A review of data from the Health Behaviours of School-Age Children (HBSC) surveys between 2002 and 2014 hase been published by the WHO Regional Office. "This report presents the latest trends in obesity, eating behaviours, physical activity and sedentary behaviour from the HBSC study and highlights gender and socioeconomic inequalities across the WHO European Region. Trends have previously been reported separately, but this report brings together for the first time HBSC data on obesity and obesity-related behaviours." The report notes that "Obesity continues to increase in all but a very few countries and regions, with disparities within and between them being marked. Trend data on dietary and physical activity behaviours are more mixed, but show some improvements for some age groups in some countries. Overall, however, the indicators show that adolescents’ dietary behaviours remain far from optimal, with too many sugary products and not enough fruit and vegetables consumed. At the same time, physical activity as part of daily life has been reduced to the bare minimum: adolescents spend most of their time sedentary. This paints a rather bleak picture that requires ambitious policy action." The report shows that some mixed progress has been made in eating habits, physical activity and sedentary time.
Although the HBSC survey reports only on behaviours and there is no mechanism to correlate or track the introduction of healthy school food policies and increases in physical activity time within the school day, we can safely assume that these HBSC data trends have coincided with increased efforts by schools to prevent obesity. Consequently, we need to question if these school-based efforts alone are sufficient to truly make a difference over the long term. A similar analysis of Canadian efforts (McCall, 2013), reported that similar little progress had been made after two decades of obesity prevention and heart healthy programs in that country.
In our view, this HBSC report requires us to ask some essential but possibly inconvenient questions:
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- Daily consumption of fruit and vegetables increased slightly between 2002 and 2014, but overall prevalence remains low.
- Daily consumption of sugary soft drinks and sweets decreased noticeably between 2002 and 2014, but consumption remains high: almost one in five adolescents drinks sugary soft drinks daily and one in four eats sweets every day.
- Overall, moderate-to-vigorous-intensity physical activity (MVPA) levels are low and decline with age during the adolescent years.MVPA levels have not changed substantially over time.
- Participation in vigorous-intensity physical activity (VPA) is reasonably high across Europe and appears to have remained stable between 2002 and 2014, with a slight positive trend in girls.
- TV-viewing is decreasing across Europe.Computer use for gaming and non-gaming purposes increased sharply between 2002 and 2014 and offset the TV-viewing decrease.
Although the HBSC survey reports only on behaviours and there is no mechanism to correlate or track the introduction of healthy school food policies and increases in physical activity time within the school day, we can safely assume that these HBSC data trends have coincided with increased efforts by schools to prevent obesity. Consequently, we need to question if these school-based efforts alone are sufficient to truly make a difference over the long term. A similar analysis of Canadian efforts (McCall, 2013), reported that similar little progress had been made after two decades of obesity prevention and heart healthy programs in that country.
In our view, this HBSC report requires us to ask some essential but possibly inconvenient questions:
- If progress seems to be happening with young people in more affluent countries and communities but the overall averages are stagnant or deteriorating, should we shift our focus away from the middle class towards the working class students?
- If schools are now doing their part, should we now focus on other environments such as the media, social media, recreation, sports and even families and introduce much stronger policies such as advertising limits, mandatory restrictions on sugars and other such measures?
- Given that research and exposure of the activities of food companies has shown that physical activity, while beneficial in many ways, does not significantly affect obesity/overweight, should we focus more on other factors such as mental health, loneliness, boredom, stating at home after school without adult supervision, stressed parents with no time to prepare or even purchase healthy food?
(This item is among the 5-10 highlights posted for ISHN members each week from the ISHN Member information service. Click on the web link to join this service and to support ISHN)
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