the nutritious food. A major effort was put into educating families. We have to declare nothing short of a war on childhood obesity and take control from the hands of those driving the market.

I thank Senator Dolan. I know this is an issue that our next speaker, Senator Catherine Noone, who has paid particular attention to it for many years. The Senator has five minutes but I will try to be as generous as I can.

I thank the Chairman. I welcome the Minister of State at the Department of Health, Deputy Marcella Corcoran Kennedy, to the House. I have had many conversations with her on this issue. I have long been a voice on the issue of obesity, in particular childhood obesity, not least because of personal experience.

The prevalence of obesity has rocketed in Ireland in recent times, with 61% of adults and 25% of children currently overweight or obese. There is no disputing that obesity is a major public challenge. I agree with Senator Dolan's points in this regard, particularly in regard to diabetes, cardiovascular disease and the significant burden it places on the individual first and foremost and on health spending. One of the most recent reports compiled by the World Health Organization, WHO, on the issue predicted that Ireland was on course to be the fattest nation in Europe by 2030. As the situation stands, 61% of adults are either overweight or obese. With one in four primary school children either overweight or obese, we are on track to have more obese adults in time.

According to A Healthy Weight for Ireland - Obesity Policy and Action Plan, the prevalence of overweight and obese children was higher in schools in disadvantaged areas than in other schools. I think that is well known. In most deprived areas, just over one in four people aged 15 years and over is obese compared with fewer than one in six in less deprived areas. The direct and indirect cost of obesity is estimated at approximately €1.13 billion. As has been highlighted by several experts in recent years, sugar consumption is one of the main culprits, not only for obesity but in the level of tooth decay. The level of tooth decay has been described by Dr. Anne Twomey, vice president of the Irish Dental Association, as catastrophic. An alarming number of young children and babies are developing cavities and decay at a very early age. According to a report from the Royal College of Surgeons in the United Kingdom, extractions among children under the age of five years has risen by almost 2,000 a year in the past decade. Experts say a combination of poor diet and too much sugar is to blame. Ensuring sugary drinks and foods that are targeted at children are more expensive is one way to prevent tooth cavities and childhood obesity.

Although I have warmly welcomed the introduction of the obesity policy and action plan and commend the Minister of State's work in this area, I believe more can be done. I agree with the point Senator Dolan made that this is not a problem that can be cured overnight. I was a member of a delegation that went to Amsterdam recently where they are ahead of the curve on this issue. One of the things I learned was that it takes patience to sort out this issue. It will take years, it did not happen overnight and will not be solved overnight.

While food served in schools accounts for a growing proportion of children's food intake, it is not subject to any national guideline or standards, despite the identification of obesity as a major threat to the current future health of this generation of children. The haphazard approach to food provision also extends to the State-funded school meals local project scheme and the school completion programme. These are excellent programmes in many respects but incorporate no mandatory requirement for the supply of healthier food options and there is no monitoring of the quality of the food provided.

The Irish Heart Foundation conducted a survey in 2015 on food provision in post-primary schools and examined what second level students were eating, models of food provision and whether national standards are needed or wanted by school authorities. The research found that 37% of schools offered full hot meals and 30% offered cold snacks such as sandwiches. Nearly 70% of schools offered hot snacks, including sausage rolls, pizza slices and paninis, all calorie-laden stodge. A quarter of schools have tuck shops and 47% had vending machines, when we know the problem we have with this issue.

I agree with Senator Dolan's point on the marketing of foods high in fat, sugar and salt to children in the digital media and on television, but also in non-broadcasting media such as commercial sponsorship in schools and codes of practice in shops. The "Stop Targeting Kids" petition is the latest step in the Irish Heart Foundation's fight to protect children from obesity, following research published last summer. In that report, it was exposed how junk food companies were deliberately targeting children in a much more individualised way online than they ever could through television advertising and using high tech analytics to target children. These analytics should be used in reverse. We should ensure companies promoting these products actively avoid children.

I will outline what can be done. We need to ban television advertising, product placement and sponsorship of food and drink. We need the introduction of a statutory regulatory system for online and digital advertising. We need to designate schools as protected environments, free from all forms of marketing, and develop a code of practice to control placement of unhealthy foods at toddler and child level at supermarket checkouts, and in fairness retailers such as Tesco have taken a responsible approach. We need to restrict the sponsorship by food companies of children's sporting events and limit the provision and sale of fatty snacks.

