IMPACT CASE STUDY

The weight of the issue: policy impact of childhood obesity surveillance in Ireland

  • 8 March 2020
  • Dr Mirjam Heinen, Dr Silvia Bel-Serrat, Ms Isobel Stanley, Dr Lachlan Mitchell, Dr John Mehegan, Dr Celine Murrin, Professor Cecily Kelleher
  • Academic, Health, Political


Summary

Research on childhood obesity surveillance by the National Nutrition Surveillance Centre at UCD has helped policymakers build a picture of the weight status of Irish children.

The research has been used by the Department of Health to define targets for overweight and obesity levels in children, as mentioned in the government’s Obesity Policy and Action Plan 2016-2025, ‘A Healthy Weight for Ireland’. Members of the research team have also been invited to address Oireachtas committees, policymakers and the media.

This research will have significant societal impact if the Government’s targets and actions – which are informed by the research – are successful in managing obesity prevalence in children. Reducing obesity will improve the population’s physical and mental health, and have a significant long-term economic impact by helping reduce the burden on the health system.

Research description

Obesity in children is an important health problem in Europe: it has been linked to adverse psychological, social and health consequences in childhood and later in life.

In 2005, both the World Health Organization (WHO) Regional Office for Europe and the National Taskforce on Obesity in Ireland recommended that the health sector systematically measure growth in children. Regular surveillance of weight status among Irish children will be essential to monitor any changes in childhood obesity prevalence. In turn, this will be crucial to inform policy and evaluate the country’s progress toward achieving targets.

As a result, in 2008 the Department of Health and the Health Service Executive (HSE) commissioned the National Nutrition Surveillance Centre (NNSC) – based at the UCD School of Public Health, Physiotherapy and Sports Science – to commence the Childhood Obesity Surveillance Initiative (COSI) in Ireland. This initiative was jointly developed by the WHO Regional Office for Europe and participating member states. It aims to systematically measure obesity among primary school children across Europe.

Three further rounds of COSI in Ireland – in 2010, 2012, and 2015 – were then commissioned by the HSE. Over the four waves, data from a total of 17,145 examinations were collected. Overall, the findings show that one out of five children in First Class were overweight or obese, and prevalence could be stabilising over time and as children become older. However, children attending disadvantaged schools show higher prevalence across all ages.

The Childhood Obesity Surveillance Initiative is a core tool to help us monitor our progress towards achieving the targets set out in The Healthy Weight for Ireland: Obesity Policy and Action Plan 2016-2025… Tackling childhood obesity is a key priority for me as Minister.

— Minister of State for Health Promotion, Marcella Corcoran-Kennedy

Research impact

The research reports produced from this work have been officially launched by the HSE. This resulted in broad national media coverage including multiple Irish newspaper articles and radio interviews.

For the launch of the third report in March 2014, Dr Stephanie O’Keeffe, HSE National Director for Health and Wellbeing wrote: “I very much welcome the findings of this research, undertaken as part of the WHO European Childhood Obesity Surveillance Initiative… This has enabled us to build up a picture of the weight status of Irish children and how their weight changes as they mature.”

A major policy impact of the COSI results was seen in 2016, when the Department of Health launched its Obesity Policy and Action Plan 2016-2025, ‘A Healthy Weight for Ireland’. The document states short-term targets for overweight and obesity levels in children to be achieved in a five-year timeframe, which are based on COSI data. It also articulates a target to reduce the inequality gap in childhood obesity levels, which again is based on COSI data.

Additionally, the policy presents a number of priority actions to prevent overweight and obesity and achieve the short-term targets. One of these actions is “to sustain ongoing obesity surveillance through Healthy Ireland and Childhood Obesity Surveillance Initiative (COSI) as means of monitoring progress.”

After launching the fourth report in May 2017, Minister of State for Health Promotion, Marcella Corcoran-Kennedy, said: “The Childhood Obesity Surveillance Initiative is a core tool to help us monitor our progress towards achieving the targets set out in The Healthy Weight for Ireland: Obesity Policy and Action Plan 2016-2025… Tackling childhood obesity is a key priority for me as Minister."

Based on the researchers’ work, the HSE launches, and the subsequent press coverage, members of the research team were invited to address two different Oireachtas Joint Committees (Education and Skills in October 2017 and Children and Youth Affairs in April 2018) on the topic of childhood obesity.

