Advertisement

The forces making our children fat and diabetic

Forty per cent of children in the UK are overweight or obese - Drazen Stader / EyeEm
Forty per cent of children in the UK are overweight or obese - Drazen Stader / EyeEm

The number of children being treated for Type 2 diabetes has risen by a staggering 50 per cent in just five years. A grim figure by any standards, yet made all the worse for its release in the same week as the Government’s Food Strategy – the long-awaited report which promised to crack down on junk food advertising and buy-one get-one-free deals, yet in the end shirked both options.

New research from Diabetes UK says growing waistlines coupled with the cost of living crisis is making cheap junk food more desirable than ever to children, creating a “perfect storm which risks irreversible harm to the health of young people”. Some 973 children and teenagers were sent for specialist care last year, up from 621 in 2015-2016.

Forty per cent of children in the UK are overweight or obese; affecting one in seven as they start primary school, rising to one in four by the time they reach the age of 11.

Seventeen-year-old Maya*, who has Type 2 diabetes, was “anxious” when she was sent to an obesity clinic for the first time “because I thought the doctors were going to judge me” based on the way she looked. Working with professionals has helped her develop a healthy eating and exercise routine to manage the condition, but she admits that “it’s quite difficult to make healthy choices when you go out with your friends – you don’t really go to Tesco and buy a bunch of veg. You’ll go to the cinema where there’s popcorn and crisps.”

In such situations she tries to explain to friends that she can’t eat those things, as portion control and an active lifestyle are essential to keeping her condition in check. “If I better myself now when I’m younger, it’s going to help me set up a better future,” she says.

Yet the odds are stacked against young people – from the fried chicken shops just yards from playgrounds to school canteens turning out mini pizzas at morning break. This “obesogenic environment” is causing havoc for their health, says Stephanie Slater, founder of School Food Matters, a charity that seeks to provide better access to nutritious food in schools. When bombarded with junk at every turn, eating it is simply a “normal response to an abnormal environment”, she explains, adding that high streets filled with fast-food chains and excessive screen time in which processed food is constantly advertised “don’t really support good health”.

The charity’s primary battle is within the school walls where, they believe, if good habits are instituted, the temptations that lie beyond its gates will be significantly diminished. That starts with breakfast – swapping sugary cereals for eggs or porridge – and goes all the way through to after-school snacks, where they want to challenge “the anomaly of sweets for treats”; the mindset that a day’s efforts are to be rewarded with unhealthy food. The biggest difference would come, she says, via a full rollout of free school meals. This week, the Welsh Government announced that they will be given to all reception children from September, and to all primary pupils in the country by 2024.

For those who remember the days of turkey twizzlers and oodles of custard on their canteen tray at lunchtime, packed lunches would appear to trump school dinners, health-wise. But Slater points to a 2020 study from Leeds University that estimated around one per cent of packed lunches met government nutritional guidelines.

Since 2015, School Food Standards have mandated one or more vegetable accompaniment to a school-produced meal each day, at least three different fruits and three vegetables each week, wholegrains over refined carbs and restrictions on fruit juice, deep-fried food and those with added sugars – yet tuck shops and vending machines can undo all of that by morning break.

Add a cost of living crisis to the mix, and reliance on cheap, calorie-dense foods is set to get “a whole heap worse”, says Anna Taylor of the Food Foundation, which aims to improve children’s diets.

“There’s a huge skew towards more disadvantaged children getting Type 2 diabetes,” she notes; Diabetes UK’s research found that four in 10 children in the poorest areas surveyed had the condition, compared with one in 19 in the richest. The condition causes tiredness and excessive thirst, as well as an increased risk of heart, eye and nerve problems. “We’re not seeing ‘levelling up’ in practice,” Slater says of the figures.

With school meals costing around £2.30-£2.50 per day, and many fast food outlets offering chicken and chips for as little as £1.50, the nutritious option simply doesn’t add up for hard-up families, Taylor explains. “We really need to be starting to look at the wider environment which our children and young people are subjected to, and how we change that to make it easier for them to eat well.”

Many were hopeful that last week’s report would address the health hazards derailing children – but it only served to “kick that can down the road to the health disparities white paper”, due later this year.

Dr James Greening, a consultant paediatric endocrinologist at Leicester Royal Infirmary, says that one of the major roadblocks has been funding for treatment for children with Type 2 diabetes, “because they are incredibly complex [cases], often, and you need a proper team behind you to treat the patients effectively, which is actually quite expensive”. By the time a child has developed the condition, a multi-disciplinary team which includes a doctor, dietitian, psychologist, social worker and nurse are necessary “in order to really help out the most extreme cases”, he says.

Dr Greening adds that the parents and children who walk through his doors fall into one of two groups: those who say they have tried everything, and the weight just won’t come off – and, more commonly, those who “haven’t really got much idea at all what to do”. His clinic avoids terms like “fat” and “obese”, choosing instead to focus on “healthy choices” and “weight management”.

Fifteen specialist NHS obesity clinics for children were rolled out in late 2021 (including in Leicester). Children who become obese at a young age risk remaining that way for longer, making them more susceptible to 13 types of cancer, strokes and heart attacks, as well as Type 2 diabetes. In the most extreme cases, Dr Greening says, liraglutide, a newly-approved weight loss drug, and surgery are the best options to battle an obesity epidemic that currently costs the NHS £6 billion each year. Type 2 diabetes treatment is predicted to cost the NHS £35.6 billion in a decade – 1.5 times the amount currently spent on all cancers combined.

With two years of Covid-induced sedentary living to contend with, and the absence of a “unified response to food and drink companies” from the Government as instituted by other countries, Dr Greening says healthy changes must begin at home. Two of the most important elements for weight maintenance are sleep and screen time; namely boosting the former and minimising the latter. “It’s really important to get the whole family on board” with these changes, Dr Greening explains – ditto healthy eating and staying active.

For Dev Sharma, 17, who campaigns for the charity Bite Back, the “relentless exposure to junk food” is a total “injustice” for young people. He cites three main areas that conspire to make healthy choices impossible: streets, schools and screens, on which adverts constantly pop up in the middle of a game, TikTok video or TV show, to promote something full of sugar or saturated fat.

Dev Sharma
Dev Sharma

“We are manipulated by the food industry and it’s really not fair,” he says of his generation, who grew up with McDonald’s adverts printed on the back of their bus tickets. “It’s overwhelming.”

Taylor believes that “the onus is on Sajid Javid” to come up with proposals to make healthy eating feasible during a time of financial constraint. And, beyond that, we must “orient the food industry towards making healthy affordable food, rather than away from an industry which is currently very good at producing vast quantities of junk food”. Last week’s Food Strategy could have tackled things head on; just as the many mandates for children’s healthy eating brought in over the past seven years should have. Post-Covid, and with a cost of living crisis upon us, “I’m just really concerned that this trend is going to continue,” Taylor says.

*Name has been changed