The Government has a duty to support disadvantaged communities to realise the benefit of family food incentives because disadvantaged communities have the highest levels of obesity. Considering ways of making healthy food accessible and affordable for people on low incomes has to be a priority. Actions to address the social determinants of health and to reduce health inequality, such as incorporating health impact assessments and health equity impacts, is a necessity.

With regard to obesity during pregnancy, a study conducted by the Best Start Resource in Canada has identified maternal obesity as a strong risk factor in the odds of offspring being overweight at aged seven years. This has been shown to increase by 3% for every kilo over the recommended weight gain guidance of the expectant mother. This is startling. I will write to the Minister on the positive measures.

I commend the Minister of State on her work. We have a long road ahead in dealing with this issue.

Senator Noone is passionate on this subject. Well done to her as she got to speak for seven minutes. It is now 6.18 p.m. and the Minister is supposed to be called at 6.22 p.m. I advise Senator O'Sullivan that Senator Buttimer wants to try to contribute as well.

I appreciate that point and I will rush through my contribution as quickly as I can.

I thank Senator O'Sullivan.

It is great to see the Minister of State, Deputy Corcoran Kennedy in the Chamber. We are hearing of the growing problem of childhood obesity and the ways in which we might begin to tackle it. The issue is complex, with part of the problem being access to good nutrition and part being a balance of physical activity. I would like to focus on girls and young women's lack of involvement in exercise and sport, in particular the drop-off rate in activity that seems prevalent among girls as they go through secondary school. This gender difference has serious consequences for the lifetime health and well-being of these young women and girls.

I am a mother of three girls and I have always been interested in and engaged in sport and other physical activity, especially surfing. I still enjoy teaching young people to surf on my native strand in Tramore.

I can see the fall-off in interest among girls and young women from the age of 14 up to 18 years. The emotional and social pressures of puberty and school life as well as the big picture social pressures from magazine, popular culture and their own peer network seems to orientate to one thing, that physical activity, organised sports in particular, are not things that girls in their teens are meant to be engaged in.

One of my daughters went through this phase, being interested in surfing and other sports one day and dropping them when she was in first or second year in school as social pressures tilted against her. Cycling to school is a case in point, the recent census at school project, a small survey of the travel and life patterns of young people in Ireland, showed that for every nine boys cycling to school, only one girl does so. That is an extremely low base, for example, only 1% of students in Waterford cycle to school. Young women have the desire to be healthy, but they are being held back from one of the easiest and most obvious ways of staying fit. In The Netherlands, a majority of students cycle to school, and there is a considerably lower level of childhood obesity there. This is a serious loss for our young women, and for the health of our country. Luckily, my daughter has returned to her sporting ways, and is now the secretary of the National University of Ireland, Galway, NUIG, surfing club. Many young women, perhaps most, however, do not and instead choose to focus on a much less balanced approach to health that affects their food intake and neglects exercise and physical activity. This has long-term consequences for their health.

What is at the root of this problem? Why are young women losing interest not just in competitive sports, but in other forms of physical activity, and what can we do to address it? We know anecdotally and from observation that a central part of the problem is that sports are not considered cool, or even socially acceptable as an activity for young women and girls to engage in. These social pressures are extremely difficult to quantify, but they are strong and self-reinforcing. They are supported and expanded through public pressures from media, and also through gender stereotypes and media focus. We saw only recently the Football Association of Ireland, FAI's, attitude towards Ireland's women's soccer team, that women in sport, and women's sport, cannot expect the same profile, coverage or benefits as those given to their male counterparts. Stereotypes about the role and behaviour of women are also to blame, and harder to tackle.

I hope the Minister of State will consider some of the following in her approach to the issue of obesity under discussion today: we need to understand the various reasons behind the drop off in interest in sports among girls aged between 12 and 18 years. To do this, we need to hear from this age cohort, through expanded surveys and feedback from experts, teachers and parents. We need to identify those aspects that are readily addressable, and those that are part of the more global issue of female self-image and gender stereotyping. We need to deliver physical activities in schools and community settings that are tailored to be enjoyable and attractive to girls. One of my daughters went through this phase, as I said. We need to incentivise a more positive approach to physical activity. Cycling to school is a good way to start. Car free zones around schools is a good policy response to get people walking to school and we need to look at the big picture to alter the way young women think about what it means to be a woman today, and help foster an image of engaged and healthy activity as part of a balanced lifestyle.