Furthermore, COSI was referred to in submissions to the Joint Committee on Children and Youth Affairs from various organisations: the Irish Heart Foundation, the HSE, the Association for the Study of Obesity on the Island of Ireland, the European Association for the Study of Obesity, and the World Obesity Federation.

As Ireland has been part of WHO European COSI since its inception, and as Dr Heinen has been part of its international advisory group, she was invited in 2015 as temporary adviser for the European Regional Consultation for the Commission on Ending Childhood Obesity. This Commission was set up to address the alarming levels of childhood obesity and overweight globally, and its final report was presented to the WHO Director-General in January 2016.

Ultimately, this research will have a profound societal and economic impact if the Government’s targets and actions, which are informed by the research, successfully prevent obesity in children. Decreasing rates of childhood obesity can help reduce health inequality, improve physical and mental health, and reduce the strain on the health system.

Policy document

A Healthy Weight for Ireland - Obesity Policy and Action Plan 2016-2025. Healthy Ireland - Department of Health. Dublin, 2016.

Reports

Heavey P et al. (2009). Childhood Obesity Surveillance Initiative in Ireland. Main Report. Dublin: Health Service Executive and Department of Health and Children.

Heinen MM et al. (2014). The Childhood Obesity Surveillance Initiative (COSI) in the Republic of Ireland: Findings from 2008, 2010 and 2012. Dublin: Health Service Executive.

Bel-Serrat S et al. (2017). The Childhood Obesity Surveillance Initiative (COSI) in the Republic of Ireland: Findings from 2008, 2010, 2012 and 2015. Dublin: Health Service Executive.

Heinen MM et al. (2016). The Childhood Obesity Surveillance Initiative (COSI) in the Republic of Ireland: Descriptives of childhood obesity risk factors. Dublin: Health Service Executive.

Articles (a sample)

NCD Risk Factor Collaboration (NCD-RisC). Rising rural body-mass index is the main driver of the global obesity epidemic in adults. Nature 2019; 569(7755): 260-4.

Bel-Serrat S et al. Clustering of Multiple Energy Balance-Related Behaviors in School Children and its Association with Overweight and Obesity—WHO European Childhood Obesity Surveillance Initiative (COSI 2015–2017). Nutrients 2019; 11(3):511.

Spinelli A et al. Prevalence of Severe Obesity among Primary School Children in 21 European Countries. Obes Facts 2019; 12(2):244-58.

Bel-Serrat S et al. Predictors of weight status in school-aged children: a prospective cohort study. Eur J Clin Nutr 2019; 73:1299-1306.

NCD Risk Factor Collaboration. Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analyses of 2416 population-based measurement studies in 128.9 million children, adolescents and adults. Lancet 2017; 390(10113):2627-42.

Conference presentations (a sample)

Bel-Serrat S et al. Overweight and obesity track over time in primary school children: Longitudinal findings in the Childhood Obesity Surveillance Initiative (COSI) in the Republic of Ireland. International Conference on Childhood Obesity (ICCO), July 2017, Portugal.

Bel-Serrat S et al. Impact of season on measured body mass index: artefact of age or effect of the environment? – The Childhood Obesity Surveillance Initiative in the Republic of Ireland – 2008, 2010, 2012 & 2015. Obes Facts 2017; 10(Suppl 1):40. European Congress on Obesity (ECO2017), May 2017, Portugal.

Heinen MM et al. Overweight and obesity trends are stabilising among children aged 7 years: Results of the Childhood Obesity Surveillance Initiative in the Republic of Ireland. Proc Nutr Soc 2016; 75(OCE3):E124. Nutrition Society Annual Summer Meeting, July 2016, Ireland.

National media coverage (a sample)

Wide radio coverage and multiple Irish newspaper articles, including:

Additional citations

Dr Celine Murrin and Dr Silvia Bel-Serrat present to and attend meeting of Joint Committee on Education and Skills on topic “Tackling obesity and the promotion of health eating in schools” (October 24, 2017).

Professor Cecily Kelleher and Dr Silvia Bel-Serrat present to and attend meeting of Joint Committee on Children and Youth Affairs on topic “Tackling childhood obesity” (April 18, 2018).