I thank the Senators for their very useful thoughts and observations on childhood obesity. I acknowledge their support for what the Government is doing to tackle this problem. It is extraordinary for us now, and for me as a parent, to see children presenting in doctors' surgeries with conditions that would have been considered adult conditions, such as high blood pressure and high cholesterol. Senator Colm Burke referred to the doctor who told the parents that their child is obese. Our front-line staff are the doctors, the dentists, and the nurses in general practices. Attention needs to be paid to them. If parents take and follow their gentle suggestions, they will find that not only will their children's quality of life be enhanced, but their behaviour also will improve if they reduce the amount of sugar they consume. Education needed on that aspect.

Senator Davitt and all the other Senators mentioned physical activity. The national physical activity plan was launched almost two years ago and is a very important component of the overall healthy Ireland framework because we must take a whole of society and cross-departmental approach to this. We want to try to make the healthy option the easier one for all of us, particularly our children. The active school flag is a marvellous programme in which over 650 primary schools are engaged. They take steps to encourage physical activity among the children and the emphasis is on activity, not competitive sports. That is a really important distinction. I had the pleasure of visiting St. Clare's national school in Ballyjamesduff which not only won the national active schools flag award in Ireland, but went on to win the European active schools flag award. It is really leading the way. The schools, parents and communities are very engaged in this programme, not to mention the children who are benefiting.

Several Senators mentioned the lower socio-economic communities. We were delighted with the establishment of the healthy Ireland fund last year despite not having collected a cent yet. We are focusing on children and those in disadvantaged areas with that fund. We are working on the criteria and see great opportunities there. The no-fry zones were referred to. Wicklow County Council led the way on this and the Department is examining how this can be rolled out across the country. Senator Devine mentioned free drinking water in schools and we are certainly advocating that and will try to ensure that children have access to drinking water in schools. The World Health Organization, WHO, report was mentioned. While we are focusing on our issues this is a problem in certain developed countries around the world. Everybody in the European Union, EU, is focusing on this.

I was asked about eating a large meal and driving. Never drink and drive is the message. Someone who feels tired after a large meal should have a snooze before getting behind the wheel. Senator Burke mentioned the former Senator, Eamonn Coghlan, leading the way in physical activity and parental awareness. If they know that children need a minimum of one hour's activity a day, that is something to strive for, and it could be divided into four 15 minute blocks as long as they get that crucial minimum. People will welcome the fact that from this year wellness will be a subject in second level schools.

Others mentioned young girls. Teen years are very challenging because of the pressures of social media and having always to aspire to be like certain people. We want to encourage young girls to choose physical activity. They do not have to be competing. They can walk, run or cycle, as long as they are aware that they need physical activity. That is crucial, as is eating healthily and well. Senator Dolan's point about being respectful and helpful to families on low income was a good one. This is not intended to blame people but to encourage them to make good decisions that enhance their quality of life. That is what we really want to do.

I also mentioned the national standards for food. We have a national nutrition plan. We are working on that this year and that will take into account everywhere that food is produced, including schools. Senator Noone mentioned the WHO. We certainly do not want to be branded the fattest people in Europe by 2030.

While it is correct in respect of Amsterdam that patience will be required in this area, at the same time, we must be proactive. Senators will be aware that communities are becoming very engaged, for example, through Parkrun events and activities arising from the "Operation Transformation" programme which engages people every year. More cycle lanes will make it easier for people to engage in physical activity.

A number of Senators, including Senator Noone, referred to online advertising and specific algorithms that can target children. As with many new technologies, we are playing catch-up to a great extent. However, the Department is working with the Broadcasting Authority of Ireland on a new code to restrict the marketing of food and drink to children. The children's code is being revised and we have made submissions in that regard.

I thank Senators most sincerely for their observations. A Healthy Weight for Ireland: Obesity Policy and Action Plan 2016 sets out ten steps forward. We recommend a number of actions the Government can pursue to assist people in their efforts to prevent and reduce obesity. The Department is making progress on the implementation of the many priority actions set out in this policy. As I indicated, the Health Service Executive is recruiting a clinical leader on obesity, who will take a lead role on this issue.